Dental trauma management compromised by dentists’ lack of knowledge
Trauma to anterior teeth in children could become a long-term problem to dental health. To a large extent, the management actions of the dentists involved determine the clinical outcome and these actions are related to their levels of knowledge. A recent study investigated dentists' management of traumatic injuries to maxillary permanent incisors in children in Victoria, Austalia. Overall, the respondents to the survey demonstrated only a moderate level of knowledge. Dr Thai Yeng explained the significance of the research and how the knowledge gap can be addressed.
Question: In your questionnaire, what were the most common misconceptions about dental trauma among the participating dentists?
Thai Yeng: A large proportion of dentists showed a lack of basic understanding with regard to the biological mechanisms causing external inflammatory root resorption and replacement root resorption. Secondly, a large proportion of the respondents believed that teeth presenting with horizontal root fractures would always require root canal treatment.
Question: What were the reasons why there was percentage of dentists who were well informed about dental trauma? Was it due to experience or training or other factors?
Thai Yeng: Based on the findings of my research published last year, ‘An investigation into dentists’ perceptions of barriers to providing care of dental trauma to permanent maxillary incisors in children in Victoria, Australia’1, approximately 90% of respondents disagreed that a lack of published treatment guidelines for management of dental trauma makes its treatment unappealing. Possible reasons could be the easily accessible information provided by the Australian Dental Association on managing dental injuries, or the comprehensive trauma management guideline that exist for all dentists working for Dental Health Service Victoria (DHSV).
Question: You conclude that continual professional development is an important vehicle through which to fill this gap in knowledge about dental trauma. What are the most important areas (in terms of content or broad themes) that need to be covered in CPD curricula to achieve this?
Thai Yeng: Based on the findings of my review article published this year, ‘Dentists’ management of dental injuries, and dental trauma in Australia: a review.’2 dentists may find it difficult to retain the theoretical knowledge taught in their undergraduate dental training or from their limited experience encountered in their working life. Continual dental education courses in dental traumatology may provide dentists with appropriate long-term skills and knowledge to manage dental injuries. In my opinion, all aspects in the treatment of dental trauma are important and should be addressed at both undergraduate and postgraduate levels. The key areas that need to be covered are as follows:
Injuries to hard dental tissues e.g. enamel fracture, enamel/dentine fracture (with or without pulpal involvement), root fracture, crown/root fracture etc. Injuries to the periodontal tissues e.g. concussion, subluxation, extrusive/intrusive/lateral luxation injuries, avulsion etc, are also important.
Question: Is there a need for these themes to be introduced at undergraduate level as well?
Thai Yeng: Based on the results of my survey published last year, ‘An investigation into dentists’ perceptions of barriers to providing care of dental trauma to permanent maxillary incisors in children in Victoria, Australia.’1, 61% of dentists agreed that their undergraduate dental training in management of dental trauma was inadequate. In my opinion, it’s the responsibility of dental educators to adequately train and equip future dentists with the appropriate minimum background knowledge for the safe delivery of dental trauma services.
Question: Will you be conducting further research about this topic?
Thai Yeng: I may consider conducting further research on the area of dental trauma in the future with Professor Peter Parashos, Head of the Endodontic Unit and Convenor of Endodontic Specialty Training at the University of Melbourne. The findings of this study could instigate a discussion on how to develop strategies for undergraduate dental students and practising general dentists on improving their management knowledge for patients who suffer dental injuries. Further research may be carried out on whether continual professional development courses can provide adequate knowledge for treating dental trauma in the clinical setting. This study focused solely on dentists registered in the state of Victoria, and therefore was unable to survey dentists working in other parts of Australia. The extent to which these local findings reflect the national knowledge level in managing dental trauma is unknown. This could be a possible future direction in research.
Thai Yeng [BDS (HK), MDentSci (Lpool), DClinDent (Melb), MRACDS (Endo)] obtained his Bachelor of Dental Surgery degree from the University of Hong Kong in 2000, his Master of Dental Science degree in Restorative dentistry from The University of Liverpool, England in 2002 and his Doctor of Clinical Dentistry degree in Endodontics from The University of Melbourne in 2007. He was admitted to the specialist stream membership of the Royal Australasian College of Dental Surgeons in 2008. Thai previously practiced as a general dentist in Singapore, New Zealand, United Kingdom and Sydney (Australia) prior to embarking his specialist training course in Melbourne. Thai is involved in teaching endodontics in the undergraduate clinic at the University of Sydney, Westmead and is currently in specialist practice in Sydney (Australia).
Reference
1. 'An Investigation Into Dentists’ Perceptions of Barriers to Providing Care of Dental Trauma to Permanent Maxillary Incisors in Children in Victoria, Australia' Aust Dent J 2007; 52(3): 210-215
2. ‘Dentists’ management of dental injuries, and dental trauma in Australia: a review.' Dent Traumatol 2008; 24(3): 268-271.
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Full article
‘An Investigation into dentists’ management methods of dental trauma to maxillary permanent incisors in Victoria, Australia’ Dental Traumatology
Volume 24 Issue 4, Pages 443 - 448
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Trauma to anterior teeth in children could become a long-term problem to dental health. To a large extent, the management actions of the dentists involved determine the clinical outcome and these actions are related to their levels of knowledge. A recent study investigated dentists' management of traumatic injuries to maxillary permanent incisors in children in Victoria, Austalia. Overall, the respondents to the survey demonstrated only a moderate level of knowledge. Dr Thai Yeng explained the significance of the research and how the knowledge gap can be addressed.
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