Prevalence of Traumatic Dental Injuries in 12-Year-Old Adolescents in Brazil: A Comparative Analysis of 2010 and 2023.

OBJECTIVE: To analyze changes in the prevalence and severity of traumatic dental injuries in permanent incisors among 12-year-old Brazilian adolescents. METHODS: This study was designed as a secondary analysis of data from two nationally representative, population-based cross-sectional surveys. Dental trauma was assessed using the O'Brien Index, according to World Health Organization (WHO) guidelines, with examinations restricted to permanent incisors. The outcome measures were the prevalence of dental trauma, defined as the presence of at least one affected tooth, and the mean number of affected teeth. Results were stratified according to injury severity. Analyses were conducted at the national and regional levels using absolute and relative frequencies. 95% confidence intervals were calculated to assess the precision of the estimates and support comparisons between surveys and geographic regions. RESULTS: Nationally, the prevalence of traumatic dental injuries decreased from 20.5% in 2010 to 13.7% in 2023, whereas the proportion of adolescents without trauma increased from 79.5% to 86.3%. This decline was observed across all Brazilian regions, although regional differences remained evident. In 2023, the Southeast region presented the lowest prevalence of traumatic dental injuries, while the highest prevalences were observed in the Northeast and Central-West regions. Enamel fractures were the most common type of injury in both surveys, despite a reduction from 16.5% to 8.5%, followed by enamel-dentin fractures, which decreased from 3.7% to 1.4%. More severe conditions, including pulp involvement and tooth loss resulting from trauma, were uncommon in both survey years. The inclusion of the "treated fracture" category in 2023 showed that only 3.4% of adolescents had restored traumatic injuries. The mean number of teeth affected by enamel fractures declined from 0.20 in 2010 to 0.12 in 2023. CONCLUSIONS: The prevalence of dental trauma among 12-year-old Brazilian adolescents decreased substantially between 2010 and 2023. However, the low proportion of treated injuries suggests significant limitations in access to timely care, with potential prognostic implications. Furthermore, the unequal distribution of dental trauma, with higher prevalence in the North and Northeast regions, reflects persistent social and regional inequalities in oral health.