Mandible fracture severity may be increased by alcohol and interpersonal violence
Version of Record online: 30 MAY 2011
© 2011 Australian Dental Association
Australian Dental Journal
Volume 56, Issue 2, pages 166–170, June 2011
How to Cite
O’Meara, C., Witherspoon, R., Hapangama, N. and Hyam, D. (2011), Mandible fracture severity may be increased by alcohol and interpersonal violence. Australian Dental Journal, 56: 166–170. doi: 10.1111/j.1834-7819.2011.01319.x
- Issue online: 30 MAY 2011
- Version of Record online: 30 MAY 2011
- (Accepted for publication 3 August 2010.)
- facial trauma;
- mandible fracture
Background: Alcohol as a cofactor in interpersonal violence (IPV) has been established by studies from a number of countries. This study aimed to determine if alcohol was a cofactor in the incidence or severity of mandible fracture.
Methods: A prospective study of mandible fracture patients presenting for oral maxillofacial review over 16 months was completed. Injury severity was assessed utilizing the Mandible Injury Severity Score (MISS).
Results: A total of 252 facial trauma cases presented to our tertiary referral centre, 83 with fractures of the mandible. The majority of presentations were secondary to IPV (n = 54, 65.06%), 49 (90.74%) of these cases involved alcohol. Overall, alcohol was involved in 63.85% of cases (n = 53). The relative risk of requiring surgical intervention with alcohol involvement was 2.68 (CI = 1.11–9.47). Alcohol significantly increased facial fracture severity for MISS: alcohol (n = 53) 13.07 ± 5.01, no alcohol (n = 30) 11.03 ± 4.87 (p < 0.05). IPV also increased facial fracture severity for MISS: IPV (n = 54) 13.09 ± 4.90, non-IPV (n = 29) 11.00 ± 4.81 (p < 0.05). The angle of the mandible was most commonly fractured (40.5% of cases).
Conclusions: Mandible fracture patients, whose injury is a result of IPV, have more severe fractures and a higher likelihood of requiring surgery if alcohol is involved. This correlates to a higher surgical workload, economic and social burden to the community. Primary alcohol and IPV prevention strategies will play an important role in reducing mandible fracture.