Traumatic dental injuries (TDIs) of hard and soft tissues within and around the oral cavity are relatively common and occur as a result of accidents during sports or leisure activities, falls, blows by objects, interpersonal violence, and motor vehicle accidents. They represent a serious public health problem with an epidemiological dimension, cause numerous clinical and financial implications, and significantly impair the quality of each stage of life [1,2,3]^[1][2][3]. TDIs often coexist with other multi-organ injuries, and therefore their consequences are underestimated [4,5]^[4][5]. There are several habits that may predispose to dental trauma: chewing ice cubes or stationery items (paper clips, pen), opening bottles, cans, or package with teeth, or practising sports without adequate protection (face mask, mouthguard) ^[6]. Appropriate actions taken immediately after a trauma have a great impact on prognosis and treatment options. First aid measures are particularly important in the case of tooth avulsion because an immediate replantation or a proper transport of such tooth to a dental surgery significantly improves the prognosis.

The prevention and posttraumatic management methods should be widely known, but numerous studies have shown a low level of such knowledge in the general population as well as among teachers, sports coaches, and even among healthcare professionals, including dentists [4,6,7,8,9,10,11]^{[4][6][7][8][9][10][11]}. Therefore, effective and efficient information about dental trauma seems to be essential. Currently, more and more tools are used to promote healthy lifestyles and minimise destructive behaviour (social media, ambient marketing). At the same time, many tools used in the past have ceased to work or bring lower effects than expected [12,13,14]^[12][13][14]. An efficient educational campaign has to be widely accessible and cost-effective. Authorities planning campaigns on dental trauma should be aware of the advantages and limitations of different modes of information delivery to choose the most appropriate one for the target group ^[14]. For this reason, it seemed important to us to collect and analyse available knowledge of the effectiveness of methods and tools used to promote information about dental injuries in general population.

2. Educate the Public about Dental Trauma

Prevention methods and first aid measures in dental trauma should be common knowledge. The unpredictable nature of such injuries and a high link between actions taken at the scene and the outcome of treatment indicate the need for dental trauma education campaigns. The aim of this scoping review was to summarise and disseminate the results of studies on educating the public about dental trauma. The results may assist policy makers and practitioners in choosing the most appropriate way to address the target population. Thirty-two papers were successfully identified that met the inclusion criteria. This indicates that such education is of research interest, particularly in Asia and the Middle East. In contrast, no papers were found from regions and countries with developed oral health programmes, such as Scandinavia, Canada, or the United Kingdom. Systematic reviews of knowledge on TDIs by Tewari and co-authors also revealed discrepancies in the geographical distribution of studies [9,10,11]^[9][10][11]. Our main observation is that a wide range of educational modalities was tested for their effects and that the studies differed in terms of the groups studied, the follow-up period and the results obtained. Another important finding is that substantial knowledge gains were observed in every study evaluated in this review, regardless of the subjects and the applied tool. However, none of them found that all participants were able to assimilate the full range of information presented to them. The most favourable outcome of dental trauma education is long-term maintenance of knowledge and improved attitudes and willingness to provide first aid to the victim. In several studies, the post-test was conducted immediately after intervention, therefore, the effectiveness of the methods evaluated was poorly validated. However, longitudinal observations indicated that knowledge retention was still observed after several months and even years, with decrease in some areas. According to Custers [51]^[15], between two-thirds and three-fourths of knowledge acquired in school would be retained after one year, falling to less than fifty percent in the following year. Data from the study with the longest observation period between the intervention and the follow-up were presented by Lieger et al. [24]^[16]. They found that a poster campaign in the population of school teachers was sufficient for adequately maintaining knowledge for five years. However, due to a very low response rate in the intervention group, these results should be interpreted with caution. It is highly likely that only those respondents who were confident in their knowledge responded to the survey. There seems to be no universal educational method suitable for every population. When planning an informative campaign, cost-effectiveness in crucial. Before making a decision, the accessibility of the target group, the literacy level of population, the socio-economic status, e.g., the access to modern technologies or the Internet, the availability of staff trained in dental trauma, and the source and size of funds have to be assessed. For the general population, the following methods should be considered: printed materials, web contents, and mass media. Printed informative brochures, leaflets, pamphlets, and posters are traditional tools for delivering knowledge to a wide audience, and their effectiveness in dental trauma education has been well documented. The cost of printed educational materials depends on their quality and quantity, but they are relatively inexpensive to produce and distribute [35,36]^[17][18]. A significant advantage is that such manuals are available for free from several sources, for example on the IADT website [41]^[19]. Nevertheless, conducting a nationwide campaign requires considerable financial resources [51]^[15]. The main disadvantage of printed materials is the limited space to provide complete information [23]^[20]. Moreover, due to the layout of an educational tool, there may be difficulties in determining the best possible action [41]^[19]. Information conveyed through printed materials may not be fully assimilated by the target group due to selective reading or incomplete understanding of given knowledge [36]^[18]. In public places, such as schools or hospitals, posters seem to be more appropriate than other printed materials. People tend to lose leaflets, whereas posters can be constantly accessible and conspicuous [39]^[21]. The only limitation is that some institutions frequently change the materials displayed on notice boards or information walls [35,36]^[17][18]. Currently, the Internet is laypeople’s preferred source of knowledge including on medical topics [52,53]^[22][23]. Mobile healthcare applications can be a way to communicate efficiently in dentistry [14,41,54]^[14][19][24]. The widespread accessibility of mobile devices (cell phones, smartphones, tablets) increases the availability of appropriate first aid procedures in dental trauma even at the scene of an accident [41]^[19]. Surprisingly, the limited number of papers evaluating the impact of using modern technologies such as educational tools in dental trauma was found [41]^[19]. Moreover, the results are inconclusive, especially those obtained by Al-Musavi et al. [44]^[25]. Participants using the Dental Trauma App as an educational tool scored higher than those attending a lecture, but those who were educated with both methods scored the lowest. In contrast, Iskander et al. [41]^[19] found that a poster and a mobile application were similarly effective in delivering dental trauma information. They also found that lower educated parents were more satisfied with the information from the mobile application than from printed materials. According to Jabocs et al. [55]^[26], the Internet should not be regarded as a substitute for other sources of health information, as this may exclude certain groups from accessing the health information necessary for making health decisions. The effectiveness of online applications depends on many aspects, such as being familiar with the use of smartphones, the type of device (screen without enlarging screen function), personal preferences, or the difficulty of using the application in a stressful emergency situation [44]^[25]. In developing countries, people may have problems with the online health education due to slow connection speeds or other technical problems or even due to the lack of Internet access [54]^[24]. For such societies, more traditional educational methods such as leaflets may be more valuable [54]^[24]. Although social media can be a promising tool for dental trauma education, this content has to be critically appraised in terms of the reliability of presented materials. Evidence-based information on dental trauma was applied in the studies evaluated, but there are reports showing that the online resources are of uncertain quality. Hutchinson et al. [56]^[27], after a detailed analysis of YouTube^TM, concluded that the materials available there on tooth avulsion were of a low quality. They even suggested that dentists should warn patients of the misleading information available on YouTube™ videos. Abu-Gazaleh et al. [57]^[28] found, based on an evaluation of Facebook content, that there was a limited number of posts about educational materials for laypeople. They mainly focused on using mouthguards. Topics on first aid and long-term management or prognosis in TDIs were missing. The acute nature of such accidents may be the reason why such content results in a lower involvement than other medical posts [57]^[28]. Abu-Gazaleh et al. [57]^[28] suggested to create interactive posts with pictures and clinical cases to attract a multitude of users. The other mass media (tv, radio, newspapers, and magazines) still offer the widest possible exposure and are very effective in raising public awareness. The media can be an efficient tool for the health promotion, provided that pertinent requirements are met [51]^[15] A multimedia approach, including video, graphic design, and audio voice-over, can also be used to convey information to people with limited literacy skills ^[9]. This mode of public communication has the advantage of spreading knowledge quickly and reaching the largest possible audience ^[29]. However, paid advertisements, especially on television, can be very expensive, therefore the costs and benefits need to be carefully weighed with regard to the education on dental trauma [51]^[15]. No studies were found on the role of traditional mass media (television, radio, printed newspapers, and magazines) as a source of knowledge of dental trauma in adults. The only study using a cartoon movie was conducted in a group of 8–11-year-old Lebanese children [31]^[30]. The authors found that for this population, the audio-visual method was a good way to convey knowledge on tooth avulsion. Comparing auditory and visual modes used separately, the first showed a greater impact on knowledge retention. When the two modes were combined, watching a movie twice was more effective than listening to a story twice. Moreover, children preferred movies to oral stories. This study also highlighted the importance of repetition in knowledge transmission, which is very easy via mass media, for example in the form of a short movie played several times before a popular children’s programme. The cost of such broadcast should be covered by national and local government agencies or even commercial companies [31]^[30]. There are some specific groups that should be educated in dental trauma prevention and first aid, including school staff and sports coaches. Children and adolescents are particularly vulnerable to TDIs, with approximately 19% of TDIs occurring at schools [58]^[31]. The scoping review of literature presented here showed that most studies addressed this audience, with teachers most frequently being the target group. Medical professionals, especially those who deal with emergency management or work with children, such as school nurses, are another group that is highly likely to encounter patients with dental trauma ^[6]. It was reported that there was a gap in the non-dental medical staff curriculum and that medical doctors showed a low level of competence in the management of dental emergencies ^[7]. For both abovementioned groups, education through personal contact with the educator (lecture, seminar, workshops) may be the most effective way to enhance knowledge and competences. The opportunity for the audience to ask questions and the doubts expressed in discussion increased the efficacy of information transfer ^[14]. Multimodal workshops were highly effective in improving self-assessed competences of emergency service providers and changed their routine in the treatment of dental emergency patients ^[29]. The “contamination effect”, e.g., the ability of teachers who attended a seminar on dental trauma management to instruct their colleagues on the proper behaviour, was observed [19,21]^[32][33]. A limitation of lectures is that they are expensive, time-consuming, and require many instructors to target an entire community (e.g., all teachers). Al-Asfour et al. [21]^[33] suggested that categories of staff other than dentists should be trained to present such information. When planning such educational campaigns, it is worth considering professional conferences, which allow a large number of participants to be reached [21,29]^[33][29]. An alternative to a lecture could be an interactive video because it does not require the presence of a lecturer, can be played many times, and can be stored for a long time [49]^[34]. Such a solution seems particularly beneficial in times of limited access to training, such as during the ongoing COVID-19 pandemic. However, the simplest way to educate medical staff is to include TDI topics in their curriculum [37]^[35].