Dental Traumatology 2015; 31: 403–408; doi: 10.1111/edt.12191

Association of dental trauma experience and first-aid knowledge among rugby players in Malaysia Dalia Abdullah1, Amy Kia Cheen Liew1, Wan Ahmad Wan Noorina 1, Selina Khoo2, Fay Chwee Lin Wee1 1 Faculty of Dentistry, Universiti Kebangsaan, Malaysia; 2Sports Centre, University of Malaya, Kuala Lumpur, Malaysia

Key words: tooth injury; dental trauma; treatment; athletic injuries; tooth fractures; tooth avulsions Correspondence to: Amy Kia Cheen Liew, Department of Dental Public Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia Tel.: +6 03 9289 7854 Fax: +6 03 9289 7845 e-mail: [email protected] Accepted 9 December, 2014

Abstract – Objectives: To assess and compare the knowledge of rugby players regarding first-aid measures for dental injuries. Methods: A crosssectional study was conducted at rugby tournaments in 2009 and 2010 on players aged 16 and over. Convenient sampling was performed. A total of 456 self-administered questionnaires were returned. Data collected were analysed using SPSS 21. Descriptive analysis was undertaken for the demographic data. The subjects were classified according to their experience of sustaining each type of injury. Cross-tabulation and chi-square tests were carried out to compare the responses. When the expected cell count was less than five, Fisher’s exact test was used. The level of significance was set at P < 0.05. Results: The prevalence of self-reported dental injuries was as follows: tooth fracture (19.3%), luxation (6.6%) and avulsion (1.1%). Significant differences were found, whereby 52.2% of those who had no history of tooth fracture were more likely to seek immediate treatment (P < 0.001), whereas 42% of those who previously experienced tooth fracture claimed that they would only visit a dentist if they experienced pain (P = 0.001). Management of luxation and avulsion did not differ significantly between the groups. However, about half of those who did not have a history of tooth avulsion admitted to not knowing the correct answer, while three of five casualties would keep the tooth iced. Conclusions: Knowledge of the management of tooth fracture and storage medium differs between previous casualties and non-casualties. Overall, knowledge of dental trauma management was insufficient, suggesting the need to educate and train the players.

Sport accidents were one of the common causes of dental trauma (1). The prevalence and severity of sportsrelated dental injuries varied, with an estimate between 0.2% and 33.5% (2–4). Contact sports exposed the players to the increased risk of dental trauma (5). In particular, rugby was considered a high-risk sport mainly due to the repeated tackles and high-impact collisions (6, 7). The prevalence of orofacial trauma in rugby was recorded between 6.7% and 71.9%, depending on the population studied (8). The types of injury ranged from uncomplicated enamel fractures to tooth avulsion. Timely and appropriate management was crucial for favourable prognosis (9–11). Nevertheless, limited access to dental care was often a hurdle for dental trauma victims (12, 13). Hence, familiarity with the emergency procedure for dental trauma was essential for improving the condition of the affected tooth. To date, knowledge assessment studies on sport participants were mainly carried out in Europe, where the knowledge of the prevention of dental trauma and the immediate protocol following dental injury was often found to be inadequate (14–17). Nonetheless, slightly © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

more than half of the Swiss rugby players interviewed were aware that avulsed teeth can be replanted (17). This finding concurred with a study by Mori et al. in which about half of the participants knew that avulsed teeth can be replanted, although only 7.1% of the sport participants had experienced it (18). However, the relationship between injury experience and knowledge of dental trauma management was not explored. Although there were around 10 000 active rugby players in Malaysia (19), their competency in handling dental emergency situations was unknown. Furthermore, any discrepancy in the knowledge levels between those who had previously experienced dental trauma and those who had not might warrant different educational content and approaches. Therefore, the aims of the present study were to assess the knowledge of rugby players regarding first-aid measures for dental injuries and to compare the management decisions of previous casualties with those of non-casualties. The research hypothesis was the first-aid knowledge to manage a specified dental injury differ between those who experienced the dental trauma before and those who never had such an experience. 403

404

Abdullah et al. spent playing rugby (hours per week), highest level of representation and playing position. Experience in dental trauma was determined by the question: ‘Have you ever experienced tooth injury when playing rugby’? This was a branching question that directed players who responded positively to further explain their rugby-related dental trauma experience, including the frequency, type(s) of dental injury and number of teeth involved. This paper focussed on Part (d) of the questionnaire: knowledge of the management of dental trauma. The following three suggested scenarios were proposed and one question was asked: 1 ‘If your tooth is fractured, you will. . .’ 2 ‘If your tooth is displaced from its original position but remains within the gums, you will. . .’ 3 ‘If your tooth is completely knocked out, you will. . .’ 4 ‘How do you store a dislodged tooth to bring it to the dentist’? Each was followed by multiple choices, but the participant could only select the most plausible answer. A response was deemed correct if it was in accordance with the Dental Trauma Guide of the International Association of Dental Traumatology (IADT) (Revised 2011) (21, 22).

Materials and methods Study population

A cross-sectional study was conducted in 2009 and 2010 at tournaments organized by, or affiliated with, the Malaysian Rugby Union. This study was approved by the Universiti Kebangsaan Malaysia (UKM) Faculty of Dentistry Research Committee (DD/036/2009). The study population consisted of rugby players in Malaysia. Samples were obtained at the COBRA Rugby 10 and Malaysian University Sports Council (MASUM) Rugby 7 tournaments, both affiliated with the Malaysian Rugby Union. All Malaysian teams playing in these tournaments were approached. Convenient sampling was performed; all the players who were eligible and willing to participate in this study were included. Each team was approached only once during the entire tournament. Subjects who were playing at more than one tournament were allowed to submit only one copy of the completed questionnaire. Verification was carried out at the data-entry stage; the researchers confirmed from the name list that there was no repeated participation. Data collection

Statistical analysis

After the players agreed and signed the terms of informed consent, self-administered questionnaires were distributed to the players. They were required to complete and return the questionnaires on the spot. The questionnaire consists of four parts: (a) demographic data, (b) experience in dental trauma, (c) mouthguard usage and (d) knowledge of the management of dental trauma. This set of questionnaires was validated and pretested in a previous study (20). The questionnaires were printed in English and Malay. Demographic data retrieved included year of birth (which was used for the computation of age as of January 1, 2009), duration of playing rugby (years), time

The data collected were analysed using SPSS Statistics 21 (IBM Corp., Armonk, NY, USA). First, descriptive analysis was performed for the age, frequency and duration of playing, and the highest level of representation for each subject. Then, subjects were substratified according to their experience with each type of dental injury, that is fracture (Yes/No), luxation (Yes/No) and avulsion (Yes/ No). Cross-tabulation and chi-square tests were carried out to compare the responses based on injury experience. When the expected cell count was less than five, Fisher’s exact test was used instead. The level of significance was set at P < 0.05.

Table 1. Demographics of players according to injury history History of tooth fracture n (%) 88 (19.3) Highest level of representation Club (%) 4 (4.5) School (%) 1 (1.1) Residential college (%) 3 (3.4) University (%) 20 (22.7) District (%) 1 (1.1) State (%) 41 (46.6) Country (%) 18 (20.5) Mean age (SD) 24.26 (5.49) Mean years of 8.17 (4.09) playing (SD) Mean hours playing 9.24 (6.19) per week (SD)

No history of tooth fracture

History of tooth luxation

No history of tooth luxation

History of tooth avulsion

No history of tooth avulsion

368 (80.7)

30 (6.6)

426 (93.4)

5 (1.0)

451 (99.0)

19 1 44 116 22 122 44 22.37 6.33

(5.2) (0.3) (12.0) (31.5) (6.0) (33.2) (12.0) (3.44) (3.76)

8.01 (6.06)

4 0 2 4 1 15 4 23.97 7.53

(13.3) (0.0) (6.7) (13.3) (3.3) (50.0) (13.3) (4.28) (4.15)

10.37 (8.39)

19 2 45 132 22 148 58 22.65 6.61

(4.5) (0.5) (10.6) (31.0) (5.2) (34.7) (13.6) (3.95) (3.87)

8.10 (5.90)

1 0 0 0 0 3 1 29.20 11.20

(20.0) (0.0) (0.0) (0.0) (0.0) (60.0) (20.0) (9.78) (2.95)

6.20 (3.42)

22 2 47 136 23 160 61 22.66 6.62

(4.9) (0.4) (10.4) (30.2) (5.1) (35.5) (13.5) (3.83) (3.87)

8.27 (6.12)

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Dental trauma and first-aid knowledge Table 2. Responses to the management of tooth fracture Management of tooth fracture (n = 456)

History of tooth fracture n (%)

No history of tooth fracture n (%)

Total n (%)



P-value

Immediately see the dentist to treat the fractured tooth Yes 26 (29.5) 192 (52.2) 218 (47.8)

Association of dental trauma experience and first-aid knowledge among rugby players in Malaysia.

To assess and compare the knowledge of rugby players regarding first-aid measures for dental injuries...
192KB Sizes 4 Downloads 10 Views