Social and behavioral risk factors for maxillary incisor trauma in an adolescent Arab population

The majority of dental traumas are due to falls or blows during regular activity, personal interaction and play inside or outside the home, suggesting that behaviors associated with certain social conditions are risk factors. Our purpose was to explore that hypothesis.

We examined a population-based sample of 1583 13-14-year-old subjects in a classroom setting. Incisor trauma was scored according to the National Institute of Dental Research index, and overjet was measured to the nearest 0.5 mm. Presence of mesial migration and/or loss of first molars and/or open caries in permanent teeth were recorded and categorized as increased caries experience. Body mass index (BMI) was calculated from standardized measurements of height and weight, as weight in kg height(-1) in m(2). Obesity was scored if BMI exceeded 30. Information on participation in physical activities, family income, and number of siblings was collected through subject and family interview.

Univariate logistic regression detected reduced trauma risk among subjects of high income families (P = 0.009) and among subjects attending private schools (P = 0.026). Sports and physical activities were more prevalent in boys than in girls (P = 0.000) and associated with trauma in the sample as a whole (P = 0.001), but not separately in boys and girls. No effect was detected of obesity, number of siblings and increased caries experience. Univariate analyzes also detected increased trauma risk in boys (P = 0.000) and in subjects with increasing intervals of overjet (P = 0.000). Following use of multiple regressions with forward selection, only male gender, increasing overjet, and high family income were included in the final prediction model. Our findings suggest that behaviors associated with high family income and private school attendance reduce the risk of incisor trauma among adolescents in Kuwait, and that the gender difference in sports activities is an unlikely explanation for the gender difference in trauma.