title: The effect of deprivation on the incidence of mandibular fractures in a British city.
abstract: OBJECTIVE
  To examine the relationship between social and material deprivation and mandibular fractures.
  
  
  METHODS
  Three hundred and forty three consecutive patients who underwent mandibular fracture fixation were selected for the study. After exclusions, 290 were divided into age groups and ranked according to their Index of Multiple Deprivation (IMD) score. Rankings were determined using postcodes, and divided into quintiles for statistical analysis.
  
  
  RESULTS
  Ages ranged from 7 to 82 with 146 (50%) patients aged between 20 and 29. Males accounted for 85% of cases. The most common site of fracture was the angle (n = 195) and assault was shown to be the most common mechanism of injury (63.3%). A strong relationship was demonstrated between fractures of the mandible and worsening deprivation, with the most striking relationship seen with fractures sustained as a consequence of assault. Females were less likely than males to sustain a fracture of the mandible as a consequence of assault; however, when assault was the mechanism of injury they were also likely to be from a deprived background.
  
  
  CONCLUSIONS
  This study has demonstrated that a strong relationship exists between deprivation and the incidence of mandibular fractures in our catchment area. Fractures that resulted from interpersonal violence were shown to have a particularly strong correlation with deprivation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospitals Bristol, United Kingdom. Electronic address: Mark.Wilson@UHBristol.nhs.uk.
authors.forename: M H
authors.initials: MH
authors.lastname: Wilson
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospitals Bristol, United Kingdom.
authors.forename: J P
authors.initials: JP
authors.lastname: Robinson
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospitals Bristol, United Kingdom.
authors.forename: R T
authors.initials: RT
authors.lastname: Sisson
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospitals Bristol, United Kingdom.
authors.forename: P J
authors.initials: PJ
authors.lastname: Revington
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospitals Bristol, United Kingdom.
authors.forename: S J
authors.initials: SJ
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004739:England; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008337:Mandibular Fractures / Q000453:epidemiology*; D008426:Maternal Deprivation; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D014754:Violence; D055815:Young Adult
keywords: Deprivation; Facial trauma; Mandibular fractures; Poverty