The Importance of Immediate Dental Trauma Care: Comprehensive Education, Treatment Approaches, and Their Profound Impact on Patients' Quality of Life

Abstract

Lateral luxation is a displacement of the tooth in lateral direction, usualy associated with a fracture or compression of the alveolar socket wall or facial cortical bone [1]. Pulp necrosis, a common complication following a lateral luxation injury, can arise due to blood supply or nerve disruption at the apical foramen, with the severity of the damage depending on the extent of the injury and the stage of root development [2, 3]. In this Issue, Tewari et al. evaluated the evidence of pulp necrosis occurrence and related complications in permanent anterior teeth with lateral luxation [4]. Systematic reviews are important in supporting treatment guidelines as they consolidate and evaluate existing research, providing evidence-based recommendations for optimal patient care.

Dental trauma in sports refers to injuries sustained to the teeth, gums, or mouth during athletic activities, highlighting the need for protective measures and prompt treatment to mitigate potential long-term consequences [5, 6]. Contact sports often pose a heightened risk of dental trauma due to the physical nature of the activities involved [7-9]. In this Issue, de Lima et al. assessed the prevalence of dental trauma in contact and non-contact sports [10]. Several databases were utilized for bibliographic search. Data were synthesized considering study characteristics, population, sport, and outcomes, analyzing 14 contact sports and five non-contact sports. Sports trauma research is a key to provide evidence-based insights that can inform targeted interventions and policies aimed at reducing the incidence and severity of sports-related injuries, thereby promoting healthier and more sustainable athletic practices.

Immediate and appropriate first aid in dental trauma is critical for preserving the affected tooth and improving the chances of successful long-term outcomes. Nevertheless, knowledge has been reported to be deficient among many members of the public [11-14]. With the rise of social networks, information on TDIs through social media and the internet has become accessible [15-19]. Furthermore, there are several mobile applications available to disseminate dental trauma information to patients and professionals, with IADT's ToothSOS app being one of them [20-22]. In this Issue, Walia et al. assessed the quality, functionality, perceived impact, and usability of available applications related to TDIs [23]. A systematic search was conducted for dental trauma applications, data extraction, and quality assessment. The results showcase the need to enhance user engagement, usability, and functionality, including regular updates, reliable content sourcing, and integration of user-friendly features. Moreover, in this Issue, Saygili et al. assessed the quality, accuracy, and reliability of YouTube and TikTok videos regarding storage solutions for avulsion injuries [24]. Video demographics and content quality were analyzed. Since prompt and appropriate post-trauma actions significantly impact the treatment results, and accurate first-aid measures are critical for a favorable prognosis, TDI apps and quality social media content may have a crucial role in aiding the wider population in the case of a traumatic dental incident.

Teeth often sustain a combination of injuries. The negative synergistic effect of concurrent different types of injuries occurring to the same tooth is more detrimental than a single injury [1, 25]. Fractured teeth, whether or not the pulp is exposed, coupled with a luxation injury, have a higher incidence of pulp necrosis and infection [26, 27]. In this Issue, Amilcar et al. assessed the epidemiology of luxation injuries with or without dental fractures in patients over the past decade [28]. Clinical records from a specialized center for dental trauma care in Brazil were reviewed. Patients with severe TDIs, such as luxation with or without tooth fracture, tend to seek immediate care, highlighting the importance of understanding the clinical and demographic profiles of these injuries to develop comprehensive short-term and long-term management strategies.

Intrapersonal violence is a significant public health issue that can result in maxillofacial injuries, including TDIs [29-34]. The correlation between alcohol consumption and interpersonal violence is well documented. However, numerous studies present conflicting findings regarding the extent to which alcohol consumption potentially contributes to an increased risk of TDIs [35-37]. In this Issue, Son et al. assessed the association between TDIs due to violence and different patterns of alcohol consumption in Korean adults [38]. Identifying risk factors for dental trauma is crucial for developing effective prevention strategies and mitigating the incidence and severity of such injuries.

TDIs represent a significant health issue that may be influenced by socioeconomic conditions, a relationship extensively investigated in numerous studies [39-42]. In this Issue, Bezerra et al. assessed the relationship between contextual and individual characteristics and TDIs in 12-year-old schoolchildren [43]. The study assessed place of residence and individual characteristics such as gender, family income, parent's education level, overjet and open bite, self-esteem, sense of coherence, oral health beliefs, and social support. TDIs were measured at baseline and at the 2-year follow-up. Rigorous research is essential to fully understand how socioeconomic factors such as income, education, employment, and social status collectively shape diverse health outcomes, including dental trauma.

Addressing dental trauma requires a comprehensive team approach, involving dentists, specialists, and other healthcare professionals to ensure holistic and effective patient care. Several studies have investigated the disparities in knowledge regarding TDI treatment between general dentists and specialists [44, 45]. However, literature on the collaboration between the two groups remains sparse. In this Issue, Taylor et al. explored specialists' role in managing traumatic dental injuries in permanent dentition in children [46]. Semi-structured interviews with specialists were conducted regarding the importance and impact of TDIs on children, the relationship between non-specialists and specialists and other healthcare providers, and potential educational requirements needed to support managing TDIs. Developing and implementing a care pathway not only supports clinical processes and enhances the quality of care but also allows for monitoring clinical activity and the effectiveness of commissioned services. Care pathways provide clear and demonstrable benefits to patients, healthcare providers, and the healthcare system across various countries [47].

Dental trauma can significantly impact the quality of life by affecting oral function, appearance, and emotional well-being. Avulsion, as one of the most severe TDIs, may lead to early tooth loss, ankylosis, tooth resorption, and irregularities in alveolar and facial growth due to the tooth's infra-position [48-50]. Adequate treatment of avulsion can positively impact the quality of life of trauma patients [41, 52, 51]. In this Issue, Celikel et al. evaluated the Pediatric Oral Health-Related Quality of Life (POQL) scores of children with dental avulsion history [53]. This cross-sectional study included 40 patients aged 8–14 with a history of dental avulsion, compared to 40 healthy individuals. Tooth avulsion necessitates extensive treatment for restoring both functionality and esthetics, and as such requires careful consideration of the patient's quality of life in developing a comprehensive treatment plan.

The volume of literature on tooth autotransplantation reflects significant interest in this technique and ongoing efforts to enhance its outcomes [54-56]. The execution of these surgical procedures significantly influences the success rate of tooth autotransplantation [57, 58]. In this Issue, Ainiwaer et al. observed the outcome of mature third molars transplantation into surgically created sockets with the assistance of computer-designed three-dimensional (3-D) printed replicas [59]. A total of 96 mature third molars were autotransplanted in either surgically created or fresh extraction sockets. Autotransplantation research is vital for expanding our understanding of dental procedures, pioneering new techniques, and ultimately improving the effectiveness of tooth replacement therapies for patients.

Inadequate and fragmented education in dental traumatology leads to insufficient clinical exposure to TDIs, underscoring the need for comprehensive dental trauma education to properly prepare dental students [60, 61]. In this Issue, Nagendrababu et al. evaluated the level of knowledge of undergraduate and postgraduate students specializing in endodontics and pediatric dentistry at 10 dental schools in 10 countries about the 2020 International Association of Dental Traumatology (IADT) guidelines regarding the management of TDIs [62]. An online survey, which included questions about the management of TDIs along with additional questions on the participants' sociodemographic and professional profiles, was distributed to final-year undergraduate students and postgraduate students in pediatric dentistry and endodontics. The lack of knowledge of undergraduate students in managing TDIs, compared to the higher proficiency demonstrated by postgraduates specializing in pediatric dentistry and endodontics, underscores the need to enhance adequate teaching and learning activities in dental traumatology.

The leading professional body in dental traumatology, the IADT, has seen steady membership growth, and the IADT Fellowship has become a valued recognition of expertise in the field [63]. In this Issue, Onetto et al. explored the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership [64]. IADT Fellowship is an esteemed international designation that acknowledges enhanced expertise and achievement in dental traumatology. It establishes a professional status within a leading global organization and connects recipients to a worldwide network of professionals sharing similar interests to promote patient care and well-being.