Management Of Traumatic Dental Injuries Research Articles

Dental trauma: assessment and acute management of fractures.

Acute dental trauma is unscheduled and presents infrequently to the majority of practitioners. Therefore, a consistent, logical and systematic process for examination, prioritisation and management is imperative for all sustained injuries to have an optimal outcome. Fractures are a frequent sequela to dental trauma and can involve any aspect of the tooth structure or supporting alveolar bone. While some minor crown fractures may initially seem inconsequential, they may be a subtle indication to a more serious underlying root fracture. Concomitant injuries and injuries that have been initially missed are generally associated with poorer outcomes. The time sensitive management of traumatic dental injuries aims to preserve pulpal and periodontal health where possible. The follow up period for tooth or alveolar fractures are important to allow for early intervention if pathology develops.

International teaching practices in dental trauma education.

Several publications highlight the insufficient knowledge possessed by dentists and dental students regarding the management of traumatic dental injuries (TDIs). A lack of clinical experience during Undergraduate (UG) education could explain the reported deficits in managing dental trauma post-graduation. Despite its importance in dentistry, there are very few reports on how, where and who teaches Dental Traumatology (DT) in the UG curriculum. The aim of this study was to investigate teaching practices in DT around the world in UG education. UG educators involved in DT teaching activities were invited to complete an online questionnaire hosted on Qualtrics®. The survey consisted of close-ended and open-ended questions on their teaching practices in DT. Only one answer per institution was included in the final descriptive analysis. A total of 203 responses from 164 institutions were obtained from 69 countries. All institutions reported that DT is included in their UG curriculum, and is mainly taught within Paediatric Dentistry and Endodontics. Most teaching and evaluation was delivered in traditional format. The number of contact hours dedicated to DT teaching activities ranged from 2 to 185 h (median = 10). Only 35% of institutions had a unified approach across disciplines. DT was taught as a separate course/module in 23% of the universities. Insufficient exposure to emergency care and the lack of formal clinical exposure to TDI was highlighted by many institutions. The need for a core curriculum was supported by 84% of the institutions with agreement on essential topics required at UG level. Teaching practices in DT varied internationally. Very few teaching hours were devoted to DT and many institutions identified a need for increased clinical exposure. There was a desire for a standardised coherent approach to DT in the UG education with suggestions to improve educational resources.

Emergency and sequalae management of traumatic dental injuries: a systematic survey of clinical practice guidelines

BackgroundThe prevalence and consequences of traumatic dental injuries (TDI) make them a public health problem. Trustworthy TDI clinical practice guidelines (CPGs) assist clinicians in determining a diagnosis and guide them to the most appropriate therapy. The aim of this systematic survey was to identify and evaluate the quality of CPGs for the diagnosis, emergency management, and follow-up of TDIs.Materials and methodsA systematic search was carried out in MEDLINE, EMBASE, Epistemonikos, Trip database, CPG websites, and dental societies to identify documents providing recommendations for the emergency and sequelae management of TDIs. Reviewers assessed the included guidelines independently and in duplicate, using the AGREE II instrument. ANOVA or Student’s t-tests were used to determine the attributes of CPGs associated with the total score in AGREE II.ResultsTen CPGs published between 2010 and 2020 were included, mostly from Europe (n = 6). The overall agreement between reviewers was very good (0.94; 95%CI 0.91–0.97). The mean scores (the higher the score, the better the domain assessment) per domain were as follows: Scope and purpose 78.0 ± 18.9%; stakeholder involvement 46.9 ± 29.6%; rigour of development 41.8 ± 26.7%; clarity of presentation 75.8 ± 17.6%; applicability 15.3 ± 18.8%; and editorial independence 41.7 ± 41.7%. The overall mean rate was 4 ± 1.3 out of a maximum score of 7. Two guidelines were recommended by the reviewers for use in practice and rated as high quality. CPGs developed by government organizations showed a significantly higher overall score.ConclusionsThe overall quality of CPGs on TDI was suboptimal. CPG developers should synthesize the evidence and formulate recommendations using high-quality methodologies and standards in a structured, transparent, and explicit way.

Comparative assessment of scientific reach and utilization of the International Association of Dental Traumatology 2020 guidelines: An altmetric and citation analysis.

The updated version of the International Association of Dental Traumatology (IADT) guidelines was published online in May 2020 in the form of four papers. They are extensively used in dental trauma education in textbooks, undergraduate and postgraduate programs, and clinical workshops. Hence, this study aimed to assess the impact, global scientific reach, and utilization of these guidelines through altmetric and citation analysis. The protocol was prepared after an expert group discussion. Dimensions database was used to derive the altmetric and citation data on April 10th, 2023. The data was extracted by using a self-designed pre-piloted form by two authors independently. The citing articles were further categorized into the type of study and the domains and subdomains of dental traumatology. The VOSviewer program was utilized to explore the correlation between the subdomains and the overlap of citations was assessed by creating a citation matrix. A total of 552 citations had been collectively received by the four papers. The highest was seen for the guidelines for fracture and luxation in permanent teeth (FL), avulsion in permanent teeth (AV), general introduction (GI), and primary teeth (PT). Dental Traumatology had the maximum number of citing papers for each guideline. They were from 52 countries with English being the commonest language. Overall, the maximum number of citations had been received in narrative reviews (n = 104) and the majority of cited papers were categorized in the therapeutic domains. The most common subdomain for the papers that cited GI, FL, and AV was "treatment protocols in permanent teeth", while it was "awareness of prevention and emergency management of traumatic dental injuries" for the papers that had cited PT. This analysis highlighted that the IADT 2020 guidelines are globally popular resources, which are widely used by the researchers across specialities and are intended towards clinical application.

Assessment of Elementary School Teachers’ Knowledge of and Attitude toward the Management of Traumatic Dental Injuries in Makkah

Background: Traumatic dental injuries (TDI) to primary and permanent teeth are not uncommon in children. Almost half of TDI in children occur at schools and the prognosis is time dependent. Hence, the teacher’s knowledge towards management of TDI is important. The aim of this study is to assess the knowledge and attitude of female elementary school teachers in Makkah, regarding the management of TDI. Methods: This is a descriptive cross-sectional questionnaire-based study, designed using Google forms to collect information from 350 female elementary school teachers from randomly selected schools in Makkah. The questionnaire collected data on participants’ demographic characteristics, knowledge, and attitude towards management of TDI. Results: 265 teachers participated in this study. 66.8% of the participants had positive attitude towards moral responsibility regarding the management of TDI. 63.4% of the participants lacked the proper knowledge regarding the management of TDI and 74.6% did not know the best storage media for an avulsed tooth. 60.7% of the participants were not satisfied with their knowledge, yet 94% had a positive attitude towards improving their knowledge. Conclusions: Female elementary school teachers in Makkah, showed insufficient knowledge but a positive attitude and willingness towards improving their level of knowledge regarding management of TDI. Hence, strategies to improve teachers’ knowledge about TDI must be planned and implemented.

Çocuk diş hekimliği kliniğine travmatik diş yaralanmaları nedeniyle başvuran hastaların değerlendirilmesi: retrospektif bir çalışma

Purpose: The purpose of this study was to evaluate the prevalence of traumatic dental injuries (TDIs), as well as to evaluate different factors associated with TDIs among children and adolescents referred over three-year period to the Pamukkale University, Faculty of Dentistry, Department of Pediatric Dentistry, Denizli. 
 Materials and methods: Dental trauma records of patients were reviewed regarding demographic data, affected teeth, type and etiology of TDIs, location and season of TDIs, time elapsed following TDIs and initial treatment, and treatment of TDIs.
 Results: Data associated with 258 patients, 471 traumatized teeth (primary teeth:152, permanent teeth:319) were analyzed. Both the primary and permanent maxillary central incisors were the most common affected teeth by TDIs. Primary teeth showed a higher frequency of periodontal tissue injuries (75.00%) and lower frequency of dental hard tissue injuries (21.05%) compared with permanent teeth (49.84% and 58.62%, respectively). Falls were the main etiological factor of TDIs both in the primary (73.68%) and permanent (58.31%) teeth. Only 27 patients (5.49%) were referred to the clinic within one hour following TDIs. 
 Conclusion: Early management of TDIs is important to improve the prognosis of traumatized teeth and prevent post-traumatic complications. The low rate of early referral indicates the need for educational and preventive programs regarding TDIs among the patients, parents/legal guardians, and teachers.

Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey.

Orthodontic treatment of patients with traumatic dental injuries is challenging, with limited evidence of routines and outcomes. The aims of this study were: (i) to describe how orthodontists perceive the information on traumatic dental injuries received by referral from the Public Dental Health Service before orthodontic treatment and (ii) to assess orthodontists' knowledge and working routines in managing traumatic dental injuries. Data were obtained through a survey of all practicing orthodontists registered as members of the Norwegian Association of Orthodontists (n = 203). Eighty-three orthodontists were enrolled, most of whom had received their dental degree (73.0%) and specialist orthodontic training (88.5%) in Norway. They reported examining patients with a history of traumatic dental injury at weekly (34.2%) or monthly (38.0%) basis. In 85.5% of cases, they obtained a history of traumatic dental injury from patients. Half of the respondents (51.3%) favoured two-phase early orthodontic treatment for patients with an overjet ≥6 mm. The observation time and treatment strategy showed considerable discrepancies across traumatic dental injury diagnoses. Most (59.1%) orthodontists considered the information on previous traumatic dental injuries provided by the Public Dental Health Services referral 'inadequate', more commonly in cases of mild (83.5%) than severe (57.5%) traumatic dental injuries. Orthodontic management of patients with traumatic dental injuries was characterised by lack of uniformity in both recommended observation time before orthodontic treatment and management strategy. The referral routines by the Public Dental Health Services for patients with traumatic dental injuries were perceived as 'inadequate' in terms of frequency and quality. The results indicate the requirement of standardisation of routines related to orthodontic management of traumatic dental injuries and referral routines by the Public Dental Health Services.

Global status of knowledge of parents for emergency management of traumatic dental injuries: a systematic review and meta-analysis.

The protocol was developed as per the recommendations of the Cochrane-handbook and PRISMA and was registered in PROSPERO. Search was performed by using MeSH-Terms and keywords in PubMed, Scopus, Embase, Web of Sciences, Lilacs, and Cochrane databases and gray literature sources 15th July 2022. There were no limits regarding the year of publication and language. Hand-searching of included articles was also performed. Titles and abstracts and later full texts were screened as per strict inclusion and exclusion criteria. Self-designed pilot-tested form was used. Risk of bias was analyzed through Joanna-Brigg's-Institute's-critical appraisal checklist. The evidence analysis was done by using the GRADE approach. Qualitative synthesis was performed for describing the study characteristics, details of sampling, and results of various questionnaires. It was discussed by the expert group and presented using KAP heat map. Meta-analysis was done by using Random Effects Model. The risk of bias was found to be low in seven and moderate in one study. It was observed that >50% of parents knew about the urgency to seek professional advice after TDI. Only <50% of parents were confident of their ability to identify the injured tooth, clean the soiled avulsed tooth, and perform the replantation. Appropriate responses regarding immediate action after tooth avulsion were given by 54.5% (95% CI: 50.2-58.8, p = 0.042) of parents. The knowledge of the parents regarding the emergency management of TDI was found to be inadequate. The majority of them were interested in obtaining information about dental trauma first aid.

Evaluation of Knowledge and Practice of Resident Dentists in Iasi, Romania in the Management of Traumatic Dental Injuries: A Cross-Sectional Study.

Dentists play an essential role in the treatment of dental and periodontal traumatic injuries by providing early and correct treatment. The purpose of the present study was to assess the level of knowledge of dental residents regarding dental trauma. The cross-sectional study was conducted at the Faculty of Dental Medicine within the "Grigore T. Popa" University of Medicine and Pharmacy in Iasi, Romania on a sample of 366 residents in General Dentistry, Pediatric Dentistry and Periodontology. To assess their knowledge, a questionnaire was created containing 18 questions about the clinical signs and therapy of dental trauma, with a focus on tooth avulsion. A very low level of knowledge (<25%) was found only for the type of splinting required to maintain an avulsed tooth on the arch. The highest number of correct answers was provided by the residents in Periodontology. Physiological serum as storage medium was recognized by a percentage of 75.9-80% of the subjects, and 60-77% of them recognized pulp necrosis as complication of dental avulsion. The study underlines the need to introduce in the curriculum of all categories of residents additional information, not only in the already existent theoretical form, but also as possible scenarios of various clinical situations.

Perceptions of emergency department physicians regarding the management of traumatic dental injuries.

The purpose of this study was to investigate the self-reported confidence level and education of Atlantic Canada emergency department physicians in the management of traumatic dental injuries and to assess the need for further education surrounding the management of dental trauma. An 18-item survey was developed and distributed electronically to physicians by their respective provincial medical associations. Traumatic dental injuries were reported in the emergency department on a weekly basis (78%). Most respondents reported that they were somewhat confident (51%) or very confident (7%) in managing traumatic dental injuries. Physicians' years in practice correlated positively with self-reported confidence levels in managing dental trauma. Urban and rural emergency department physicians reported similar levels of access to general dentists (38% and 30%, respectively); however, urban emergency department physicians reported greater access to pediatric dental specialists (43%) and oral and maxillofacial surgeons (81%) than rural practicing colleagues (4% and 30%, respectively). Most emergency department physicians (85%) agreed that it was important to receive training on the management of traumatic dental injuries and reported that education on managing traumatic dental injuries during residency (37%) and access to a dental trauma decision-making pathway (30%) would be of most value. This study highlights the role of emergency department physicians as first responders and demonstrates opportunities for improvement in the initial management of traumatic dental injuries. These implications can be achieved through the incorporation of further training in emergency medicine residency programs and through the implementation of decision-making pathways in emergency departments.

Management of traumatic dental injuries: a survey of paediatric emergency department health professionals

ObjectiveTo assess paediatric emergency department (PED) health professionals’ confidence, experience and awareness in managing traumatic dental injuries (TDIs).DesignA cross-sectional online survey.SettingPED at Alder Hey Children’s Hospital and Birmingham Children’s Hospital.Results94...

Evaluation of the Effectiveness of an Educational Intervention Program on Knowledge, Attitude and Practice among School Teachers Regarding Management of Traumatic Dental Injuries in Mangaluru City

Background Traumatic dental injuries can have an adverse effect on a childrsquos psychological functional and aesthetic well-being.Aim To assess school teachers knowledge attitude and practice KAP with reference to emergency management of traumatic dental injuries before and after an educational intervention.Method The current study was a questionnaire-based interventional study conducted in three phases among 300 school teachers of government state and CBSE schools in Mangaluru. Total 20 self-structured questions were included in the survey which was given in both English and a regional language. Kannada. Following a baseline survey an informative lecture on dental trauma and its management was given in the second phase and a follow-up survey was conducted after six months to assess the outcome.Results During the preliminary phase teachers from all schools showed a dearth of KAP regarding dental trauma and its management. Significant growth in the mean knowledge p0.000 attitude p0.000 and practice p0.000 scores was observed after the intervention as compared to knowledge scores at baseline in all the schools.Conclusion There is a lack of knowledge among teachers with reference to emergency management of dental trauma and educational programs must be implemented to improve knowledge.

Elementary school teachers' knowledge and attitudes toward emergency management of traumatic dental injuries.

The consequences of traumatic dental injuries can be even more serious when their emergency management procedures are inadequate. Since traumatic accidents frequently occur at school, it is crucial that teachers be knowledgeable enough to assist an injured child. This study aimed to assess the knowledge and attitudes of the elementary school teachers of a Brazilian city toward dental trauma in permanent teeth, and its emergency practices. A combination of convenience and snowball sampling methods was used. An online questionnaire was distributed through social media, consisting of three parts: demographic characteristics and professional information; previous experiences and attitudes toward dental trauma; teachers' knowledge of this subject. Descriptive and statistical analyses were carried out. Pearson chi-squared test (p < 0.05) was used. A total of 217 teachers participated in the study. The power of the sample was 95%. Half of the teachers had already witnessed a dental trauma incident involving students, and 70.5% never received any information on the subject. The teachers who were provided previous information were the ones who opted to search for the tooth fragment (p=0.036) in cases of crown fracture, and for the lost tooth (p = 0.025) in cases of avulsion. They were also the ones who chose to wash the tooth in running water (p = 0.018), and look for a dentist in the first 30 or 60 minutes after the trauma (p = 0.026). Most of the teachers assessed did not have adequate knowledge of dental trauma. Having previous information was associated with more assertive practices in trauma management.

Evaluation of educational needs assessment and management of dental traumas in primary school teachers, in Iran and worldwide: A systematic review

Background: Every year, many primary school children suffer from dental trauma. The long-term success of treatment depends on immediate emergency care and initial professional management after the injury occurs. Therefore, primary school teachers can play an important role in the management of traumatic dental injuries (TDIs). As no systematic review has been conducted on this subject in Iran, the present study aimed to investigate the educational needs assessment and management of dental trauma in primary school teachers in Iran and in other countries. Methods: In this systematic review, four main electronic databases, PubMed, Web of Science, Scopus, and Google Scholar, were examined with keywords derived from MESH and by designing a detailed search strategy. The studies were then transferred to EndNote software version 20 and screened based on preferred reporting items for systematic reviews and according to the study input criteria. Then, the selected studies were reviewed to extract the data based on the objectives of the study. Results: Eventually 19 studies were included in the final review phase out of the 774 studies obtained during the systematic search. Five of these studies were specific to Iran. The present study showed that the knowledge of primary school teachers about managing dental traumas is insufficient, and it is necessary to train them on appropriate trauma management to improve their ability and performance. Conclusion: There are gaps in the management of dental traumas that confirm the need for effective education and intervention to improve the knowledge, performance, attitude, and ability of teachers.

Undergraduate dental students' perception of paediatric dental teaching in an urban and rural Australian dental school.

Confidence in performing paediatric dental treatment is important as it ensures better oral health outcomes in the patient's adulthood. To investigate the confidence and attitudes of final year dentistry students, attending an urban and rural dental programme, towards their paediatric dentistry training. A questionnaire was distributed to final year dentistry students at the urban-based university, The University of Queensland, and at the rural-based university, La Trobe University. The questionnaire collected information using 5-point Likert scale and short-answer questions, which explored the theoretical, observational, preclinical and clinical aspects of students' paediatric dentistry training. Jamovi and GraphPad Prism were used for data analysis and the creation of graphs. The questionnaire was completed by 32 rural students and 47 urban students, with a response rate of 79%. Rural students were found to be less confident with the theory on restorative procedures than urban students. Observations of a dentist performing treatment on child were completed by a significantly larger proportion of urban students (70.2%) than rural students (46.9%). Students from both universities reported to have developed the least confidence in the preclinical training of pulp therapies and expressed the need for additional preclinical sessions for more training. At both universities, students indicated they were the least confident in the clinical practice of pulp therapies and management of traumatic dental injuries. Urban students were found to be more confident than their rural counterparts in the clinical practice of examination, treatment planning and preventative procedures, as well as in restorative procedures. Both urban and rural students were found to have the least confidence in preclinical and clinical skills related to pulp therapies. Restorative dentistry was an area in which urban students were significantly more confident than rural students in both the theoretical and the clinical aspects.

Mothers’ knowledge and self-reported performance regarding the management of traumatic dental injuries and associated factors: a cross-sectional study

BackgroundDental trauma is common among children. It has negative effects on a child’s quality of life. Parental knowledge, especially among mothers is an important factor for the long-term success of this emergency. This study aimed to investigate mothers’ knowledge and self-reported performance regarding the management of traumatic dental injuries and associated socio-demographic factors.MethodsIn this cross-sectional study, 277 mothers of children (8–12 years) attending the pediatrics department of Alborz dental school were studied by convenience sampling. The participants completed a valid reliable questionnaire about the management of traumatic dental injuries. The predictor variables were the child’s gender, maternal education and employment status, economic status, and accommodation status. The outcome variables were the mothers’ knowledge about the management of traumatic dental injuries (Eight statements with 10 scores) and self-reported performance including four case scenarios of traumatic dental injury (Five questions with 7 scores). Data were analyzed by T-test or One-way ANOVA to test the within-group changes, Pearson’s correlation coefficient and Linear multiple regression to examine the effect of predictor variables on maternal knowledge and self-reported performance.ResultsThe mean score of mothers’ knowledge was 3.43; SD = 1.58 (total score ranged from 0 to 10). The mean score of mothers’ performance was 3.38; SD = 1.2 (total score ranged from 0 to 7). Mothers who work (p < 0.001) and mothers with high qualifications (p < 0.001) had higher knowledge. Furthermore, mothers who work (p = 0.011), mothers with high qualifications (p < 0.001), and those who have had previous experience with traumatic dental injuries (p < 0.001) had higher self-reported performance. The results of multiple linear regression analysis demonstrated the association between mothers’ knowledge with mothers’ education (β = 0.22, p = 0.001) and mothers’ employment status (β = 0.15, p = 0.017), while there is a relationship between mothers’ self-reported performance and mothers’ education (β = 0.27, p < 0.001).ConclusionSince the means of mothers’ knowledge and performance scores regarding dental trauma management, were less than half of the obtainable scores as well as mothers have a crucial role in the children’s oral health, it is important to increase the mothers’ knowledge and improve their performance in this context. Therefore, running educational programs is necessary for this respect.

The importance of establishing a core outcome set for endodontic clinical trials and outcomes studies.

Endodontic therapy aims to preserve teeth by preventing and treating apical disease, therefore, evaluation of treatment outcome in clinical trials and outcomes studies should effectively assess if it achieves these aims. Traditionally, treatment outcomes have been reported by clinicians after history and clinical examination in what is known as clinician-reported outcomes (CROs). Much less commonly employed however, are patient-reported outcomes (PROs) in which patients directly report on their condition. Endodontic treatment outcome reporting is evolving from a focus on CROs to increasing consideration for patient and disease-focused outcomes, with different criteria being proposed for assessment of treatment outcomes. Unfortunately, this has led to considerable variability and a lack of consensus on the definition, appropriate measurement and reporting of these outcomes. Heterogeneity in outcome reporting in clinical research provides a significant major barrier to conduct meta-analysis, guidelines development, clinical decision making, and ultimately affecting patient care. These effects could, however, be reduced by the establishment of a core outcome set (COS) in endodontics, which is defined as an agreed, standardized set of outcomes that should be included, measured and reported as a minimum in all trials and outcome studies. COS development is a regulated and validated process requiring involvement of appropriate stakeholders as well as a rigorous methodology. To date, COS has been developed for the management of traumatic dental injuries, orthodontic and periodontal treatment and is currently being developed for endodontic treatment. The aim of this review is to discuss the importance of COS in endodontics with focus on the evidence for and impact of heterogeneity in reporting endodontic treatment outcomes. An overview of an ongoing process for development of COS for different endodontic treatment modalities will also be provided.

KNOWLEDGE OF SCHOOL PROFESSIONALS REGARDING EMERGENCY MANAGEMENT OF DENTAL AVULSION BEFORE AND AFTER THE CONDUCTION OF AN AWARENESS PROGRAM: A CROSSSECTIONAL STUDY

Background: Avulsion is one of the most serious dental injuries due to its implications for tooth loss and sequelae following treatment. Most dental accidents in children occur at home, followed by the school therefore, rst aid provided by school professionals and other school staff must be appropriate for the management of traumatic dental injury as it plays a major role in improving the prognosis. The study aims to assess the gain in knowledge of school profes Aim: sionals before and after the conduction of an awareness program regarding the emergency management of dental avulsion in Lucknow District. A cross-sectional, Materials and methods: questionnaire-based observational study was conducted in various schools in Lucknow. The questionnaire collected information on school professionals' education level, demographic characteristics, rst-aid training, and attitudes towards emergency management of dental avulsion before and after the conduction of an awareness program. 200 school professionals completed Results: the questionnaire and knowledge about tooth avulsion was inadequate, and rst aid training was not associated with correct responses to the management of avulsed teeth. A signicantly higher percentage of school professionals expressed the need for future education in dental trauma avulsion management. However, after the conduction of an awareness program comparatively higher percentage of school professionals reported having gained knowledge regarding the emergency management of dental avulsion. Considering that there is a lack of knowl Conclusion: edge among school professionals regarding emergency management of dental avulsion, educational programs can prove to improve knowledge and awareness among school professionals.

Knowledge and Attitudes of Saudi Medical Students about Emergency Management of Traumatic Dental Injuries.

Several studies indicate that physicians lack emergency management knowledge concerning traumatic dental injuries (TDIs), emphasizing the fact that medical students are not taught about this topic. This study aimed to assess the basic knowledge and attitudes of medical students in Saudi Arabia about emergency TDI management. This cross-sectional study recruited a convenience sample of medical students in their clinical years through social networking sites and asked them to answer a pretested internationally accepted questionnaire that included demographic questions, two case scenarios about crown fractures and avulsion of permanent teeth, and self-assessment questions. The data were analyzed statistically using descriptive statistics and the chi-squared test (p < 0.05). A total of 761 medical students responded. Only 5.8% of the students reported receiving information about TDIs in their curriculum. Medical students, mainly those ready to graduate, were more knowledgeable of the emergency management of a crown fractured permanent tooth than an avulsed permanent tooth (p < 0.0001). However, more than half of the students were unable to differentiate between a primary versus permanent fractured tooth and would manage an avulsed primary or permanent tooth similarly. Regarding students' attitudes, less than one-quarter of the students (13.5%) were confident about diagnosing TDIs and/or providing emergency management when required (18.1%). Furthermore, only about one-tenth of the students (9.3%) were satisfied with their self-perceived knowledge, and most (71%) reported needing further education about the topic. Medical students in Saudi Arabia have insufficient knowledge about the emergency management of TDIs. Gaps in students' knowledge of emergency management of avulsion injury were identified in addition to their low confidence level to either diagnose or immediately treat TDIs if required. Students felt dissatisfied with their current knowledge level, this being most prominent among graduating students. There is a need to elaborate the undergraduate medical curriculum in Saudi Arabia to include emergency management of TDIs.

Knowledge, Attitude, and Practices (Kap) Survey on the Management of Traumatic Dental Injuries (Tdis) among Dental Students in Prince Sattam Bin Abdulaziz University (Psau), Alkharj.

Background:Traumatic dental injury (TDI) is described as a lesion of variable extension, intensity, and severity caused by forces acting on teeth due to falls, fights, traffic accidents, collisions against objects or people, and para-function and/or as a result of an assault. Appropriate treatments of TDIs can improve the outcome chance and reduce stress and anxiety for both patients and the dental team. Despite the importance of this topic, there remains a paucity of evidence on the current situation of TDI management among dental students in Prince Sattam bin Abdulaziz University.Objectives:To assess the knowledge, attitude, and practice (KAP) of dental students about the management of TDIs and compare the knowledge according to the year of study.Methodology:A KAP survey was conducted on undergraduate dental students at Prince Sattam bin Abdulaziz University dentistry college. All clinical dental students (4th–5th year) and interns enrolled during the 2019–2020 academic year were invited to participate in the study (n = 92). Participants filled out a questionnaire containing 16 items related to KAPs toward the management of TDIs.Results:The majority of fifth-year students (78.8%) and interns (70.8%) perceived that TDIs have the priority to be seen as an urgent case, compared to only 45.7% of fourth-year students (P = 0.013). Also, more than half of study participants reported not following any protocol for TDIs with no significant differences between study years. Furthermore, 69.7% of fifth-year students and 66.7% of interns considered the Hanks-balanced solution as the best medium for storing an avulsed permanent tooth.Conclusion:The current results demonstrated a significant shortage in the KAP toward TDI management among dental students in Prince Sattam bin Abdulaziz University. Almost half of the students (45.7%) did not know any guidelines for the treatment of TDIs. The majority of study participants had no exposure to any previous workshops, symposiums, or conferences about managing TDIs, which makes it more difficult for them to understand and manage dental traumatic injuries. Hence, there is a need to assess the reasons behind this issue and develop solutions to improve the current situation.