OBJECTIVE: To identify factors associated with the prevalence of traumatic dental injuries (TDI) in children at 4 years of age. METHODS: Participants from the 2015 Pelotas (Brazil) birth cohort were included. Demographic, socioeconomic, behavioral, and environmental data were collected through interviews and physical examinations during cohort follow-up. Dental examination at 4 years of age revealed the presence of TDI. A theoretical model was constructed using a directed acyclic graph (DAG). A descriptive analysis was performed, followed by Poisson regression models relating TDI to each outcome. RESULTS: Data from 3650 4-year-old children were analyzed; the prevalence of dental trauma was 20.2% (95% confidence interval [CI] 18.9%-21.5%). The prevalence of TDI was lower among girls compared with boys, suggesting a protective effect of female sex (relative risk [RR] 0.80 [95% CI: 0.79-0.91]). Increased height for age (RR 1.55 [95% CI: 1.14-2.09]), increased overjet (RR 1.45 [95% CI: 1.2-1.74]), and anterior open bite (RR 1.26 [95% CI: 1.01-1.56]) demonstrated an association with TDI after testing regression models based on DAGs. CONCLUSION: Male sex, increased height, and increased overjet and open bite were factors predisposing to TDI at 4 years of age. Understanding these factors can contribute to the implementation of targeted prevention strategies for reducing TDI and their potential long-term consequences.
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