Epidemiology of Maxillofacial Injuries in Ontario, Canada

Published:December 27, 2014DOI:


      The aims of this study were to 1) calculate rates for maxillofacial (MF) injury-related visits in emergency departments (EDs) and hospitals in Ontario, Canada, 2) identify and rank common causes for MF injuries, 3) investigate the variation and trends in MF injuries according to gender, age, and socioeconomic status, and 4) describe the geographic distribution of MF injuries.

      Materials and Methods

      An 8-year retrospective study design was implemented. The Discharge Abstract Database and the National Ambulatory Care Reporting System datasets were used. After examining demographic and diagnostic information, frequencies, percentages, and rates were calculated. Color-coded maps were created using ArcGIS to display the geographic distribution of MF injuries.


      From 2004 through 2012, 1,457,990 ED visits and 41,057 hospitalizations occurred as a result of MF injury in Ontario. The mean age of patients for each ED visit was 30.6 years and for each hospitalization was 52.6 years. Rates of ED visits and hospitalizations owing to MF injury show a slight decrease during the 8-year period. MF injuries were most frequent in the evening, during the weekends, and during the summer. Falls were reported as the leading cause of MF injuries. Rural areas had higher rates of ED visits and hospitalizations.


      This study highlighted the public health impact of MF injuries, offering policy makers important epidemiologic information, which is fundamental to formulate and optimize measures aimed at protecting Canadians from injuries that are largely predictable and preventable. Future injury prevention programs should enhance the population-based approach and focus on high-risk groups such as male youth and elderly women in low-income families.
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        • Locker D.
        Prevalence of traumatic dental injury in grade 8 children in six Ontario communities.
        Can J Public Health. 2005; 96: 73
        • Shahim F.N.
        • Cameron P.
        • McNeil J.J.
        Maxillofacial trauma in major trauma patients.
        Aust Dent J. 2006; 51: 225
        • Goodisson D.
        • MacFarlane M.
        • Snape L.
        • et al.
        Head injury and associated maxillofacial injuries.
        N Z Med J. 2004; 117: U1045
        • Hayter J.P.
        • Ward A.J.
        • Smith E.J.
        Maxillofacial trauma in severely injured patients.
        Br J Oral Maxillofac Surg. 1991; 29: 370
        • Gassner R.
        • Tuli T.
        • Hächl O.
        • et al.
        Cranio-maxillofacial trauma: A 10 year review of 9,543 cases with 21,067 injuries.
        J Craniomaxillofac Surg. 2003; 31: 51
        • Hogg N.J.
        • Stewart T.C.
        • Armstrong J.E.
        • et al.
        Epidemiology of maxillofacial injuries at trauma hospitals in Ontario, Canada, between 1992 and 1997.
        J Trauma. 2000; 49: 425
        • Sojot A.J.
        • Meisami T.
        • Sandor G.K.
        • et al.
        The epidemiology of mandibular fractures treated at the Toronto general hospital: A review of 246 cases.
        J Can Dent Assoc. 2001; 67: 640
        • Quiñonez C.
        • Gibson D.
        • Jokovic A.
        • et al.
        Day surgery visits for dental problems.
        Community Dent Oral Epidemiol. 2009; 37: 562
        • Quiñonez C.
        • Gibson D.
        • Jokovic A.
        • et al.
        Emergency department visits for dental care of nontraumatic origin.
        Community Dent Oral Epidemiol. 2009; 37: 366
        • Quiñonez C.
        • Ieraci L.
        • Guttmann A.
        Potentially preventable hospital use for dental conditions: Implications for expanding dental coverage for low income populations.
        J Health Care Poor Underserved. 2011; 22: 1048
        • CIHI
        Coding Standards for Version 2009 ICD-10-CA and CCI, Revised September 2009.
        Canadian Institute for Health Information, Ottawa, ON, Canada2009
        • CIHI
        Products and Services Guide, 2011-2012.
        Canadian Institute for Health Information, Ottawa, ON, Canada2011
        • Macpherson A.K.
        • Schull M.
        • Manuel D.
        • et al.
        Injuries in Ontario. ICES Atlas.
        Institute for Clinical Evaluative Sciences, Toronto, ON, Canada2005
        • Al Ahmed H.E.
        • Jaber M.A.
        • Abu Fanas S.H.
        • et al.
        The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: A review of 230 cases.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 166
        • Lim L.H.
        • Kumar M.
        • Myer C.M.
        Head and neck trauma in hospitalized pediatric patients.
        Otolaryngol Head Neck Surg. 2004; 130: 255
        • Hung Y.C.
        • Montazem A.
        • Costello M.A.
        The correlation between mandible fractures and loss of consciousness.
        J Oral Maxillofac Surg. 2004; 62: 938
        • Olson R.A.
        • Fonseca R.J.
        • Zeitler D.L.
        • et al.
        Fractures of the mandible: A review of 580 cases.
        J Oral Maxillofac Surg. 1982; 40: 23
        • Motamedi M.H.
        An assessment of maxillofacial fractures: A 5-year study of 237 patients.
        J Oral Maxillofac Surg. 2003; 61: 61
        • Rajendra P.B.
        • Mathew T.P.
        • Agrawal A.
        • et al.
        Characteristics of associated craniofacial trauma in patients with head injuries: An experience with 100 cases.
        J Emerg Trauma Shock. 2009; 2: 89
        • Hu G.
        • Baker S.P.
        Recent increases in fatal and non-fatal injury among people aged 65 years and over in the USA.
        Inj Prev. 2010; 16: 26