1 Introduction

Dental trauma (DT) refers to any injury to the teeth and their supporting tissues such as gums, alveolar bone, and periodontal ligaments [1]. Many factors, such as violent acts, accidents, and sports-related activities or falls, may play a significant role in the occurrence of these injuries [2]. DT has become an important global public health concern due to its high frequency and poor effects on the general health of individuals [3]. The acute effects of this condition manifest as bleeding, pain, and tooth loss, but the long-term continuation is functional compromise, poor appearance, and psychological stress [4]. Timely diagnosis and treatment of DT are essential to avoid such adverse consequences, but among the obstacles for this task is the need for dental care and health system limitations that differ considerably among regions [5].

In Southeast Asia, variations in healthcare systems and income disparities among countries are key contributors to the region's DT burden [6]. The 11 member countries of the Association of Southeast Asian Nations (ASEAN) collectively house over 650 million people, each with varying cultural, economic, and healthcare settings [7]. The area represents a mix of countries (with some close to rural areas and low-income level, along with others consisting mainly of urbanized cities and largely middle-income countries) [8]. Here, variations lead to a discrepancy in public health framework, professional accessibility, and care availability, which all control the incidence followed by reporting and managing dental trauma [3]. Furthermore, the occurrence of DT cases may jump with increasing industrialization, road traffic accidents in this area, and lifestyle factors like playing contact sports [9]. The trouble of DT in “Southeast Asia” is highly multifaceted and intricate, with cultural, socioeconomic, and environmental determinants affecting the epidemiological landscape of the region [10]. Previous studies have reported a high prevalence of dental trauma in children, with some zones showing high frequencies of 33% [3, 11]. The reasons for which these numbers are very high vary among the regions in the world but include more children participating in physical activities and outdoor sports now, less adult supervision, and low access to preventative measures or intervention as needed [12].

The DT is recognized to be common, but little is known about its prevalence in Southeast Asia [3]. Most of the countries in the region do not have organized DT surveillance systems, and data, if available, is distributed among academic research, hospital records, and school surveys at national or subnational levels [13]. Therefore, accurate and reliable data collection is essential to establish the true burden of DT in Southeast Asia, leading to the identification of ‘high risk’ populations, thus helping in planning preventive measures [14].

Pediatric dental trauma constitutes a significant public health issue in Southeast Asia, exacerbated by high traffic density, inadequate access to protective sports gear, and restricted availability of dental care, leading to a rise in trauma events among children [15]. In pediatric patients, trauma often results in the premature loss of primary teeth, potentially disrupting the natural progression of dental development. Premature tooth loss in children can influence jaw development, tooth alignment, and spacing, resulting in practical and esthetic consequences that may endure into adulthood. Traumatic loss of primary or permanent teeth in children can cause malocclusions. Premature loss of primary teeth disrupts the dental arch's natural spacing and alignment, causing crowding, midline shifts, and other misalignments that complicate orthodontic treatment. In addition to esthetic issues, malocclusions affect chewing efficiency and speech development, increasing the likelihood of adolescent orthodontic intervention [16].

The early identification and treatment of trauma-related dental injuries, especially in children, have been enhanced by developments in diagnostic technologies. More accurate evaluations of dental injuries are made possible by technologies like digital imaging, panoramic radiography, and cone-beam computed tomography (CBCT), which also lower the possibility of misdiagnosis and promote precise treatment planning [17]. In order to manage sequelae like malocclusions, early and correct diagnosis is essential since it enables prompt therapies that can avoid more serious crowding and misalignment problems. Disparities in care are caused by the fact that many rural and underprivileged parts of Southeast Asia still lack adequate access to these diagnostic instruments.

Surveillance systems are required not only to monitor incidence rates, but also to identify trends and direct public health policies and interventions. Governments can set up targeted preventative measures, deploy assets, and ensure that when a DT case is identified in response to effective surveillance, it is treated promptly [11]. Considering the complexity of healthcare systems and nonuniform resource allocation across Southeast Asia, its unified approach implies that much of DT could go underreported, especially in rural or underserved regions. The goal of this review is to navigate the available literature on the epidemiology of DT in Southeast Asia, identify key patterns, and highlight gaps in data reporting and management.

2 Methodology

3 Results

3.1 Selection of Study

A total number of 1589 publications were listed from the online databases: PubMed (n = 589), Scopus (n = 65), Web of Science (n = 446), and Google Scholar (n = 489). No additional articles were found through manual search. After eliminating 395 duplicate studies, 1194 studies remained for title and abstract screening. Following the evaluation, 1145 studies were excluded as they did not fulfill the inclusion criteria, resulting in 49 records for full-text review.

Out of the 49 records requested for retrieval, all were retrieved without any missing reports. However, 31 studies were excluded because the full reports were either inaccessible or did not align with the scope of the current review. Finally, a total of 18 articles were selected in the scoping review. The study selection process is illustrated in the PRISMA flowchart (Figure 1).

4 Discussion

The literature on the epidemiology of DT in Southeast Asia is relatively limited but diverse, with most studies focusing on specific populations or regions within individual countries. The included studies span multiple Southeast Asian countries, such as Malaysia, Thailand, Vietnam, Indonesia, and Singapore, and explore various age groups, with an emphasis on schoolchildren and adolescents.

This scoping review included a total of 18 studies, encompassing various study designs such as cross-sectional studies, retrospective record reviews, national oral health surveys, and prospective studies. The wide span of sample sizes, from large national surveys (e.g., 4085 participants in Nik-Hussein et al. [27]) to small cohorts (e.g., 35 participants in Luciana et al. [32]), highlights the diversity of the research area. The studies normally related to dental injuries occur from general trauma, motor vehicle accidents (MVAs), falls, and sports injuries, reflecting the wide spectrum of reasons related to dental trauma in Southeast Asia.

There is a perceptible geographic attentiveness to research, with Malaysia being the highest studied country, considered for 9 of the 18 included studies. Malaysian studies range from retrospective studies of hospital data [23, 30] to surveys of national oral health [27], indicating a huge focus on comprehension of the epidemiology of dental trauma. Other countries, such as Thailand, Indonesia, and Vietnam, have fewer studies, and Cambodia had only one study [22]. Notably, no studies were identified from Laos, Myanmar, or Brunei, which suggests significant gaps in the regional understanding of DT in these countries.

Most studies employed cross-sectional or retrospective record review designs, with only a few utilizing prospective study methods [25, 28]. Cross-sectional studies, such as those conducted by Malikaew et al. [19] in Thailand and Gopinath et al. [26] in Malaysia, provided a snapshot of DT prevalence in school-aged children, an age group at high risk for dental injuries. Retrospective studies often drew from hospital or clinic records to analyze the causes and demographics of dental injuries [10, 30], while national surveys offered insight into broader population-level trends [27].

The sample sizes of the studies varied significantly. For example, Lee et al. [10] studied 630 participants in Malaysia, while Nik-Hussein [27] examined a much larger sample of 4085 schoolchildren. These variations in sample size affect the generalizability of findings across the region. Furthermore, most studies examined specific subgroups within the population, primarily focusing on children and adolescents, particularly those aged 12–18 years [19, 26]. This focus on younger populations reflects the fact that dental trauma is most prevalent in this age group, as they are more likely to engage in physical activities that increase their risk of injury [35]. However, this emphasis may also leave gaps in understanding DT incidence in other high-risk populations, such as the elderly or individuals with specific occupations.

The epidemiological patterns of dental trauma in Southeast Asia exhibit significant variability across countries and populations. Several key findings can be drawn from the included studies regarding the incidence, prevalence, and risk factors associated with DT. The pervasiveness rates of DT in Southeast Asia differ widely and rest on the study design, country, and population. In Malaysia, pervasiveness rates start from 2.6% amidst 12–13-year-old school-going children [31] to 41.4% in a retrospective study of patients with dental injuries at Seremban Hospital [30]. Malikaew et al. in Thailand [19] reported a remarkable DT prevalence among primary school-going children (45.3% admits males and 25.2% admits females); on the other hand, Tumkosit [25] recorded a 9.3% prevalence among adolescents aged 11–18 years. Studies by Wibowo [33] in Indonesia, and Luciana et al. [32] saw even increased rates, mainly among individuals associated with motorbike accidents. A study by Wibowo [33] recorded that 46.5% of motorbike riders involved in traffic incidents sustained maxillofacial fractures, reinforcing the high risk of DT among this population. Hanh et al. in Vietnam [20] found a pervasiveness of 61.9% among males aged < 12 to > 18 years, depending on the avulsion of maxillary incisors, a usual form of DT.

The highest pervasiveness of dental trauma is detected in Malaysia, Thailand, and Indonesia, mainly in studies including motor vehicle accidents [30, 33]. The volatility in pervasiveness between rural and urban areas is another major pattern, as city areas report higher rates of DT, certainly due to higher participation in activities such as traffic-related incidents or sports. This finding was reinforced by Nik-Hussein [27], who reported a higher pervasiveness of traumatic injuries in urban areas compared to rural regions in Malaysia.

Studies recorded that dental trauma is more prevalent in the younger generation, mainly adolescents and children [19, 26]. This trend is ascribed to the reason that younger persons are more expected to engage in pursuits that higher their risk of injury, like participating in outdoor activities or playing sports. Additionally, studies reported that males are at increased risk of dental trauma compared to females [10, 25]. Such as Lee et al. [10] recorded that 85.4% of maxillofacial trauma cases in Sabah, Malaysia, took place among males, mainly those aged 21–30, escorted by motor vehicle accidents in the most common regions. MVAs are a crucial contributor to dental trauma in Southeast Asia. This is mainly obvious in countries like Indonesia, Cambodia, and Malaysia, where motorbike utilization is widespread. Multiple studies highlight the notable role of MVAs in donating to maxillofacial trauma, mainly amid young adult males [30, 33]. Roehler et al. in Cambodia, [22] related local road safety issues with the increased rate of DT, proposing that improving road safety could mainly lower DT incidence.

Another usual risk reason for dental trauma in Southeast Asia is involvement in sports, mainly contact sports like rugby. Abdullah et al. [29] reported a 27% prevalence of tooth fracture management along with storage media. These outcomes suggest the need for better preventive measures and awareness, like the use of mouthguards, mainly among athletes. The lack of standardization in dental trauma surveillance across Southeast Asia appears to be multifactorial. One major barrier is the absence of unified national policies or formal guidelines mandating routine data collection and reporting on DT. Without these frameworks, healthcare providers may not consistently document DT cases, resulting in fragmented or incomplete data. Additionally, resource limitations including inadequate funding for oral health programs, shortages of trained dental professionals, and a lack of digital health infrastructure further constrain the development of standardized reporting systems, especially in rural and underserved areas. Cultural and societal factors may also contribute; in many Southeast Asian countries, dental trauma is not widely recognized as a public health priority, and awareness of the importance of early intervention or preventive care remains low. These challenges collectively hinder the establishment of national DT registries and surveillance systems, emphasizing the need for targeted investment, policy development, and education to bridge existing gaps.

Multiple gaps in the literature along with the current practices of recording and managing dental trauma in Southeast Asia were recognized in this review. A significant gap in the existing literature is the absence of standardized dental trauma observation systems across Southeast Asia. A few countries, like Malaysia and Singapore, have somewhat organized systems in place to monitor as well as report dental trauma cases [21, 30]. Even in these countries, the recording mechanisms are initially hospital-based and fail to capture the full expanse of dental trauma in the general population, mainly in underserved or rural areas. The absence of a concentrated, standardized system for DT recording means that data on the occurrence and pervasiveness of DT are frequently fragmented, with few cases reported in hospital reports, others in school records, and still others in academic research studies. For example, in Vietnam, Hanh et al. [20] reported on a specific subset of dental trauma (avulsed teeth) among children, but there is no comprehensive national database to track other forms of dental trauma. The lack of a national or regional registry hinders efforts to accurately assess the burden of dental trauma and to implement effective public health interventions.

Another notable gap is the uneven distribution of research across Southeast Asia. As referred to earlier, the majority of studies involved in this review were supervised in Thailand, Indonesia, and Malaysia, and no studies were found in countries like Myanmar, Brunei, or Laos. This deficiency of research from a few Southeast Asian countries restricts the generalizability of records and advises that the true struggle of dental trauma in the area may not be reported accurately. The lack of research from some countries may be ascribed to various elements, including bounded resources for managing epidemiological studies, a dearth of trained individuals to manage trauma cases, along with a lower sort of oral health in the public health programs of these countries. Without more research from these underrepresented countries, it will be hard to develop an extensive grip on DT in Southeast Asia.

Specific studies illustrate these challenges. The Brunei Darussalam National Oral Health Survey (2014–2017) found a 9.1% overall DT prevalence among 5–15-year-olds, increasing with age and more common in boys. However, it lacked data on etiology and injury types [36]. A 2006 study (2006) in Vientiane, Laos, revealed similar age and gender trends (7% prevalence in 12-year-olds) and found that most injuries occurred during play or sports. Alarmingly, only 7% of Lao children with DT received treatment, highlighting unmet needs [37]. A 2009 study in Yangon, Myanmar, showed a 14.5% DT prevalence among 10–16-year-olds, with a staggering 99.5% of cases untreated [38, 39].

Several studies aimed to address gaps in the prevention and management of dental trauma. In 2015, Abdullah et al. [29] noted notable gaps in the understanding of tooth fracture management in rugby players. Sae-Lim and Yuen [21] reported that more acute forms of dental trauma, like injuries involving several teeth, were mostly inadequately treated or underreported. The lack of proper awareness and training in the management of DT is especially concerning in groups at high risk, such as individuals involved in motor vehicle accidents and athletes. Besides, the application of preventive actions, like mouthguards in sports, is not practiced widely across Southeast Asia. This gap in preventive care was focused on studies including schoolchildren and rugby players, where a large number of participants were ignorant of the outcomes of taking protective measures to prevent DT [26, 29].

Addressing pediatric dental trauma through protective strategies, including education on the importance of using mouthguards during sports and increasing parental awareness, is crucial to reducing the frequency and impact of early tooth loss in this population [40]. Furthermore, immediate post-trauma interventions, such as space maintenance, can help preserve the integrity of the developing dental arch and prevent complex orthodontic needs in later years. Early orthodontic evaluation is essential in children with a history of dental trauma to monitor any developmental deviations and address them proactively, thus reducing the complexity and cost of orthodontic treatment in adolescence. Providing accessible orthodontic assessments as part of routine trauma follow-up could be particularly beneficial in addressing alignment issues before they escalate [41]. By improving access to advanced diagnostic resources, countries in Southeast Asia can enhance early diagnosis, improve treatment outcomes, and prevent long-term complications associated with untreated pediatric dental trauma.

5 Conclusion

This scoping review underscores the significant burden of DT in Southeast Asia, with varying prevalence across the region due to socioeconomic disparities and inconsistent reporting. Countries like Malaysia, Thailand, and Indonesia show higher DT rates, particularly among children, adolescents, and motor vehicle accident victims, while data gaps remain in other nations of Southeast Asia. To address DT effectively, Southeast Asian countries must implement public health strategies focused on prevention, awareness campaigns, and healthcare provider training, particularly for high-risk groups. Future research should target gaps in rural areas and underserved countries to guide comprehensive DT management across the region.

Author Contributions

Mohmed Isaqali Karobari: writing – original draft, visualization, supervision, methodology, formal analysis, data curation. Niher Tabassum Snigdha: writing – review and editing, visualization, investigation, data curation. Mohammad Fareed: writing – review and editing, validation, investigation. Viet Hoang: writing – original draft, visualization, supervision, investigation, formal analysis, data curation, conceptualization. Thantrira Porntaveetus: original draft, visualization, supervision, investigation, formal analysis, data curation. Gowri Sivaramakrishnan: original draft, visualization, supervision, investigation, formal analysis, data curation. Anand Marya: writing-original draft, visualization, supervision, investigation, formal analysis, data curation, conceptualization.

Conflicts of Interest

The authors declare no conflicts of interest.