title: Problem behaviour and traumatic dental injuries in adolescents.
abstract: OBJECTIVE
  To explore the relationship between problem behaviour and traumatic dental injuries (TDI) among 15- to 16-year-old schoolchildren from East London.
  
  
  METHODS
  This cross-sectional study used data from 794 adolescents who participated in phase III of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents. Participants completed a questionnaire and were clinically examined for TDI, overjet and lip coverage. The Strength and Difficulties Questionnaire (SDQ) was used to assess problem behaviour, which provided a total score and five domain scores (emotional symptoms, conduct problems, hyperactivity, peer problems and pro-social behaviour). The association between problem behaviour and TDI was assessed in unadjusted and adjusted logistic regression models. Adjusted models controlled for demographic (sex, age and ethnicity), socio-economic (parental employment) and clinical factors (overjet and lip coverage).
  
  
  RESULTS
  The prevalence of TDI was 17% and the prevalence of problem behaviour, according to the SDQ, was 10%. In the adjusted model, adolescents with problem behaviour were 1.87 (95% confidence interval: 1.03-3.37) times more likely to have TDI than those without problem behaviour. In subsequent analysis by SDQ domains, it was found that only peer problems were associated with TDI (OR = 1.78, 95% CI: 1.01-3.14), even after adjustment for confounders.
  
  
  CONCLUSIONS
  This study found evidence for a relationship between problem behaviour and TDI among adolescents, which was mainly due to peer relationship problems.
authors.affiliation: Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK.
authors.forename: Damini
authors.initials: D
authors.lastname: Ramchandani
authors.affiliation: Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Wagner
authors.initials: W
authors.lastname: Marcenes
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
authors.affiliation: Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK.
authors.forename: Eduardo
authors.identifier: http://orcid.org/0000-0002-1858-3713
authors.initials: E
authors.lastname: Bernabé
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D010379:Peer Group; D015995:Prevalence; D000066553:Problem Behavior; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D018677:Tooth Injuries / Q000453:epidemiology*
keywords: Adolescent psychology; Tooth injuries, Adolescent behaviour; social behaviour disorders