Prevalence and risk factors associated with traumatic dental injuries among adolescent school children: epidemiological survey findings from Sri Lanka

Background Traumatic dental injuries (TDIs) can occur at any age, in children at a higher susceptibility. TDIs involving anterior teeth pose functional concerns and have aesthetic and psychological implications. A variety of physical, sociodemographic and socioeconomic factors influence traumatic injuries. This study aims to determine the TDI prevalence, its perceived impact and associated risk factors among adolescents in the school setting in Ratnapura district, Sri Lanka. Methods A descriptive cross-sectional study was conducted among 585 government school children aged 15 years in the Ratnapura Education division. The children were selected using a two-stage cluster sampling technique with probability proportionate to size. A self-administered questionnaire was used to ascertain information on factors related to TDI, followed by a clinical oral examination to assess dental trauma and malocclusion status. For children who had TDI, the Adolescent Oro Dental Trauma Impact Index (AODTII) was used to assess the impact of TDI on oral health-related quality of life. Statistical analysis was conducted using SPSS version 23. Descriptive analysis, chi-square test, Fisher's exact test and multiple logistic regression were applied for statistical analysis. The significance level was set at p < 0.05. Results Dental trauma was experienced by 14.9% of the study sample of 585, with a female predominance. Most TDIs occurred at home (46%), while falling (51.7%) was the primary etiology for TDIs. Bivariate analysis revealed that TDI was significantly associated with sex, mother’s education, mother’s occupation, engagement in sports activity, presence of malocclusion, degree of overjet and lip coverage. Multiple logistic regression analysis indicated that sex, mother’s occupation and degree of overjet were significant predictors of TDI. AODTII showed that out of those who had TDI, the greatest impact on quality of life was social factors (42.5%) followed by physical factors (39.1%). Conclusions This study revealed a substantial prevalence of TDI among 15-year-old school children in the Ratnapura Education Division, and it was significantly influenced by sex, mother’s occupation and degree of overjet. TDI had a more negative impact on children's quality of life.