The Impact of the COVID-19 Pandemic on the Pattern and Presentation of Traumatic Dental Injuries in Children in a Tertiary Health Institution

Background: Traumatic dental injuries (TDI) are often seen among children majorly due to poor balance and slow reflexes (in pre-schoolers), and poor supervision during play/sports. The COVID-19 pandemic came with adaptive changes in lifestyle with a possible impact on the incidence of traumatic dental injuries. This study was therefore aimed at comparing the presentation of traumatic dental injuries in children pre-COVID-19 pandemic and during the COVID-19 pandemic periods.

Methodology: This was a retrospective study done using clinical records of children aged 16 years and below that presented at the paediatric dental clinic of the University of Port Harcourt Teaching Hospital; March 2019 –February 2020(838) and July 2020 - June 2021(599). Information such as demographics, aetiology, type of injuries, and dentition type was elicited from the 1437 clinical records. Data were analyzed and the level of significance was set at p< 0.05.

Result: One hundred and eighteen (8.2%) patients presented with TDIs [77 (9.2%) and 41(6.8%) pre-pandemic and pandemic periods, respectively], and their mean age was 7.3(+4.3) years. There were 68 (57.6%) males. The commonest aetiology of dental injury was falling 91(77.1%) and tooth fractures 36(30.5%), respectively. There were no statistically significant differences in age (p=0.24), sex (p=0.30), aetiology (p=0.17), type of TDI (p=0.10), and dentition affected (p=0.44) between the pre-pandemic and pandemic periods.

Conclusion: The incidence of TDIs was higher pre-pandemic, however, there were no significant differences in the pattern of TDI between the pre-pandemic and pandemic periods; this may be due to difficulty in enforcing COVID-19 restrictions among children.

背景：创伤性牙外伤（Traumatic dental injuries, TDI）在儿童群体中较为常见，主要诱因包括学龄前儿童平衡能力欠佳、反应迟缓，以及玩耍或运动期间看护不周。新冠疫情（COVID-19 pandemic）对大众的生活方式造成了适应性改变，这可能会对创伤性牙外伤的发病率产生影响。因此本研究旨在对比新冠疫情暴发前与新冠疫情暴发期间，儿童创伤性牙外伤的临床表现特征。

方法学：本研究为回顾性研究，分析对象为2019年3月至2020年2月（共838例）以及2020年7月至2021年6月（共599例）期间，在哈科特港大学教学医院儿童牙科门诊就诊的16岁及以下儿童的临床病历。研究人员从总计1437份临床病历中提取了人口统计学信息、致病原因、损伤类型以及牙列类型等相关数据。数据分析采用统计学方法，显著性水平设定为p<0.05。

结果：共计118例（占比8.2%）患者确诊为TDI，其中疫情前时期77例（占比9.2%），疫情期间41例（占比6.8%）；患者的平均年龄为7.3(±4.3)岁，男性患者共68例（占比57.6%）。最常见的致病诱因为跌倒，共计91例（占比77.1%）；最常见的损伤类型为牙折，共计36例（占比30.5%）。疫情前与疫情期间两组患者在年龄（p=0.24）、性别（p=0.30）、致病原因（p=0.17）、TDI类型（p=0.10）以及受累牙列（p=0.44）方面均无统计学显著性差异。

结论：疫情前时期创伤性牙外伤的发病率更高，但疫情前与疫情期间儿童TDI的发病模式并无显著差异；这一现象可能与儿童群体难以严格落实新冠疫情防控限制措施有关。