Development of a minimum dataset for recording traumatic dental injuries in children

Background: Traumatic dental injuries (TDI) are common and can occur across the life course. Children with TDI experience negative social judgments, bullying and teasing by their peers about their appearance. Poor epidemiological data and limited recording of diagnosis and treatment in general dental practice hinder quantifying the impact and burden of TDI to children, their families and healthcare services.

Aim: To develop and feasibility test a minimum dataset for TDI (MDS-TDI) for use in routine clinical practice.

Methods: The MDS-TDI was conceptualised and developed as a complex intervention whilst Normalisation Process Theory (NPT) was used as an underpinning implementation framework. Formal consensus techniques guided the inclusion of outcomes in the dataset. User testing was used to integrate the MDS-TDI into an existing electronic patient record. A single-site feasibility study undertaken in a teaching hospital assessed data collection processes and acceptability of outcome measures. A focus group with clinicians was audio-recorded before coding and framework analysis informed by NPT.

Results: Dentists, dental specialists, patient and parent representatives and other stakeholders were recruited to the consensus study. The MDS-TDI comprises clinician-oriented outcomes (pulp healing, periodontal healing, discolouration, tooth loss) and patient-oriented outcomes (communication, aesthetics, pain, quality of life). User testing enabled the integration of the outcomes to the electronic patient record in a clinician-friendly way. The feasibility study assessed data from 95 patient appointments; patient outcome completion rates were high at all study time-points. Clinicians understood and valued the MDS-TDI but identified challenges in integrating the MDS-TDI within daily practice.

Conclusions: An MDS-TDI has been developed and integrated into an existing electronic patient record. The MDS-TDI is feasible and acceptable to use in a specialist paediatric dentist setting. Further work is required to validate the patient-oriented outcome measures and explore MDS-TDI feasibility in other clinical settings.