Prevalence of anterior teeth fracture among institutionalized visually impaired individuals in Himachal Pradesh, India - A cross-sectional study

Background: Trauma is the major cause of the injury to the anterior teeth superimposed by many local factors, such as anatomy of the teeth, proclination, and lip coverage. Because of their impaired vision, blind children are at greater risk for anterior tooth trauma. Aim: The aim of the study was to determine the prevalence of anterior tooth fracture among visually impaired individuals and to know the probable cause and risk factors of anterior teeth trauma. Settings and Designs: This cross-sectional study was conducted among visually impaired children in two special needs schools at Dhalli, district Shimla and at Sunder Nagar, district Mandi, in Himachal Pradesh. Materials and Methods: This study was carried out on a conveniently sampled group of 99 blind individuals (64 males and 35 females) aged 9-22 years in December 2011. The study was carried out by a single examiner according to World Health Organization (WHO) criteria and using the WHO classification for teeth fracture. Statistical Analysis: Statistical analysis was carried out using SPSS version 15 (SPSS Inc., Chicago, IL, USA). Chi-square test was used for comparison. P < 0.05 and P < 0.01 were considered as statistically significant and highly significant respectively. Results: An overall prevalence of 33.3% of traumatic injuries to anterior teeth was found in the study population. Females experienced significantly more trauma than males and indoor fall injuries were the most common cause. The permanent maxillary central incisors were most commonly injured, involving enamel and dentin. Increased overjet and inadequate lip coverage were significantly associated with the occurrence of trauma. Conclusion: The present study revealed a higher prevalence of traumatic injuries to anterior teeth among blind individuals. Hence, there is a distinct need for strengthening the provision of oral health-care facilities to these  disabled children, such as preventive orthodontic treatment and the use of mouthguards.