Injury Repetition in Children with Dental Trauma: the Role of Aggressive Behavior.

Abstract

Introduction: Traumatic dental injuries (TDI) are widespread and, according to their frequency, they are second most frequent oral disease after dental caries. Dental trauma occurs in a complex interaction of child with social and physical environment. It is considered that child's aggressiveness could play an important role as a risk factor.

Objectives: The aim of the present study was to evaluate role of child's aggression in the occurrence of repeated injuries in a group of children aged 9 - 17 years.

Material and methods: The aggressive behavior was assessed in 114 patients (80 males and 34 females) with TDI. The group comprised children with single injury (SI) and with repeated injuries (RI). The Overt Aggression Scale (OAS) was used to assess children's aggression and to obtain information about four types of aggressive behavior (verbal aggression and aggression against objects, self, and others).

Results: Males with RI displayed significantly higher aggression against others than males with SI (F = 13.66; P < 0.001). Aggressive behavior in males with RI was significantly higher in age groups 9-11 and 12-17 years. Males aged 12-17 years have 7 times higher risk for injury repeating than males with SI (OR = 7.000; CI = 1.485-41.360). Females with RI in both age groups showed similar level of aggressive behavior.

Conclusion: Aggressive behavior and increased score of aggression against others are frequent symptoms of male patients with repeated injuries. The use of OAS in children with TDI could help detect patients with increased risk for injury repetition. Referral of aggressive children to the child psychiatrist could contribute to the improvement of child's behavior and decrease a risk for further injuries.