The Role of Environmental Determinants in Oral and Maxillofacial Trauma: Insights from a systematic Review

Background: Oral and maxillofacial trauma (OMFT) represents a substantial public health burden, with consequences extending beyond physical injury to include functional impairment, aesthetic concerns, and psychosocial distress. While individual-level and clinical risk factors have been extensively investigated, the influence of upstream environmental determinants remains insufficiently understood. This review aimed to synthesize current evidence on the association between physical, socioeconomic, and familial environmental factors and the occurrence of OMFT.

Methods: A comprehensive literature search was conducted across MEDLINE (PubMed), Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar without date restrictions. English-language observational studies examining environmental influences on OMFT were eligible for inclusion. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Prevalence Studies. Findings were synthesized narratively.

Results: Twenty-five observational studies from ten countries, published between 1982 and 2024, were included. Sample sizes ranged from 731 to 55,858 participants. The evidence demonstrated that physical environments, particularly schools and homes, constitute major settings for injury occurrence. Area-level socioeconomic disadvantage was consistently associated with a higher prevalence of OMFT, whereas supportive family environments were linked to reduced injury risk. Quality assessment indicated a low risk of bias across all included studies.

Conclusions: Environmental determinants play a significant role in shaping the risk and distribution of oral and maxillofacial trauma. By identifying physical, socioeconomic, and familial domains as key contributors, this review highlights opportunities for targeted prevention strategies and public health interventions. Future research should further investigate the mechanisms through which social and environmental determinants influence trauma outcomes and inform evidence-based prevention policies.