Awareness and Knowledge of Tooth Reimplantation After Avulsion Among Dental and Non-dental Populations: A Systematic Review.

Abstract

Tooth avulsion is one of the most severe forms of traumatic dental injury, and its prognosis depends heavily on immediate and appropriate first-aid management, including prompt reimplantation or correct temporary storage of the avulsed tooth. This systematic review evaluates global awareness and knowledge of tooth reimplantation across dental populations (dentists, dental professionals, and dental students) and non-dental populations (parents, school teachers, emergency physicians, first responders, and the general public). A comprehensive search of PubMed, ScienceDirect, Cochrane Library, and Google Scholar identified 8,133 records, of which 19 cross-sectional studies met the eligibility criteria, representing 5,752 participants from 10 countries. Most studies demonstrated moderate methodological quality. The findings reveal substantial deficiencies in knowledge, particularly among non-dental populations. Awareness that an avulsed tooth can be replanted ranged widely, from as low as 23% among parents to over 80% among dental professionals; however, even among trained providers, detailed protocol-based knowledge was inconsistent. Understanding of critical steps - including the optimal replantation window (<30 minutes), appropriate storage media such as milk or saline, and correct handling techniques - was generally poor across most groups. Only 2-37% of respondents in non-dental populations indicated willingness or ability to attempt immediate replantation. Misconceptions regarding inappropriate storage materials, delayed referral, and handling of the root surface were prevalent. Studies that included educational interventions demonstrated marked improvements in awareness and decision-making. Overall, this review demonstrates a significant global knowledge gap in the emergency management of tooth avulsion, particularly among non-dental populations, underscoring the urgent need for targeted educational interventions and improved dissemination of evidence-based guidelines to enhance reimplantation outcomes.