Perioperative Dental Injury Management Among Anesthesiologists in Mainland China: A Survey of Knowledge, Attitudes, and Practices

INTRODUCTION: Perioperative dental injury is an important yet often under-recognized complication of anesthesia and airway management, with significant medicolegal and patient safety implications. MATERIALS AND METHODS: This descriptive cross-sectional survey assessed Chinese anesthesiologists' knowledge, attitudes, and practices regarding perioperative dental injury management. An anonymous online questionnaire based on the Knowledge-Attitude-Practice framework was distributed from July 22 to September 1, 2025. RESULTS: A total of 551 valid responses were analyzed, representing anesthesiologists from 29 provinces. Most respondents worked in grade A tertiary hospitals (70.8%) and had more than 10 years of clinical experience (55.2%). Knowledge of dental avulsion management varied widely, with correct response rates ranging from 7.6% to 80.8%. Only 7.6% identified milk as an appropriate storage medium, and 26.3% recognized that replantation within 30 min is optimal. Respondents from grade A tertiary hospitals demonstrated higher correct rates than those from primary and lower-level hospitals (p = 0.023, adjusted p = 0.044). Knowledge was also higher among those willing to receive training (p = 0.004). Nearly half (46.1%) reported encountering complete tooth avulsion, and 18.9% of these cases involved airway or esophageal obstruction. Male anesthesiologists (adjusted OR 1.78, 95% CI: 1.25-2.55, p = 0.001) and those with 5-10 years of experience (adjusted OR 3.89, 95% CI: 1.22-15.13, p = 0.030) had higher odds of reporting avulsion. Only 8.5% had received prior training, but 87.7% expressed willingness to attend future programs, particularly via online videos, academic lectures, or hospital-based education. CONCLUSIONS: Substantial knowledge and practice gaps in perioperative dental injury management among anesthesiologists in mainland China. The strong educational demand underscores the need for structured, interdisciplinary training and institutional protocols to improve clinical preparedness, enhance patient safety, and reduce medicolegal risk.