Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 13 3 2026 10 21 327 337 Haniyeh Hosseinzadeh Dentist, Private Practice, Tehran, Iran. Simin Mohebbi Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Kharazifard Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Samaneh Razeghi Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2026 06 22 2026 09 18 Introduction: Traumatic dental injuries (TDIs) are common among school-aged children and often require immediate and appropriate first-aid management to improve treatment outcomes. However, evidence regarding children’s knowledge and intended responses to TDIs in Iran remains limited. This study aimed to assess the knowledge and self-reported practice of Iranian elementary school students regarding the emergency management of TDIs and to identify associated factors.  Materials and Methods: A descriptive-analytical cross-sectional study was conducted among 487 students aged 10–13 years from four public elementary schools in Tehran, Iran. Participants completed a structured self-administered questionnaire comprising demographic characteristics, 10 knowledge items, and 5 scenario-based self-reported practice items related to TDI management. Knowledge and practice scores were converted to percentages, with higher scores indicating better performance. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple linear regression analysis.  Results: The mean age of participants was 10.73 ± 0.85 years, and 57.1% were female. The mean knowledge score was 64.83 ± 9.54, while the mean self-reported practice score was 80.89 ± 16.30. Although most students recognized the importance of seeking immediate dental care after tooth mobility (82.1%), only 6.6% knew that an avulsed permanent tooth could be replanted. Knowledge regarding the critical extra-alveolar time and appropriate storage media for avulsed teeth was also low. Only 4.5% of participants selected immediate replantation as the correct management of an avulsed tooth, and 17.7% identified milk as an appropriate storage medium. Regression analysis showed that knowledge scores were positively associated with previous TDI training (β = 0.15, p = 0.001) and negatively associated with age (β = −0.10, p = 0.03). Self-reported practice scores were associated with gender (β = 0.19, p < 0.001), while an unexpected inverse association was observed with previous training (β = −0.15, p = 0.001).  Conclusion: Elementary school students demonstrated inadequate knowledge regarding the emergency management of TDIs, particularly tooth avulsion. School-based educational interventions are needed to improve emergency preparedness and evidence-based responses to dental trauma.  Keywords: Tooth injuries; Knowledge; Practice; Students; Child; Adolescent. https://jcr.tums.ac.ir/index.php/jcr/article/view/686 https://jcr.tums.ac.ir/index.php/jcr/article/download/686/512