Traumatic Dental Injuries in Infants and Toddlers Under 4 Years of Age: Burden, Injury Patterns and Early Sequelae in a Hospital‐Based Dental Emergency Service: A Retrospective Observational Study

BACKGROUND/AIM: Traumatic dental injuries are a major cause of emergency dental visits during early childhood, yet comprehensive data in children under 4 years of age remain limited. This study aimed to describe the clinical burden, injury patterns, management, and early post-traumatic sequelae of traumatic dental injuries in children under 4 years of age attending a hospital-based dental emergency service. MATERIALS AND METHODS: A retrospective observational study was conducted using clinical records from the paediatric dental emergency service of Hospital HM Nens (Barcelona, Spain) between 2021 and 2025. Of 5516 paediatric emergency visits, 1125 involved children under 4 years of age. After excluding 47 visits because of unavailable or insufficient clinical records, 1078 evaluable visits were analysed. Trauma-related visits included visits in which dental trauma was the main reason for consultation, emergency consultations for post-traumatic sequelae, and trauma-related visits involving previously traumatized teeth. Descriptive statistics were performed, and 95% confidence intervals were calculated using the Wilson method. RESULTS: Trauma-related conditions accounted for 743 of 1078 evaluable emergency visits (68.9%; 95% confidence interval: 66.1-71.6), of which 589 (79.3%) were visits in which dental trauma was the main reason for consultation. Periodontal injuries predominated, followed by hard tissue and combined injuries, mainly affecting the primary maxillary central incisors. Falls were the leading mechanism of injury, whereas educational settings and home were the most frequent locations. Soft tissue injuries commonly involved the lips, gingiva, and labial frenum. Non-operative management was the most frequent treatment. Post-traumatic sequelae accounted for 104 emergency visits, comprising 150 recorded sequelae. Previous healthcare contact was documented in a minority of patients before referral to the dental emergency service. CONCLUSIONS: Traumatic dental injuries constitute a substantial proportion of hospital-based paediatric dental emergencies in children under 4 years of age and are frequently associated with early post-traumatic sequelae. These findings emphasize the importance of timely diagnosis, appropriate emergency management, structured follow-up, and preventive strategies for the primary dentition.