title: Impact of traumatic dental injuries with unmet treatment need on daily life among Albanian adolescents: a case-control study.
abstract: BACKGROUND
  Traumatic dental injuries (TDI) are common in children and adolescences. Neglected or inadequate treatment may lead to psychosocial distress during late adolescence.
  
  
  OBJECTIVE
  To investigate the potential impact of traumatic dental injuries (TDI) with unmet treatment need, on the quality of life of 16-19 year-olds in Tirana, Albania.
  
  
  METHODS
  A case-control survey (1:2) was conducted in public high schools in Albania, comprising 95 subjects affected by TDI with unmet treatment need based on objective clinical signs. Controls (n = 190) with no history of TDI were matched by age, sex and belonging to the same school class and group of friends as the respective case. The Oral Impact on Daily Performances (OIDP) index was used to measure the impacts. DMFT, Community Periodontal Index and the Aesthetic Component of the Index of Orthodontic Treatment Need as well as social parameters were recorded.
  
  
  RESULTS
  The response rate was 98%. Overall, the impact prevalence of OIDP was 88.4% among the cases, and 58.9% among the controls (P < 0.001). The most prevalent OIDP impact was 'smiling and showing teeth without embarrassment': cases had significantly higher values than controls (78.9% vs 31.6%). Multiple conditional logistic regression analysis was used to disclose the effect of TDI with unmet treatment need on quality of life by adjusting for possible confounders. Compared to the control group, TDI cases with unmet treatment need are at greater overall risk of impacts measured as OIDP, with an odds ratio of 3.9 (95% CI: 1.6-9.1).
  
  
  CONCLUSIONS
  TDI with unmet treatment need in this sample of adolescents is associated with reduced OHRQoL. Compared to adolescents with no history of TDI, those affected by TDI with unmet treatment need are at greater risk of suffering impacts on OHRQoL in the form of OIDP.
authors.affiliation: Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. dorina.thelen@ok.uib.no
authors.forename: Dorina Sula
authors.initials: DS
authors.lastname: Thelen
authors.forename: Tordis A
authors.initials: TA
authors.lastname: Trovik
authors.forename: Asgeir
authors.initials: A
authors.lastname: Bårdsen
mesh_terms: D000293:Adolescent; D000415:Albania; D001294:Attitude to Health; D016022:Case-Control Studies; D004245:DMF Index; D003743:Dental Enamel / Q000293:injuries; D003751:Dental Fistula / Q000523:psychology; D003793:Dental Restoration, Permanent / Q000523:psychology; D003804:Dentin / Q000293:injuries; D004435:Eating / Q000502:physiology; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D020380:Needs Assessment; D010512:Periodontal Index; D011788:Quality of Life; D012890:Sleep / Q000502:physiology; D012904:Smiling / Q000502:physiology; D012959:Socioeconomic Factors; D013060:Speech / Q000502:physiology; D013315:Stress, Psychological / Q000523:psychology; D014075:Tooth Discoloration / Q000523:psychology; D014082:Tooth Fractures / Q000145:classification / Q000523:psychology; D018677:Tooth Injuries / Q000523:psychology*; D016388:Tooth Loss / Q000523:psychology; D055815:Young Adult