JCDA - Canadian Dental Association

5 Background
Although there have been several studies of the prevalence
and incidence of traumatic dental injuries, the
economic implications of traumatic dental injuries are
almost unknown. The purpose of this study was to analyze
the type and extent of traumatic dental injuries treated at a
major trauma centre in Copenhagen, Denmark. The study
also analyzed acute and subsequent treatment demands and
treatment costs.
6 What
Background
Dental health professionals play a critical role in the
prevention and management of traumatic dental injuries.
Although many of these injuries require medical attention,
it is estimated that less than half are treated first in a hospital.
There is a lack of information on craniofacial and oral
injuries, especially from primary care practices. This study
was undertaken to provide national estimates of the
number of episodes of orofacial injuries treated in U.S.
private dental practices.
Methods
The data for this study were collected using a survey of
a stratified random sample of 6,391 dentists in private
dental practice in the U.S. conducted by the American
Dental Association.
Results
At the national level, dentists in private practice treated
an average of 46.4 episodes of care for orofacial injury per
Journal of the Canadian Dental Association
Clinical Abstracts
What are the economic implications of traumatic dental injuries?
Borum MK, Andreasen JO. Therapeutic and economic implications of traumatic dental injuries in Denmark: an
estimate based on 7549 patients treated at a major trauma centre. Int J Paediatr Dent 2001; 11(4):249–58.
Methods
A therapeutic and economic analysis was performed for
7,549 patients who visited the trauma centre during an
11-year study period (total of 16,116 injured teeth). All
patients answered a questionnaire containing 65 questions
about the trauma event and its implications. Cases were
classified according to the WHO trauma classification as
uncomplicated (enamel and dentin fractures, subluxations
and concussions) or complicated (crown fractures with
exposed pulps, root fractures, luxation injuries with tooth
displacement and bone fractures). The cost of acute trauma
services was estimated based on time and materials needed
to treat traumatic dental injuries by staff, oral surgeons and
other personnel at the centre. The cost of individual
restorative procedures was based on information from the
Danish Dental Association.
Results
An average of 686 patients per year or 1.9 patients per
day presented for treatment of dental injuries; 59.9% had
injury to the permanent dentition, while 38.1% had injury
to the primary dentition. The average cost of treating a
permanent tooth after an uncomplicated injury was
$420 US, and $1,490 US after a complicated injury.
The average cost of treating a primary tooth injury after
uncomplicated injury was $60 US, and $200 US after
complicated injury. The cost of treatment was estimated to
be $0.6 to $1 million US a year for patients treated in this
trauma centre. When this figure was transferred to an estimated
trauma population in Denmark, the estimated
yearly cost of traumatic dental injuries ranged from $2 to
$5 million US per one million inhabitants per year.
Clinical Significance
Because traumatic dental injuries are common and
potentially serious, they can result in high costs for
patients, insurance companies and public health services. C
is the dentist’s role in treating orofacial trauma in private practice?
Gift HC, Bhat M. Dental visits for orofacial injury: defining the dentist’s role. J Am Dent Assoc 1993; 124(11):92–6, 98.
year. There were significant differences in the number of
episodes per year when examined by specialty. Oral and
maxillofacial surgeons reported the highest number of
episodes (159.5), followed by pediatric dentists (134.9)
and general practitioners (41.9). On the basis of these data,
an estimated 5.9 million cases of orofacial trauma were
treated by dentists in private practice in 1991.
Clinical Significance
This study showed that dental health care professionals
encounter traumatic dental injuries on a regular basis.
Thus, there is potential for the early identification of highrisk
behaviours and predisposing risk factors, and for
prompt treatment or referral. Prevention through counselling
(use of mouth or face guards during sporting
activities), public education and legislative enforcements
(use of helmets and restraints in vehicles) can help reduce
the prevalence of secondary disabilities and hospitalizations
due to orofacial and dental injury. C
November 2003, Vol. 69, No. 10 675