Medical emergency preparedness of dental clinics in war-torn syria: a cross-sectional study

The ability to recognize and effectively manage medical emergencies in dental practices is critical to patient safety and care quality. Although global data indicate that most dentists will encounter emergencies during their careers, little is known about preparedness in conflict-affected areas. In Syria, years of war have stretched health infrastructure to breaking point, likely leaving many dental clinics poorly equipped for acute crises. This study assesses how often Syrian dentists face such emergencies, their confidence in managing them, and the availability of essential equipment and medications to identify the most pressing training and resource needs. In March 2025, an anonymous, Delphi-based online survey (Cronbach's α = 0.87; n = 1,034) was conducted among general dentists, residents, and specialists practicing in Damascus and its surrounding rural areas. Five domains were covered: patient pre-assessment, medical resources and equipment, team training and readiness, emergency types and frequency, and conflict-related challenges. Responses were analyzed descriptively and inferentially. Of 1,821 invited practitioners, 1,034 completed the survey (56.8% response rate). Significant gaps were identified: 91.2% (n = 943) lacked written emergency plans, 61.8% (n = 639) had no basic emergency kits, and 85.4% (n = 883) lacked oxygen supplies; no clinic possessed an automated external defibrillator. Half of the staff (50.1% n = 518) had received no emergency-management training, and 70.7% (n = 731) rated university education as inadequate. Conflict-driven barriers were stark: 65.6% (n = 678) reported severe medicine shortages due to sanctions, 61.9% (n = 640) performed no regular equipment maintenance, and 44.1% (n = 456) faced disrupted training access. Syrian dental clinics face major preparedness shortfalls-including absence of emergency plans, critical equipment shortages, and insufficient training-exacerbated by war and sanctions. We recommend partnering with international organizations to secure supplies, implementing simplified emergency protocols with mandatory equipment checks, and linking clinic licensing to minimum preparedness standards. These recommendations are based on data from dentists in Damascus and its rural surroundings and may not fully generalize to other Syrian regions.