Malaysian Dental Students' Knowledge of Traumatic Dental Injury Management and Barriers in Implementing International Association of Dental Traumatology Guidelines: A Mixed-Methods Study.
BACKGROUND/AIM Traumatic dental injuries (TDIs) are the most common dental emergencies in children and young adults. Implementing trauma guidelines into clinical settings is a bigger challenge faced by many students worldwide. This study is aimed at assessing Malaysian dental students' knowledge of traumatic dental injury management and identifying perceived barriers in its clinical implementation. MATERIALS AND METHODS A convergent parallel mixed-methods study was conducted among Malaysian undergraduate dental students between October 2024 and February 2025. Quantitative data were collected through a validated questionnaire while qualitative data were obtained by semi-structured interviews. Quantitative data were analyzed using descriptive and non-parametric tests. Qualitative data were analyzed using thematic analysis, and final integration using joint display. RESULTS A total of 231 students completed the questionnaire, and 47 participated in qualitative interviews. Overall, students demonstrated a moderate level (mean score 5.06 ± 1.02) of knowledge of TDI management. Final-year students achieved significantly higher knowledge scores than Year 3 and Year 4 students (p < 0.05). More than half (55.4%) of the students reported no previous experience managing TDIs during undergraduate training. Limited clinical exposure (62.9%), inadequate practical training (56.6%), insufficient curriculum integration (32.3%), resource limitations (28.7%) and lack of confidence (27.9%) emerged as the principal barriers to implementing the IADT guidelines. Final-year students (adjusted β = 0.83, 95% CI: 0.26-1.40, p = 0.004) and those with previous clinical experience (adjusted β = 0.67, 95% CI: 0.08-1.26, p = 0.026) managing traumatic dental injuries demonstrated significantly higher knowledge scores. CONCLUSION Malaysian dental students demonstrated a moderate level of knowledge and several educational and institutional barriers limited the translation of this knowledge into clinical practice. Strengthening undergraduate dental trauma education, minor curriculum reforms, simulation-based training and enhanced integration of the IADT guidelines within competency-based curricula may improve students' knowledge to manage traumatic dental injuries.