Knowledge of Emergency Management of Traumatic Dental Injuries and Reported Availability of Tooth Rescue Boxes Among School Teachers in Lower Saxony, Germany: A Cross‐Sectional Survey

ABSTRACT Background and Objectives 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. Materials and Methods A cross‐sectional 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‐item 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–Whitney U tests, Kruskal–Wallis tests, and multivariable linear regression, with Poisson and proportional‐odds ordinal logistic regression as sensitivity analyses. Data from 349 complete responses were analysed. Results The mean knowledge score was 3.18 out of 5 (standard deviation 1.02, median 3, interquartile range 2–4). While 38.1% of teachers answered four or five items correctly, approximately one in four (27.8%) answered two or fewer. The lowest correct‐response 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‐directed information‐seeking 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. Conclusions 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‐sectional design, such measures merit implementation alongside prospective evaluation of their effectiveness. Reporting Guideline STROBE (cross‐sectional studies).