Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions
Abstract
:1. Introduction
2. Materials and Methods
2.1. Systematic Review and Meta-Analysis Protocol
2.2. Eligibility Criteria
- (i)
- to provide readers with a more comprehensive review of the topic,
- (ii)
- to verify the potential impact of validation on the outcomes of interest (through meta-analytical techniques and meta-regression analyses), and
- (iii)
- to identify new research avenues, capitalizing on the lessons learned and overcoming shortcomings in previous research.
2.3. Information Sources and Search
2.4. Study Selection
2.5. Data Collection
2.6. Quality Assessment
- (i)
- face validity;
- (ii)
- pre- or pilot testing;
- (iii)
- content validity (review or evaluation of the instrument by experts);
- (iv)
- test–retest reliability (measured by computing the Cronbach’s α coefficient); and
- (v)
- internal consistency (measured by computing the intra-class correlation and/or the Cronbach’s α coefficient).
2.7. Meta-Analysis and Meta-Regressions
3. Results
3.1. Study Selection
3.2. Study Characteristics
- (i).
- personal and professional data (sex, age, teaching experience, first-aid training background);
- (ii)
- questions based on imaginary cases of dental injuries, and
- (iii)
- multiple-choice questions on the management of avulsed and/or fractured teeth and the use of mouthguards.
3.3. Attitudes Regarding Dental Injuries
3.4. First-Aid Dental Trauma Knowledge
3.5. Washing and Transporting Medium
3.6. Extra-Alveolar Period of Avulsed Tooth
3.7. Knowledge About the Effectiveness of Mouthguards
3.8. Quality Assessment
4. Discussion
4.1. Attitude Regarding Dental Injuries
4.2. First-Aid Dental Trauma Knowledge
4.3. Practical Recommendations
4.4. New Avenues for Research
4.5. Strengths and Weaknesses
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Janssen, I.; LeBlanc, A.G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act. 2010, 7, 40. [Google Scholar] [CrossRef] [PubMed]
- Biddle, S.J.; Asare, M. Physical activity and mental health in children and adolescents: A review of reviews. Br. J. Sports Med. 2011, 45, 886–895. [Google Scholar] [CrossRef] [PubMed]
- Gomez-Pinilla, F. The combined effects of exercise and foods in preventing neurological and cognitive disorders. J. Prev. Med. 2011, 52, S75–S80. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lind, R.R.; Geertsen, S.S.; Ørntoft, C.; Madsen, M.; Larsen, M.N.; Dvorak, J.; Ritz, C.; Krustrup, P. Improved cognitive performance in preadolescent Danish children after the school-based physical activity programme “FIFA 11 for Health” for Europe–A cluster-randomised controlled trial. Eur. J. Sport Sci. 2018, 18, 130–139. [Google Scholar] [CrossRef] [PubMed]
- Glendor, U. Epidemiology of traumatic dental injuries—A 12 year review of the literature. Dent. Traumatol. 2008, 24, 603–611. [Google Scholar] [CrossRef] [PubMed]
- Yamaguchi-Ueda, K.; Kawarabayashi, K.; Miyazaki, A.; Kurogoushi, R.; Iwata, K.; Sugimoto, A.; Akazawa, Y.; Hasegawa, T.; Iwamoto, T. Prevention of sports-related dental Injuries in children. J. Oral Health Biosci. 2018, 31, 68–72. [Google Scholar]
- García-Godoy, F.; Sánchez, R.; Sánchez, J.R. Traumatic dental injuries in a sample of Dominican schoolchildren. Community Dent. Oral Epidemiol. 1981, 9, 193–197. [Google Scholar] [CrossRef] [PubMed]
- Bastone, E.B.; Freer, T.J.; McNamara, J.R. Epidemiology of dental trauma: A review of the literature. Aust. Dent. J. 2000, 45, 2–9. [Google Scholar] [CrossRef]
- Gábris, K.; Tarján, I.; Rózsa, N. Dental trauma in children presenting for treatment at the Department of Dentistry for Children and Orthodontics, Budapest, 1985–1999. Dent. Traumatol. 2001, 17, 103–108. [Google Scholar] [CrossRef]
- Sgan-Cohen, H.D.; Yassin, H.; Livny, A. Dental trauma among 5th and 6th grade Arab schoolchildren in Eastern Jerusalem. Dent. Traumatol. 2008, 24, 458–461. [Google Scholar] [CrossRef]
- Al-Jundi, S.H.; Al-Waeili, H.; Khairalah, K. Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma. Dent. Traumatol. 2005, 21, 183–187. [Google Scholar] [CrossRef] [PubMed]
- Berger, T.D.; Kenny, D.J.; Casas, M.J.; Barrett, E.J.; Lawrence, H.P. Effects of severe dentoalveolar trauma on the quality of life of children and parents. Dent. Traumatol. 2009, 25, 462–469. [Google Scholar] [CrossRef] [PubMed]
- Pujita, C.; Sivakumar Nuvvula, G.S.; Nirmala, S.V.S.G.; Yamini, V. Informative promotional outcome on school teachers’ knowledge about emergency management of dental trauma. J. Conserv. Dent. 2013, 16, 21. [Google Scholar] [PubMed]
- Emerich, K.; Nadolska-Gazda, E. Dental trauma, prevention and knowledge concerning dental first-aid among Polish amateur boxers. J. Sci. Med. Sport 2013, 16, 297–301. [Google Scholar] [CrossRef]
- Andreasen, J.O.; Andreasen, F.M.; Skeie, A.; Hjørting-Hansen, E.; Schwartz, O. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries–a review article. Dent. Traumatol. 2002, 18, 116–128. [Google Scholar] [CrossRef]
- Andreasen, J.O.; Andreasen, F.M.; Andersson, L. Textbook and Color Atlas of Traumatic Injuries to the Teeth; Wiley-Blackwell: Oxford, UK, 2018. [Google Scholar]
- Frujeri, M.E.; Costa, E.D. Effect of a single dental health education on the management of permanent avulsed teeth by different groups of professionals. Dent. Traumatol. 2009, 25, 262–271. [Google Scholar] [CrossRef]
- Flores, M.T.; Andersson, L.; Andreasen, J.O.; Bakland, L.K.; Malmgren, B.; Barnett, F.; Bourguignon, C.; DiAngelis, A.; Hicks, L.; Sigurdsson, A.; et al. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent. Traumatol. 2007, 23, 130–136. [Google Scholar] [CrossRef]
- Emerich, K.; Kaczmarek, J. First aid for dental trauma caused by sports activities. Sports Med. 2010, 40, 361–366. [Google Scholar] [CrossRef]
- Levin, L.; Zadik, Y. Education on and prevention of dental trauma: it’s time to act! Dent. Traumatol. 2012, 28, 49–54. [Google Scholar] [CrossRef]
- Andersson, L.; Andreasen, J.O.; Day, P.; Heithersay, G.; Trope, M.; DiAngelis, A.J.; Kenny, D.J.; Sigurdsson, A.; Bourguignon, C.; Flores, M.T.; et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent. Traumatol. 2012, 28, 88–96. [Google Scholar] [CrossRef]
- Andersson, L.; Andreasen, J.O.; Day, P.; Heithersay, G.; Trope, M.; DiAngelis, A.J.; Kenny, D.J.; Sigurdsson, A.; Bourguignon, C.; Flores, M.T.; et al. Guidelines for the management of traumatic dental Injuries: 2. Avulsion of Permanent Teeth. Pediatr. Dent. 2018, 39, 412–419. [Google Scholar]
- Andreasen, J.O.; Andreasen, F.M. Essentials of Traumatic Injuries to the Teeth: A Step-by-Step Treatment Guide; John Wiley & Sons: New York, NY, USA, 2010. [Google Scholar]
- Roettger, M.; Greaves, M.; Ahmad, M.; Leon-Salazaar, V. Sports-Related Oral and Dentoalveolar Trauma: Pathophysiology, Diagnosis, and Emergent Care. In Modern Sports Dentistry; Springer: Champaign, IL, USA, 2018; pp. 23–55. [Google Scholar]
- Nirwan, M.; Syed, A.A.; Chaturvedi, S.; Goenka, P.; Sharma, S. Awareness in primary school teachers regarding traumatic dental injuries in children and their emergency management: A survey in south Jaipur. Int. J. Clin. Pediatr. Dent. 2016, 9, 62. [Google Scholar] [PubMed]
- Newman, L.J.; Crawford, P.J. Dental injuries: “first aid” knowledge of Southampton teachers of physical education. Dent. Traumatol. 1991, 7, 255–258. [Google Scholar] [CrossRef]
- Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann. Intern. Med. 2009, 151, 264–269. [Google Scholar] [CrossRef] [PubMed]
- Downs, S.H.; Black, N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J. Epidemiol. Community Health 1998, 52, 377–384. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Duval, S.; Tweedie, R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000, 56, 455–463. [Google Scholar] [CrossRef]
- Jorge, K.O.; Moysés, S.J.; Ferreira, E.F.; Ramos-Jorge, M.L.; de Araújo Zarzar, P.M.P. Prevalence and factors associated to dental trauma in infants 1–3 years of age. Dent. Traumatol. 2009, 25, 185–189. [Google Scholar] [CrossRef]
- Pagliarin, C.L.; Zenkner, C.L.; Barletta, F.B. Knowledge of physical education teachers about emergency management of tooth avulsion. Stomatos 2011, 17, 33–42. [Google Scholar]
- Granville-Garcia, A.F.; Lima, E.M.; Gomes Santos, P.; De Menezes, V.A. Avaliação do conhecimento dos professores de educação física de Caruaru-PE sobre avulsão-reimplante. Pesqui. Bras. Odontopediatria Clin. Integr. 2007, 7. [Google Scholar] [CrossRef]
- D’Assunção, F.L.C.; de Melo, Â.B.P.; Salazar-Silva, J.R.; de Oliveira Lima, J.; Fernandes, L.C.C.; de Melo, N.F.P. Knowledge level of physical educators regarding dental trauma in a Brazilian subpopulation. Pesqui. Bras. Odontopediatria Clin. Integr. 2015, 15, 441–449. [Google Scholar]
- Subramaniam, R.; Mittal, S.; Hiregoudar, M.; Mohandas, U.; Sakeenabi, B.; Prashant, G.M.; Chandu, G.N. Knowledge of upper primary and secondary school physical education instructors in Davangere city, India, about emergency management of dental trauma. J. Educ. Ethics Dent. 2011, 1, 18. [Google Scholar]
- Mohandas, U.; Chandan, G.D. Knowledge, attitude and practice in emergency management of dental injury among physical education teachers: A survey in Bangalore urban schools. J. Indian Soc. Pedod. Prev. Dent. 2009, 27, 242. [Google Scholar] [PubMed]
- Singh, M.; Ingle, N.A.; Kaur, N.; Yadav, P. Evaluation of knowledge and attitude of school teachers about emergency management of traumatic dental injury. J. Int. Soc. Prev. Community Dent. 2015, 5, 108. [Google Scholar] [CrossRef] [PubMed]
- Chan, A.W.; Wong, T.K.; Cheung, G.S. Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong. Dent. Traumatol. 2001, 17, 77–85. [Google Scholar] [CrossRef]
- Lecor, P.A.; Niang, P.D.A.; Diouf, M.; Sarr, M.; Diop, E.C.; Sall, O.H.; Touré, B. Connaissances et attitudes des enseignants d’éducation physique et sportive (EPS) sur la prise en charge de l’expulsion de l’incisive centrale maxillaire. J. Traumatol. Sport 2013, 30, 220–224. [Google Scholar] [CrossRef]
- Panahi, J.; Havasian, M.R.; Roozegar, M.A. Knowledge of physical education teachers’ toward tooth avulsion in Tehran, Iran. J. Oral Health Oral Epidemiol. 2014, 3, 66–71. [Google Scholar]
- Vergotine, R.J.; Govoni, R. Public school educator’s knowledge of initial management of dental trauma. Dent. Traumatol. 2010, 26, 133–136. [Google Scholar] [CrossRef]
- Bhandary, S.; Shetty, S. Emergency management of dental trauma among physical education teachers of 2 districts in Karnataka, India. Asian J. Sports Med. 2014, 5, 139–140. [Google Scholar]
- Holan, G.; Cohenca, N.; Brin, I.; Sgan-Cohen, H. An oral health promotion program for the prevention of complications following avulsion: The effect on knowledge of physical education teachers. Dent. Traumatol. 2006, 22, 323–327. [Google Scholar] [CrossRef]
- Anand, A.; Mukherjee, C.G.; Shukla, J.N.; Sharma, S. Knowledge and Awareness Regarding Traumatic Dental Injuries in School Children among Physical Education Teachers in Patna: A Cross-Sectional Study. Int. J. Sci. Study 2016, 4, 51–54. [Google Scholar]
- Andersson, L.; Bodin, I. Avulsed human teeth replanted within 15 min: A long-term clinical follow-up study. Endod. Dent. Traumatol. 1990, 6, 37–42. [Google Scholar] [CrossRef] [PubMed]
- Blomlöf, L.; Otteskog, P.; Hammarström, L. Effect of storage in media with different ion strengths and osmolalities on human periodontal ligament cells. Eur. J. Oral Sci. 1981, 89, 180–187. [Google Scholar] [CrossRef] [PubMed]
- Nordenvall, K.J. Milk as storage medium for exarticulated teeth: Report of case. ASDC J. Dent. Child. 1992, 59, 150–155. [Google Scholar] [PubMed]
- Trope, M. Clinical management of the avulsed tooth: Present strategies and future directions. Dent. Traumatol. 2002, 18, 1–11. [Google Scholar] [CrossRef]
- Al-Asfour, A.; Andersson, L.; Al-Jame, Q. School teachers’ knowledge of tooth avulsion and dental first aid before and after receiving information about avulsed teeth and replantation. Dent. Traumatol. 2008, 24, 43–49. [Google Scholar] [CrossRef]
- Al Sari, S.; Kowash, M.; Hussein, I.; Al-Halabi, M. An educational initiative for Dubai school nurses and physical education teachers on the management of traumatic dental injuries. J. Sch. Nurs 2018, in press. [Google Scholar] [CrossRef]
- Raphael, S.L.; Gregory, P.J. Parental awareness of the emergency management of avulsed teeth in children. Aust. Dent. J. 1990, 35, 130–133. [Google Scholar] [CrossRef]
- Stokes, A.N.; Anderson, H.K.; Cowan, T.M. Lay and professional knowledge of methods for emergency management of avulsed teeth. Dent. Traumatol. 1992, 8, 160–162. [Google Scholar] [CrossRef]
- Costa, A.B.M. Traumatismos Alvéolo-Dentários: Avaliação dos Conhecimento e Atitudes de uma Amostra de Professores do Ensino Fundamental do Município de São Paulo; 135f. Dissertação (Mestrado); Faculdade de Odontologia, Universidade de São Paulo: São Paulo, Brazil, 2002. [Google Scholar]
- Pacheco, L.F.; Filho, P.F.G.; Letra, A.; Menezes, R.; Villoria, G.E.M.; Ferreira, S.M. Evaluation of the knowledge of the treatment of avulsions in elementary school teachers in Rio de Janeiro, Brazil. Dent. Traumatol. 2003, 19, 76–78. [Google Scholar] [CrossRef]
- Panzarini, S.R.; Pedrini, D.; Brandini, D.A.; Poi, W.R.; Santos, M.F.; Correa, J.P.T.; Silva, F.F. Physical education undergraduates and dental trauma knowledge. Dent. Traumatol. 2005, 21, 324–328. [Google Scholar] [CrossRef]
- Mori, G.G.; Turcio, K.H.L.; Borro, V.P.B.; Mariusso, Â.M. Evaluation of the knowledge of tooth avulsion of professionals from Adamantina, São Paulo, Brazil. Dent. Traumatol. 2007, 23, 2–5. [Google Scholar] [CrossRef] [PubMed]
- Randhawa, A.K.; Kaur, K.; Walia, S.S.; Kaur, G. Mangement of traumatic dental injuries in school children: A questionnaire survey on the school teachers to assess their knowledge regarding the same. IJCDC 2015, 5, 514–517. [Google Scholar]
Search Strategy Item | Search Strategy Details |
---|---|
String of keywords | ((dental OR “dental trauma” OR “dental injury” OR “dental accident” OR “tooth avulsion” OR “avulsed tooth” OR “tooth displacement” OR “displaced tooth” OR “tooth fracture” OR “fractured tooth” OR “broken tooth” OR “tooth breaking” OR “tooth breakage” OR “tooth break” OR “tooth crack” OR “tooth cracking” OR “cracked tooth” OR “tooth loss” OR “lost tooth” OR “dental avulsion” OR “dental displacement” OR “dental facture” OR “dental breakage” OR “dental breaking” OR “dental break” OR “dental crack” OR “dental cracking” OR “dental loss” OR mouthguards) AND first-aid AND (knowledge OR attitudes OR practices)) AND (“teachers of physical education” OR “physical education teachers”) |
Searched databases/bibliographic thesauri | PubMed, ISI/Web of Science |
Inclusion criteria | P (population): Physical education teachers I (intervention/exposure): None C (comparators/comparisons): Any kind of comparisons/comparators (such as age, gender, years of teaching experience) O (outcomes): Knowledge and attitudes concerning dental trauma S (study type): Primary, original study (any study design included) |
Exclusion criteria | P: Teachers not teaching physical education, coaches, athletes, parents, reports where physical education teachers were combined with teachers of other disciplines, and it was not possible to extract data relevant only to the former I: None C: None O: Outcomes not described in sufficient detail S: Commentaries, expert opinions, letters to editor, editorials, original article without sufficient details, reviews, conference abstracts or proceedings |
Time filter | None applied (search from inception) |
Language filter | None applied (any language) |
Hand-searched target journals | “Dental Traumatology”, “Endodontic & Dental Traumatology”, “International Journal of Clinical Pediatric Dentistry”, “International Journal of Dentistry”, “Journal of Indian Society of Pedodontics and Preventive Dentistry”, “Journal of Oral Health and Biosciences”, “Pediatric Dentistry”, “The British Dental Journal”, “The Journal of Contemporary Dental Practice” |
Reference (Author, Year, Country) | N (Sex) | Teaching Experience | Level of Teaching | Age (Years) | First-Aid Training | Tool Design | Questionnaire Summary | Knowledge/Attitude and Correct/Incorrect Answers (%) | ||
---|---|---|---|---|---|---|---|---|---|---|
Number of Items | Question Type | Validation | ||||||||
Newman and Crawford (1991) [26]; England | 66 (45 M; 21 F) | 37 teachers between 6 and 30 years | 9%: Junior school. 38%: Middle school. 48%: senior school. | NM | 91% had been trained in first-aid | SDQ | 3 | Multiple-choice | Not validated |
|
Chan et al. (2001) [37]; Hong Kong | 166 (94 M, 72 F) | 139 (84%) > 5 years | Secondary school | 49 between 20–29 years; 73 between 30–39 years; 36 between 40–49 years; 8 aged 50 years and above | 165 (99%); 8 recalled the emergency management of dental trauma as being covered. 127 replied that they had not received training. 30 teachers were unsure | MEQ | 3 | Close-ended | Not validated |
|
Holan et al. (2006) [42]; Israel | 126 (29 M, 32 F, 5 NM) | NM | NM | NM | NM | SDQ | 2 | Multiple-choice | Not validated |
|
Granville-Garcia et al. (2007) [32]; Brazil | 79 (47 M; 32 F) | 77.2% between 11 and 25 years | NM | NM | None | Interview | NA | NA | NA |
|
Mohandas and Ghandan (2009) [35]; India | 580 (402 M; 178 F) | NM | Primary, middle, and high schools | 56 (10%) were under 25 years of age, 185 (32%) were between 25 and 34 years, 244 (42%) were between 35 and 44 years of age, 62 (11%) were between 45 and 54 years and above age group. 33 (6%) were above 55 years | 527 (91%) had first-aid training. 24 (4%) of them had no first-aid training | SDQ | 3 | Multiple-choice | Not validated |
|
Subramaniam et al. (2011) [34]; India | 109 (75 M; 34 F) | 32% (n = 35) of the respondents had less than five years’ experience | NM | 32% (n = 38) were aged between 20 and 30 years and 388% (n = 41) were aged between 31 and 40 years | Majority of the respondents (87%) said that their training included first-aid training. Only 10% recalled that their course covered management of dental trauma | NM | MEQ | Close-ended | Not validated |
|
Jorge et al. (2009) [30]; Brazil | 53 | NM | Faculty | mean age = 41 years | NM | MEQ | 3 | Multiple-choice | Not validated |
|
Vergotine and Govoni (2010) [40]; USA | 119 | 50% > 10 years teaching experience | High and middle schools | NM | 72% had specific trauma training for athletic setting with 62% of teachers having dental component included in training | SDQ | NM | Multiple-choice questions | Not validated |
|
Pagliarin et al. (2011) [31]; Brazil | 102 | Mean length working as a teacher was 19.61 years | NM | Mean age was 46 years (range: 33 to 59 years) | 24 (23%) reported to have received prior information on dental trauma | SDQ | 2 | Multiple-choice questions | Not validated |
|
Lecor et al. (2013) [38]; Sénégal | 162 (131 M; 31 F) | 25% between 1 and 5 years; 26% between 6 and 10 years; 7% between 16 and 20 years; 15% between 11 and 15 years; 15% more than 20 years; 2% less than 1 year | NM | 10% did not mention; 61% between 20–40 years; 33% between 41–60 years; 2% less than 20 years; 6 teachers did not mention | NM | MEQ | 3 | Multiple-choice | Not validated |
|
Panahi et al. (2014) [39]; Iran | 165 (86 M and 70 F) | 8 years’ work experiences | Primary schools | The mean age of the subjects was 32 years | NM | MEQ | 3 | Multiple choice questions | Partially validated |
|
Bahandary and Shetty (2014) [41]; India | 243 (165 M; 59 F) | 93% had more than 5 years teaching experience | NM | 41% were in the age group of 40–49 years | 94% had first-aid training. However, only 25% of them had training regarding management of dental trauma | MEQ | 3 | Close-ended | Partially validated |
|
Singh et al. (2015) [36]; India | 165 | NM | NM | NM | NM | SDQ | 3 | Multiple-choice | Not validated |
|
D’Assunção et al. (2015) [33]; Brazil | 103 | NM | NM | Over 18 years old | NM | MEQ | 3 | Open and closed, dichotomous and multiple choice | Not validated |
|
Anand et al. (2016) [43]; India | 60 (42 M; 18 F) | NM | NM | NM | NM | MEQ | 3 | Multiple-choice | Not validated |
|
Reference | Reporting | Knowledge Tool Validity | Total Score/14 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | ||
[26] | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 6/13 |
[37] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[42] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 7/14 |
[32] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 1 | 0 | 0 | 0 | 0 | 8/13 |
[35] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 8/13 |
[34] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[30] | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[40] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[31] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[38] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[39] | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | NA | 0 | 1 | 1 | 1 | 1 | 11/13 |
[41] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[36] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 1 | 0 | 1 | 0 | 9/13 |
[33] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 7/13 |
[43] | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | NA | 0 | 0 | 0 | 0 | 0 | 6/13 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Trabelsi, K.; Shephard, R.J.; Zlitni, S.; Boukhris, O.; Ammar, A.; Khacharem, A.; Khanfir, S.; Bragazzi, N.L.; Chtourou, H. Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions. Educ. Sci. 2019, 9, 251. https://doi.org/10.3390/educsci9040251
Trabelsi K, Shephard RJ, Zlitni S, Boukhris O, Ammar A, Khacharem A, Khanfir S, Bragazzi NL, Chtourou H. Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions. Education Sciences. 2019; 9(4):251. https://doi.org/10.3390/educsci9040251
Chicago/Turabian StyleTrabelsi, Khaled, Roy Jesse Shephard, Sahar Zlitni, Omar Boukhris, Achraf Ammar, Aimen Khacharem, Saber Khanfir, Nicola Luigi Bragazzi, and Hamdi Chtourou. 2019. "Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions" Education Sciences 9, no. 4: 251. https://doi.org/10.3390/educsci9040251
APA StyleTrabelsi, K., Shephard, R. J., Zlitni, S., Boukhris, O., Ammar, A., Khacharem, A., Khanfir, S., Bragazzi, N. L., & Chtourou, H. (2019). Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions. Education Sciences, 9(4), 251. https://doi.org/10.3390/educsci9040251