Malikaew, Peerasak; (2001) The relationship between school environment and childhood traumatic dental injuries. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Traumatic dental injuries are a major public health problem. There is a relatively little information about the epidemiology of traumatic dental injuries and in particular, their determinants. Since the school environment may be a factor contributing to trauma in general, attending a supportive school may reduce the frequency of traumatic dental injuries. The objective of this study was to assess the prevalence of traumatic dental injuries and investigate the relationships between traumatic dental injuries and the schools' social and physical environment. A cross-sectional study was carried out in 52 schools in an urban area of Thailand on a sample of 2,725 children. Cluster analyses were performed to classify the schools as supportive and non-supportive schools according to social and physical environmental characteristics. Associations between traumatic dental injuries and school environments were carried out using multilevel analyses, taking into consideration school variations and controlling for confounding factors at the children' level. The results show that 954 children (35.0%) experienced traumatic dental injuries. The associations between traumatic dental injuries and the school environments were sequentially adjusted for sex, marital status of parent, employment status of parent, family income, educational status of parent, anterior tooth protrusion and body mass index. The prevalence of traumatic dental injuries was significantly lower in the schools with a supportive social environment. Crude OR = 0.6 (95% Cl = 0.4 to 0.8, p = 0.004). After controlling for the confounding factors, the adjusted OR was 0.7 (95% Cl = 0.5 to 0.9, p = 0.02). This statistically significant association existed in males but only an insignificant tendency of association was found in females. There was no statistically significant association between traumatic dental injuries and the physical environment of the schools. Nevertheless, an insignificant tendency of association appeared in females. It is concluded that traumatic dental injuries are significantly lower in male children attending schools with supportive social environments.

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