Emergency Management of Avulsed Permanent Teeth: National Knowledge Gaps, Clinical Predictors, and a Proposed Intervention Framework

Background Tooth avulsion is a severe traumatic dental injury where prognosis depends on immediate management and adherence to guidelines. No nationwide assessment of Sri Lankan dentists’ knowledge on tooth avulsion has been reported. Aim To evaluate knowledge, practices, and barriers regarding avulsed tooth management among Sri Lankan dentists, and to identify predictors of knowledge performance. Methods A cross-sectional survey (January 2021–March 2022) was conducted using a validated 21-item questionnaire based on IADT 2020 guidelines. Stratified random sampling identified 750 eligible dentists; 256 participated (response rate 34.1%). Knowledge was assessed in emergency and long-term management domains. Analyses included descriptive statistics, nonparametric tests, Spearman correlation, and multivariable regression with robust errors. Results Participants included 163 females (63.7%) and 93 males (36.3%), mean service 11.6 ± 9.0 years. Correct responses were low for accident-site management (44.9%) and storage media order (44.5%), but higher for tooth handling (99.6%) and splinting time (71.9%). Mean scores: knowledge 2.38 ± 1.0, management 3.00 ± 0.9, grand total 5.38 ± 1.6 (range 0–9). Only 0.8% achieved full scores. Knowledge declined with years of service (ρ = −0.18, p = 0.004). Regression showed statistically significant higher scores among diploma holders, postgraduate trainees, and senior academics compared with dental surgeons (all p < 0.001). Conclusion Significant knowledge gaps exist in avulsion management, especially among experienced practitioners. Targeted continuing education and system-level integration of IADT guideline training are urgently required to improve patient outcomes.