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© Borgis - Nowa Stomatologia 4/2018, s. 135-141 | DOI: 10.25121/NS.2018.23.4.135
*Anna Szufnara1, Małgorzata Lipczyńska-Lewandowska2, Sylwia Majewska-Beśka3, Joanna Szczepańska3
The assessment of teachers’ and medical professionals’ knowledge on first aid in tooth injuries
Ocena wiedzy nauczycieli oraz personelu medycznego na temat udzielania pierwszej pomocy w przypadkach urazów zębów
1Doctoral studies, Department of Paediatric Dentistry, Medical University of Łódź
Head of Department: Professor Joanna Szczepańska, MD, PhD
2Doctoral studies, Department of Dental Surgery, Medical University of Łódź
Head of Department: Professor Anna Janas-Naze, MD, PhD
3Department of Paediatric Dentistry, Medical University of Łódź
Head of Department: Professor Joanna Szczepańska, MD, PhD
Streszczenie
Wstęp. Urazy zębów stanowią poważny problem kliniczny współczesnej stomatologii wieku rozwojowego. Szczególnie istotna w przypadku urazu zęba jest prawidłowa i szybko udzielona pierwsza pomoc.
Cel pracy. Celem pracy była ocena wiedzy środowiska medycznego oraz nauczycieli na temat udzielania pierwszej pomocy dzieciom w następstwie urazów zębów, z uwzględnieniem przebytego szkolenia w tym zakresie.
Materiał i metody. Anonimowe dobrowolne badanie ankietowe objęło 727 osób. Przeprowadzone zostało w styczniu i lutym 2017 roku na terenie województw łódzkiego, lubelskiego i małopolskiego. Ankietowanych podzielono na grupy ze względu na wykonywany zawód związany ze szkolnictwem lub medycyną oraz wiek, płeć, liczbę posiadanych dzieci i stopień wykształcenia. Analizie poddane zostały wzorce zachowań w przypadku zwichnięcia całkowitego lub złamania korony zęba.
Wyniki. Według badań 577 ankietowanych (79,4%) uczestniczyło co najmniej raz w życiu w kursie udzielania pierwszej pomocy. Prawie co trzeci ankietowany – 233 osoby (32%) – był świadkiem urazu zęba. Najczęstszymi typami urazów napotkanymi przez ankietowanych były uraz tkanek miękkich i złamanie korony zęba – odpowiednio: 114 (35%) i 96 (29%) przypadków. Grupą zawodową, która najczęściej podejmowała próbę udzielenia pierwszej pomocy w urazach zębów w podobnym odsetku, byli nauczyciele – 56% przypadków oraz osoby związane z medycyną – 53%, a pozostałe zawody – 36%.
Wnioski. Kursy udzielania pierwszej pomocy niezwykle rzadko podejmują temat urazów w obrębie jamy ustnej. Pomimo tego faktu prawie co druga osoba biorąca udział w badaniach próbowała udzielić pomocy, będąc świadkiem zdarzenia, jednak ich działania często były niepoprawne.
Summary
Introduction. Tooth injuries constitute a serious clinical problem in contemporary paediatric dentistry. Immediately delivered and correct first aid is particularly important in the case of dental trauma.
Aim. The aim of the study was to assess the general knowledge of teachers and medical professionals on providing first aid to children in the case of dental trauma. Taking part in a first aid training course was also analysed.
Material and methods. An anonymous, voluntary questionnaire was administered to 727 people. It was conducted in January and February 2017 in three Polish provinces. The respondents were divided into groups depending on their age, sex, educational level, number of children and profession related to medicine or school education. Behavioural patterns were analysed in the event of a complete tooth dislocation or crown fracture.
Results. According to the study, 577 respondents (79.4%) have participated in a first aid training course at least once. Every third person: 223 (32%) has been a witness of a tooth injury. The most frequent type of encountered trauma was soft tissue injury and tooth crown fracture: 114 (35%) and 96 (29%) cases, respectively. The professionals who tried to provide first aid in dental trauma at a similar percentage were teachers: 56% of cases and people associated with medicine: 53%; the remaining professionals did so in 36% of cases.
Conclusions. The issue of first aid in dental trauma is rarely raised during first aid training courses. Despite this, every second person participating in the study has tried to provide first aid. However, their actions were incorrect in most cases.
Introduction
Dental trauma represents a serious and common medical and aesthetic problem; it is also a significant challenge for the dentist, particularly if the patient is a child. According to a study conducted in 2012-2013 at the Department of Paediatric Dentistry of the Medical University of Łódź, Poland, 3.4% of the patients who reported to the facility had a history of oral trauma. School boys are at the highest risk for such injuries (1). Dental trauma accounts for 5% of traumatic body damage in all age groups (2).
The correct administration of first aid on the site of an accident is of vital importance for prognosis in mechanical dental trauma, particularly as serious one as tooth avulsion, for example. Securing the trauma area and the lost part of or whole tooth appropriately and starting professional treatment quickly dramatically improves the prognosis. Individuals who take care of children on a daily basis, parents and teachers, who are the most common witnesses to such accidents, should have a basic knowledge on first aid in dental trauma. Healthcare professionals should be aware of the proper trauma management protocol and know to which specialist they should refer the patient for treatment continuation, if necessary. These principles are necessary to ensure optimal conditions for healing and increase the chances of preserving the affected teeth in the oral cavity.
Aim
The aim of the study was to assess the knowledge of teachers and healthcare professionals: physicians, nurses, dental assistants and public health nurses on dental trauma first aid in children and the training that they have received on the matter.
Material and methods
An anonymous, voluntary questionnaire was administered to 727 individuals. It was conducted in January and February 2017 in the Łódzkie, Lubelskie and Małopolskie provinces in Poland. The questionnaire was distributed at schools, in hospitals, clinics and on the Internet. The questionnaire was divided into three parts. The first one regarded demographic and social data. The respondents were divided into groups based on their education- or medicine-related profession as well as their age, gender, number of children and educational level. The second part of the questionnaire concerned the participation in first aid courses, the range of topics covered in those courses and the number of times the subjects had witnessed dental trauma. The third part of the questionnaire included questions on the management of complete tooth avulsion or tooth crown fracture cases.
The Excel software was used for statistical analysis. The frequency of qualitative features was determined. The relationships between the frequencies of non-measurable features in the different groups were studied using the chi-square independence test. A significance level of α = 0.05 was adopted. Cramer’s V was used to investigate the strength of the association between two properties. Values of < 0.3 signified a weak association, those of < 0.3-0.5 > a minor association and (0.5-0.6 > a moderate association. For the range of (0.6-0.8 > the association is relatively strong and for values higher than 0.8 the association is strong.
Results
In the present study, 483 individuals (66.4%) were female and 244 (33.6%) were male. There were 141 individuals employed in education, who accounted for 19.4% of subjects, and 219 individuals were members of the medical community (30.1%). The remaining respondents (367; 50.5%) practised different professions than the ones mentioned. The age of the subjects was 18-30 years (68.2%), 31-40 (12.1%), 41-50 (10.2%) and 51-60 (9.5%). Among the respondents, 223 individuals (30.7%) had at least one child and 504 (69.3%) did not have any children at all.
There were 370 subjects with higher education (50.9%), 332 with secondary education (45.7%) and 25 with primary education (3.4%). The study group included 594 city dwellers (81.7%) and 133 rural inhabitants (18.3%).
According to the study, 577 respondents (79.4%) have participated at least once in a first aid training course (fig. 1). Only 94 individuals (16.3%) took part in first aid courses in which the subject of oral trauma was raised. A weak association between the profession and participation in a first aid course was observed (chi2 = 25.1, Cramer’s V = 0.19), which was statistically significant (p = 0.0000034) (tab. 1). From among healthcare professionals 88% took part in a course; 86% of teachers and 72% of representatives of other professions did as well.
Fig. 1. Subjects’ participation in a first aid course
Tab. 1. Analysed associations with regard to age, profession and educational level
Studied associationp valueChi-square independence testCramer’s V
Age and participation in first aid course0.0001865919.80160.16504
Age and first aid provision0.2433154.173630.13298
Profession and first aid provision0.0209337.732830.18101
Profession and participation in first aid course0.000003425.18310.18612
Educational level and participation in first aid course0.0178858.047580.10521
Nearly one third of respondents: 233 (32%) have witnessed dental trauma. Among medical professionals the figure was 38%, among teachers 34 and 28% of members of other professions have witnessed such events. A first aid attempt was made by 109 subjects (46.8%) who witnessed an accident. Statistical analysis showed no relationship in the study group between prior participation in a course and the provision of first aid by accident witnesses.
The trauma usually involved soft tissue injury and tooth crown fracture: 114 (35%) and 96 cases (29%), respectively. The lowest number of trauma cases were associated with temporomandibular joint damage and maxillary fracture (fig. 2). First aid was provided most commonly in soft tissue trauma: 68 cases (61%) and tooth crown fracture: 31 cases (32%).
Fig. 2. Rate of occurrence and types of trauma witnessed by the subjects
In the study group, a relationship between the profession and first aid provision was observed (chi2 = 7.7; p = 0.02) and the strength of this relationship expressed by Cramer’s V was 0.18 (tab. 1). The professionals who attempted to provide first aid in tooth injury at a similar rate were teachers (56% of cases) and individuals working in medicine (53%). The members of the remaining professions made a first aid attempt in 36% of cases (fig. 3).
Fig. 3. Behaviour of different professional groups witnessing dental trauma

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Piśmiennictwo
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otrzymano: 2018-10-04
zaakceptowano do druku: 2018-10-25

Adres do korespondencji:
*Anna Szufnara
Zakład Stomatologii Wieku Rozwojowego Uniwersytet Medyczny w Łodzi
ul. Pomorska 251, 92-216 Łódź
tel./fax: +48 (42) 675-75-16
szufnara.ania@gmail.com

Nowa Stomatologia 4/2018
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