{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:59:02Z","timestamp":1791374342205,"version":"4.3.1"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Dental Traumatology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background and Objectives<\/jats:title>\n Traumatic dental injuries are among the most common dental emergencies in children, and school teachers are frequently the first responders. This study aimed to assess knowledge of emergency management of traumatic dental injuries, the reported availability of tooth rescue boxes and training demand among school teachers in Lower Saxony, Germany.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A cross\u2010sectional online survey was conducted among teachers from 856 schools across all four regional school authorities in Lower Saxony. The questionnaire comprised 37 items covering knowledge of traumatic dental injury management, tooth rescue box availability and awareness, prior incident experience, and training preferences. Knowledge was assessed using a five\u2010item score derived from the 2020 International Association of Dental Traumatology avulsion management guidelines, with a maximum score of five. Statistical analysis included descriptive statistics, Mann\u2013Whitney\n U<\/jats:italic>\n tests, Kruskal\u2013Wallis tests, and multivariable linear regression, with Poisson and proportional\u2010odds ordinal logistic regression as sensitivity analyses. Data from 349 complete responses were analysed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean knowledge score was 3.18 out of 5 (standard deviation 1.02, median 3, interquartile range 2\u20134). While 38.1% of teachers answered four or five items correctly, approximately one in four (27.8%) answered two or fewer. The lowest correct\u2010response rates concerned identification of appropriate storage media: only 34.1% of teachers identified milk as a suitable option, with a similarly low rate for physiological nutrition solution (33.8%). Correct handling of a tooth by its crown was identified by 63.9% of teachers. Of the 349 respondents, 124 (35.5%) reported that a tooth rescue box was present at their school, while 144 (41.3%) were unaware of whether one existed. In multivariable analysis, active self\u2010directed information\u2010seeking and awareness of tooth rescue boxes were the only independent positive predictors of knowledge score; having witnessed a prior dental trauma incident in the school setting showed a small negative association that was consistent in direction across all models but sensitive to model specification, and should therefore be interpreted with caution. Interest in training was expressed by 85.9% of participants.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Knowledge of avulsion management was heterogeneous across the sample, with pronounced gaps in storage medium identification. Reported tooth rescue box availability was limited and teacher awareness of existing provisions was poor. These findings indicate a need for targeted training initiatives and coordinated school health programmes developed in collaboration with dental professional organisations; given the cross\u2010sectional design, such measures merit implementation alongside prospective evaluation of their effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Reporting Guideline<\/jats:title>\n STROBE (cross\u2010sectional studies).<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/edt.70140","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:48:54Z","timestamp":1791373734000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge of Emergency Management of Traumatic Dental Injuries and Reported Availability of Tooth Rescue Boxes Among School Teachers in Lower Saxony, Germany: A Cross\u2010Sectional Survey"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-6758","authenticated-orcid":false,"given":"Georg","family":"Hoene","sequence":"first","affiliation":[{"name":"Clinic for Oral and Maxillofacial Surgery University Medical Center Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5690-1290","authenticated-orcid":false,"given":"Calvin","family":"Kalischinski","sequence":"additional","affiliation":[{"name":"Clinic for Oral and Maxillofacial Surgery University Medical Center Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7206-1357","authenticated-orcid":false,"given":"Shabnam","family":"Shahpasand","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics and Pediatric Audiology University Hospital Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3677-9822","authenticated-orcid":false,"given":"Frederik","family":"Holdorf","sequence":"additional","affiliation":[{"name":"Clinic for Oral and Maxillofacial Surgery University Medical Center Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3749-8757","authenticated-orcid":false,"given":"Matthias","family":"R\u00f6diger","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics University Medical Center Goettingen, Georg\u2010August University Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2008-7188","authenticated-orcid":false,"given":"Henning","family":"Schliephake","sequence":"additional","affiliation":[{"name":"Clinic for Oral and Maxillofacial Surgery University Medical Center Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Wolfer","sequence":"additional","affiliation":[{"name":"Clinic for Oral and Maxillofacial Surgery University Medical Center Goettingen Goettingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/edt.12931","article-title":"The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) Guidelines for Prevention of Traumatic Dental Injuries: Part 10: First Aid Education","volume":"40","author":"Tewari N.","year":"2024","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/adj.12395","article-title":"Epidemiology and Outcomes of Traumatic Dental Injuries: A Review of the Literature","volume":"61","author":"Lam R.","year":"2016","journal-title":"Australian Dental Journal"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/edt.12389","article-title":"World Traumatic Dental Injury Prevalence and Incidence, a Meta\u2010Analysis\u2010One Billion Living People Have Had Traumatic Dental Injuries","volume":"34","author":"Petti S.","year":"2018","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_5_1","first-page":"102","article-title":"Epidemiology of Traumatic Dental Injuries","volume":"35","author":"Andersson L.","year":"2013","journal-title":"Pediatric Dentistry"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/edt.12478","article-title":"Changes in the Aetiological Factors of Dental Trauma in Children Over Time: An 18\u2010Year Retrospective Study","volume":"35","author":"K\u0131rz\u0131oglu Z.","year":"2019","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/edt.12573","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth","volume":"36","author":"Fouad A. F.","year":"2020","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_8_1","first-page":"216","article-title":"Traumatic Dental Injuries \u2013 Practical Management Guide","volume":"50","author":"Majewski M.","year":"2022","journal-title":"Polski Merkuriusz Lekarski"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/edt.12578","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations","volume":"36","author":"Bourguignon C.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/adj.12396","article-title":"Emergency Assessment and Treatment Planning for Traumatic Dental Injuries","volume":"61","author":"Moule A.","year":"2016","journal-title":"Australian Dental Journal"},{"key":"e_1_2_12_11_1","first-page":"244","article-title":"Replantation After Dental Avulsion: A Scoping Review and Proposal of a Flow Chart","volume":"25","author":"Zerman N.","year":"2024","journal-title":"European Journal of Paediatric Dentistry"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/edt.12579","article-title":"Global Status of Knowledge for Prevention and Emergency Management of Traumatic Dental Injuries Among School Teachers: A Systematic Review and Meta\u2010Analysis","volume":"36","author":"Tewari N.","year":"2020","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1590\/1807-3107bor-2023.vol37.0073","article-title":"Elementary School Teachers' Knowledge and Attitudes Toward Emergency Management of Traumatic Dental Injuries","volume":"37","author":"Kneitz F. B.","year":"2023","journal-title":"Brazilian Oral Research"},{"key":"e_1_2_12_14_1","first-page":"ZC08","article-title":"Awareness of Dental Trauma Management Among School Teachers of Kannur, Kerala, India","volume":"11","author":"Chandukutty D.","year":"2017","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.70089"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.2334\/josnusd.25-0425","article-title":"Preschool and Primary School Teachers' Knowledge of Emergency Management of Traumatic Dental Injuries: A Cross\u2010Sectional Study","volume":"68","author":"Comert H.","year":"2026","journal-title":"Journal of Oral Science"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","DOI":"10.1155\/ijod\/6614216","article-title":"Knowledge on First Aid Management of Traumatic Dental Injuries Among Primary School Teachers of Dharan, Nepal","volume":"2025","author":"Shrestha A.","year":"2025","journal-title":"International Journal of Dentistry"},{"key":"e_1_2_12_18_1","first-page":"79","article-title":"Knowledge, Attitude, and Practice of First Aid Management of Avulsed Teeth Among Primary School Teachers in Ibadan, Nigeria","volume":"23","author":"Williams A. T.","year":"2025","journal-title":"Annals of Ibadan Postgraduate Medicine"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4103\/sjmms.sjmms_306_20","article-title":"Awareness of Dental Trauma Management Among School Teachers in Dammam, Saudi Arabia","volume":"10","author":"Al\u2010Khalifa K. S.","year":"2022","journal-title":"Saudi Journal of Medicine & Medical Sciences"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1186\/s12903-025-06904-4","article-title":"Knowledge and Practice Gaps in the Emergency Management Practices of Children With Dental Trauma: A Cross\u2010Sectional Survey Among Primary School Health Teachers and Parents in Urumqi","volume":"25","author":"Aierken W.","year":"2025","journal-title":"BMC Oral Health"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/j.1600-9657.2008.00598.x","article-title":"Practicability of a Tooth Rescue Concept\u2014The Use of a Tooth Rescue Box","volume":"24","author":"Filippi C.","year":"2008","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1034\/j.1600-9657.2001.017002077.x","article-title":"Lay Knowledge of Physical Education Teachers About the Emergency Management of Dental Trauma in Hong Kong","volume":"17","author":"Chan A. W. K.","year":"2001","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.4103\/njcp.njcp_466_19","article-title":"Orofacial Trauma Awareness Among Sports Teachers in Southern Saudi Arabia","volume":"23","author":"Eroje A. B.","year":"2020","journal-title":"Nigerian Journal of Clinical Practice"},{"key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/edt.12938","article-title":"Enhancing Elementary School Teachers' Knowledge in Managing Traumatic Dental Injuries: The Effectiveness of Educational Sessions","volume":"40","author":"Alomari A.","year":"2024","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0074833","article-title":"Effectiveness of Educational Poster on Knowledge of Emergency Management of Dental Trauma\u2013Part 1. Cluster Randomised Controlled Trial for Primary and Secondary School Teachers","volume":"8","author":"Young C.","year":"2013","journal-title":"PLoS One"}],"container-title":["Dental Traumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/edt.70140","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/edt.70140","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/edt.70140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:48:59Z","timestamp":1791373739000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/edt.70140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":24,"alternative-id":["10.1111\/edt.70140"],"URL":"https:\/\/doi.org\/10.1111\/edt.70140","archive":["Portico"],"relation":{},"ISSN":["1600-4469","1600-9657"],"issn-type":[{"value":"1600-4469","type":"print"},{"value":"1600-9657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"edt.70140"}}