# Dental Trauma Epidemiology in Primary Dentition: A Cross-Sectional Retrospective Study
## 1 Introduction  
Dental trauma (DT) on primary dentition represents a health hazard that may reduce the child and the family's quality of life. Moreover, it is an often-neglected public health issue [1]. A recent meta-analysis showed that DT in primary teeth has a 22.7% worldwide prevalence and stressed the need for worldwide awareness of the importance of recognizing DT that may cause functional impairments according to their severity [2]. Concerning children aged 0-6, oral lesions account for 18% of all physical trauma injuries. The mouth is the second most frequent area affected by trauma after the head [3].  
Infants learning to crawl and later walk have a lack of balance and coordination, leaving them at risk of falls that can lead to DT. Falls and collisions at preschool during playtime are the most common causes of DT. A smaller percentage is a consequence of child abuse, car accidents, and other causes [4]. Repeated DT is not infrequent. Periodontal tissue injuries of central and lateral incisors are the most frequently observed. DT and in particular luxation injuries are frequently associated with bleeding and pain and may be the reason behind the first dental visit.  
In this context, both DT as well as the negative management of DT may be the cause of dental anxiety and therefore reduced child cooperation. Primary teeth DT may be associated with complications regarding the tooth itself (dyschromia, tooth necrosis, pathologic root resorption, and archylosis) as well as the corresponding permanent tooth (enamel defects, crown and/or root malformation, ectopic eruption, and tooth formation arrest) as a direct consequence of the impact of the primary root on the developing crown or because of a primary root infection. DT that occurs below the age of 2 years may havelong-term effects on the crown of the developing permanent tooth. In general, unless there has been severe tooth displacement, children with injuries to the primary dentition are often underdiagnosed at the time of injury, and their parents are not aware of the potential sequelae to the developing dentition in the long term [5]. For this reason, enamel defects on anterior permanent teeth must be submitted to a thorough anamnesis including past events of trauma on the corresponding primary teeth to help distinguish such defects from fluorosis and molar incisor hypomineralisation defects [6]. In children over 4 years of age, DT can result in disturbances affecting the root of the developing permanent tooth.  
Epidemiology is the key to prevent DT and its complications: knowledge regarding environmental, oral cavity, and social risk factors for DT will allow clinicians to identify patients at risk and to establish primary and secondary prevention measures. A recent bibliometric analysis exploring the profile of articles on DT in primary teeth during the previous 15 years concluded that the number of articles had increased, but remained low. The most common topics were frequency, etiology, and associated factors. The evaluation of the study designs and topics addressed identified gaps that could contribute to the development of new studies on DT in the primary dentition [7]. This retrospective study was carried out through the analysis of dental records with the aim of investigating the epidemiologic profile of DT on primary teeth.