Predictors for Dental Intervention in Children after Dental Injury: A Retrospective Analysis and Literature Review

Objective This study aimed to explore risk factors for dental intervention in patients presenting to the pediatric emergency department (PED) after dental injury. Methods We retrospectively explored patients aged 0 to 18 years who presented to our PED between 2017 and 2021 after dental injury. Results Of the total of 830 patients (mean age 7.1 ± 3.9 years, 589 [71.0%] male patients), 237 (28.5%) required dental intervention. All patients with alveolar fractures and those with involvement of permanent teeth with extrusive luxation mandated urgent dental consultation. Additional independent predictors for dental intervention for primary tooth injury were: root fracture (adjusted odds ratio [aOR] 38.4; 95% confidence interval [CI], 3.95-373.22; P = 0.002), facial bone involvement (aOR 12.40; 95% CI, 2.33-65.93; P = 0.003), lateral luxation (aOR 6.9; 95% CI, 4.27-11.27; P < 0.001), extrusive luxation (aOR 6.44; 95% CI, 2.74-15.14; P < 0.001), and avulsion (aOR 2.06; 95% CI, 1.23-3.45; P = 0.006). Additional independent predictors for permanent tooth injury were lateral luxation (aOR 27.8; 95% CI, 6.1-126.6; P < 0.001) and avulsion (aOR 6.8; 95% CI, 2.9-15.9; P < 0.001). Conclusions Alveolar fracture is a severe dental injury, requiring intervention, for primary and permanent teeth injuries. Tooth luxation with significant mobility or malocclusion, incomplete avulsion, a suspected root involvement, or facial bone injury in the primary teeth and tooth luxation (extrusive/lateral) and avulsion in the permanent teeth dictate urgent dental consultation and intervention. Clinical algorithms for dental injury management are suggested.