Association of a ToothSOS-based educational intervention with schoolteachers’ knowledge of emergency management of traumatic dental injuries: a longitudinal single-arm study

BACKGROUND: Traumatic dental injuries (TDIs) represent a significant public health concern because of their clinical, economic, and quality-of-life consequences. Improving schoolteachers' knowledge of TDIs is important for appropriate emergency management of injuries occurring in school settings. This study aimed to examine changes in schoolteachers' knowledge of TDIs following a ToothSOS-based educational intervention. METHODS: This longitudinal single-arm interventional study initially enrolled 87 schoolteachers. Baseline knowledge was assessed before the intervention (T0). Participants then received education using the ToothSOS mobile application developed by the International Association of Dental Traumatology. Knowledge was reassessed immediately after the intervention (T1) and at a 1-month follow-up (T2). 65 participants who completed all three assessments were included in the final analysis. Knowledge scores were compared across time points using the Friedman test, followed by Wilcoxon signed-rank tests with Bonferroni correction for pairwise comparisons. Effect sizes were also calculated. RESULTS: At baseline, participants demonstrated low knowledge levels (range: 0-4; mean: 1.77; median: 2). Knowledge scores were higher immediately after the intervention (T1; range: 5-8; mean: 6.65; median: 7). At the 1-month follow-up (T2), scores showed a wider distribution (0-8) but remained above baseline overall (mean: 4.74; median: 6). Repeated-measures analysis showed a statistically significant difference in knowledge scores across the three time points (p < 0.001). Pairwise comparisons showed significant differences between all time points after Bonferroni correction. CONCLUSION: Knowledge scores increased after the ToothSOS-based educational intervention and remained above baseline at the 1-month follow-up, although some decline was observed over time. These findings suggest that the ToothSOS application may be a useful educational resource for improving awareness of TDI emergency management among schoolteachers. However, controlled studies using validated instruments and longer follow-up are needed.