Guideline awareness and knowledge in the emergency management of traumatic dental injuries: a multicenter cross-sectional study

Abstract

Abstract Background The prognosis of traumatic dental injuries (TDIs) is highly time-dependent, and emergency departments are often the first point of care. Despite the availability of International Association of Dental Traumatology (IADT) guidelines and validated standardized documentation tools, emergency physicians’ knowledge of and awareness of these recommendations remain unclear. This multicenter study therefore aimed to assess emergency physicians’ knowledge, self-perceived competence, self-reported clinical approaches, and awareness of standardized documentation in the management of traumatic dental injuries. The study also sought to evaluate physicians’ self-reported approaches and to identify physicians’ preferred approaches for future training and education. Methods This cross-sectional study was conducted between November and December 2025 among physicians working in the emergency departments of 10 hospitals in İzmir, Türkiye (2 university hospitals, 3 training and research hospitals, and 5 state hospitals). Data were collected using a structured questionnaire developed in accordance with the IADT recommendations and the national clinical protocol of the Turkish Ministry of Health, covering demographic characteristics, self-perceived competence, eight items assessing TDI management knowledge and guideline-related awareness and preferred educational methods. Group comparisons were performed using the Kruskal–Wallis test, the Mann–Whitney U test, or one-way ANOVA, as appropriate. Multivariable linear regression was used to identify factors independently associated with the guideline-related knowledge and awareness score. Reporting followed the STROBE guidelines. Results A total of 145 physicians participated (52.1% emergency medicine residents, 22.2% specialists, 25.7% general practitioners). Participants reported inadequate theoretical knowledge (66.2%), lack of practical skills (46.2%), and low awareness of validated standardized dental trauma documentation tools: 77.2% were unaware of any such system, and only 2.8% reported occasional use. Pronounced knowledge gaps were observed in avulsion management, intrusion injuries, and the use of structured documentation. Guideline-related knowledge and awareness scores differed significantly by professional status ( p = 0.009) and institution type ( p = 0.042), but not by years of experience. In multivariable analysis, specialist status remained an independent predictor of higher knowledge (adjusted β = 1.11; 95% CI, 0.36–1.85), whereas the association with institution type was attenuated. Hands-on workshops and emergency department decision-making protocols were the most preferred educational strategies. Conclusions A persistent gap in guideline awareness and self-reported knowledge exists in the emergency management of TDIs, characterized by limited theoretical knowledge, low self-perceived competence, and minimal awareness of validated documentation tools, despite the international and national publication of evidence-based recommendations. Targeted implementation strategies including hands-on training, structured emergency department decision-making pathways, and the active integration of validated documentation systems into routine workflows may help support more consistent guideline-informed management of dental trauma.

The authors' abstract, as published at the source. BMC Oral Health, 2026 · DOI ↗