Impact of educational posters on the lay knowledge of school teachers regarding emergency management of dental injuries Injury to both primary and permanent teeth and their supporting structures is one of the most common dental problems seen in children. Falls are the main cause of dental injuries in children (1–3). It has been suggested that the frequency of dental trauma may soon exceed other dental problems such as caries or periodontal diseases (4). In Scandinavia, 30% school children expe- rienced trauma in the primary dentition and 22% in the permanent dentition (2, 5, 6). Another study showed that in the 7–30 year old population, oral injuries are the fourth most common type of reason for dental atten- dance (7). Dental injuries can result in functional and esthetic impairment and lead to great concern for parents and children. The prognosis of injured teeth may also depend on the appropriate emergency management by lay people such as parents and school teachers. Studies on avulsion injuries have shown that the prognosis depends on the viability of the periodontal ligament remaining on the root surface of an avulsed tooth (8, 9). In animal models it showed that the most important factors for the outcome are the appropriate handling of the avulsed tooth, the extra-oral storage medium and time duration out of its socket (10– 14). Several studies have assessed the correlation of the time lag between trauma and reimplantation and the prognosis the affected tooth (8, 9, 15–17). They showed that reimplantation should be done as soon as possible, ideally within minutes after trauma. If laypeople do not feel comfortable to perform this procedure, they can place the tooth in a special storage medium and consult the nearest dentist immediately. In order to find media suitable for storage of avulsed teeth, the survival rate of periodontal cells in different media has been analyzed in vitro (8, 12, 13, 15, 18–27) (Table 1). Up to now, no in vivo randomized controlled trials on this topic are available. Multiple studies have investigated the lay knowledge of teachers with regards to dental injuries (28–35). The majority of the teachers appeared to have only rudimen- tary knowledge of emergency management. The recom- mendation of these studies was to invest in the training of lay people in the handling of dental emergencies. In 2001, the Department of Oral Surgery and Stoma- tology of the University of Bern published a poster about the emergency management of injured teeth. The title was ‘Dental injuries, what should you do?’. The poster presented guidelines for lay people for the emergency *[Correction added after online publication 9 June, 2009: The authors’ names were changed from Lieger Olivier, Graf Christoph, Mohammed El-Maaytah, Von Arx Thomas to Olivier Lieger, Christoph Graf, Mohammed El-Maaytah, Thomas Von Arx.] Dental Traumatology 2009; 25: 406–412; doi: 10.1111/j.1600-9657.2009.00798.x 406 Ó 2009 John Wiley & Sons A/S Olivier Lieger 1 , Christoph Graf 2 , Mohammed El-Maaytah 3 , Thomas Von Arx 2, * 1 Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; 2 Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; 3 Oral & Maxillofacial Surgery Department, Eastman Dental Hospital, London, UK Correspondence to: Olivier Lieger, MD, DMD Department of Cranio-Maxillofacial Surgery, Inselspital, CH-3010 Bern, Switzerland Tel.: +41 31 632 3317 Fax: +41 31 382 0279 e-mail: olivier.lieger@ksl.ch Accepted 3 April, 2009 Abstract – The purpose of this study was to investigate the knowledge of school teachers about the emergency management of dental trauma, after an educa- tional poster campaign. A total of 1000 questionnaires were sent to 100 schools in the area where the poster had been distributed. This was compared to another 100 schools (1000 questionnaires) in an area, Where the poster had not been distributed. The questionnaire surveyed demographic data, basic knowledge of emergency management of tooth fracture, luxation and avulsion injuries. A total of 511 questionnaires were returned (25.5%) and analyzed. Results showed differences between the two assessed areas. Teachers, who worked in the area with poster distribution, had better knowledge in handling tooth injuries. For the management of tooth fractures the portion of teachers, who knew the correct handling procedure, was 78.9% (area with poster campaign) vs 72.1% (area with no poster campaign), for the management of tooth luxation it was 87% vs 84% and for the management of tooth avulsion it was 71% vs 54%. In the area with the poster campaign 49% (n = 90 out of 185) of the teachers stated to have gained some knowledge about this topic beforehand. Out of these, 75 teachers (75/90 = 83%), had gained their information from the educational poster. Out of the 75 teachers, who had seen a poster on this topic, 68 (68/75 = 91%) would have managed such an emergency correctly. The present study shows the positive effect of educational poster campaigns. It therefore should encourage professionals in this field to embark on similar projects.