Dental trauma in children: monitoring, management, and challenges—a narrative review

Traumatic dental injuries (TDIs) in children pose a significant public health challenge, with a global prevalence of 20-30%. These injuries predominantly affect preschool-aged children (1-3 years) due to underdeveloped motor coordination, while school-aged children face risks from sports and accidents. Maxillary central incisors are most commonly involved, often leading to complications such as pulp necrosis, root resorption, and malocclusion, which impair long-term oral function and aesthetics. Socioeconomic disparities exacerbate outcomes, with higher prevalence and severity in low-resource settings. This narrative review synthesizes current evidence on the classification, risk factors, diagnostic advancements, and management strategies for pediatric TDI, focusing on emerging technologies and biologically driven therapies. A comprehensive literature search was conducted across MEDLINE/PubMed, Scopus, and Web of Science, prioritizing studies from the past decade (2015-2025). Key topics included epidemiology, International Association of Dental Traumatology (IADT) classification, pulp vitality assessment (e.g., laser Doppler flowmetry, pulse oximetry), regenerative endodontics, and preventive interventions. The IADT guidelines provide a standardized framework for TDI classification and management. Modern diagnostic tools improve accuracy in detecting pulp vitality and root fractures. Bioceramic materials and stem cell-based therapies show promise in preserving pulp vitality and promoting periodontal healing. Preventive strategies, including educational programs and mouthguard policies, demonstrate efficacy in reducing TDI incidence. Pediatric TDI require multidisciplinary management combining accurate diagnosis, biologically driven treatments, and preventive measures. Future research should prioritize longitudinal outcome studies and the integration of artificial intelligence in trauma assessment.