title: Traumatic dental injuries in children with special health care needs.
abstract: OBJECTIVE
  Children with special healthcare needs (CSHCN) are at an increased risk for traumatic dental injuries (TDI) due to unique predisposing factors; moreover, their access to dental care is compromised. In Jordan, there is a need to study TDI among CSHCN to highlight their dental care needs. The aim of this study was to identify the prevalence, types, possible risk factors associated with TDI, and treatment-seeking behavior in CSHCN in Jordan.
  
  
  METHODS
  Children (n=959) were examined in schools/centers for CSHCN, and compared to a healthy age- and gender-matched control group. Data concerning demographics, types of trauma, risk factors associated with TDI, and treatment-seeking behavior were collected. Data were analyzed using SPSS for descriptive and bivariate analyzes. Significance level was set at P≤.05.
  
  
  RESULTS
  Prevalence of TDI in the study group (age, 11.76±4.2 years) and control group (age 11.70±4.2 years) was (83 of 959, 8.7%) and (42 of 1010, 4.1%), respectively. TDI prevalence was highest in children with multiple disabilities (14.0%), followed by intellectual disabilities (13.1%), and cerebral palsy (12.2%). The most common type of TDI was an uncomplicated crown fracture (91.0%). Increased overjet and incompetent lips were significant risk factors associated with TDI. Reasons for not seeking treatment in the study vs control group included parental attitude and lack of dental awareness (68.1% vs 60%), difficulties getting an appointment and availability of dental clinics willing to see CSHCN (36.2% vs 0%), P≤.01, and financial reasons (31.9% vs 40%).
  
  
  CONCLUSIONS
  Prevalence of TDI was higher in CSHCN, and associated with increased overjet and incompetent lips. Uncomplicated crown fracture was the most common injury. In both groups, the main reason for not seeking treatment was lack of dental awareness among parents/caregivers; however, difficulties in getting an appointment and availability of dental clinics willing to see children were more prominent in the CSHCN group.
authors.affiliation: Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan.
authors.forename: Ola B
authors.identifier: http://orcid.org/0000-0003-1670-497X
authors.initials: OB
authors.lastname: Al-Batayneh
authors.affiliation: Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan.
authors.forename: Arwa I
authors.initials: AI
authors.lastname: Owais
authors.affiliation: Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan.
authors.forename: Majd O
authors.initials: MO
authors.lastname: Al-Saydali
authors.affiliation: Department of General Dentistry, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: H Barry
authors.initials: HB
authors.lastname: Waldman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children; D003730:Dental Care for Persons with Disabilities; D019988:Children with Disabilities; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D018677:Tooth Injuries / Q000453:epidemiology*
keywords: children; special healthcare needs; traumatic dental injuries; treatment