Traumatic dental injuries in special health care needs children and association with obesity

BACKGROUND: Special needs children are at a higher risk of dental trauma because of neurological, physical, mental, and behavioral impairments. They are also at higher risk of developing obesity due to the side effects of medication. OBJECTIVE: Assess the association between traumatic dental injuries (TDIs) and obesity in children with special health care needs. DESIGN: Analytical cross-sectional study. SETTING: Schools for special needs children. STUDY POPULATION AND METHODS: Special needs children with a diagnosis of TDI according to the Andreasen criteria were included in the study. Data on the disability status were obtained from a national demographic survey in 2016. Demographic and dental variables were measured for analysis. Multivariable logistic regression was used to analyse any relationship between TDI prevalence and obesity. MAIN OUTCOME MEASURE: Relationship of body mass index (BMI) to TDI prevalence. SAMPLE SIZE: 350 (131 boys and 219 girls) special needs children with a median (interquartile range) age of 12.0 (2.0) years. RESULTS: Eighty-one (23.1%) children presented with TDIs. The mean (standard deviation) BMI for the entire study population was 24.7 (7.8). Children with obesity had a 30.3% TDI prevalence compared normal-weight children (20.6%) (P=.035), but BMI category was not statistically significant in the regression analysis (P=.541), which showed that children with an overjet of >3 mm were 4.82 times (CI: 2.55-9.09, P=.001) more likely to have TDI than children with an overjet of <= 3 mm. Those with inadequate lip coverage were 2.85 times (CI: 1.49-5.44, P=.002) more likely to have TDI. Children with cerebral palsy were 3.18 times (CI: 1.89-11.32, P=.024) more likely to have TDI than children with other disabilities. CONCLUSION: The study showed a significant association between TDI prevalence and increased overjet, inadequate lip coverage, and cerebral palsy. The prevalence of TDI among obese special needs children was statistically significant according to bivariate analysis, but not in a multivariate analysis that adjusted for other variables. LIMITATIONS: Causal relationship cannot be established with cross-sectional study.