Professional Design of a Dental Emergency Management Protocol for Nigerian Secondary Schools

Dental emergencies in school settings including tooth avulsion, fracture, and acute dental pain require immediate first-aid management, and the absence of protocols in Nigerian schools leaves children at risk of preventable permanent dental injury. This study designed a dental emergency management protocol for adoption in secondary schools across Nigeria, with contextualisation for the South East zone as the primary design environment. A professional protocol design methodology was applied, drawing on review of IADT guidelines for dental trauma management, structured consultations with 15 school health nurses, 10 secondary school principals, and 8 paediatric dental specialists, and benchmarking against established school dental emergency protocols in Australia and UK. Consultations confirmed that dental emergencies in schools were managed in an unstructured manner, that no school possessed a dental first aid kit, and that most school nurses were unaware of the importance of immediate tooth replantation for avulsed teeth. The protocol designed covers six dental emergency scenarios: tooth avulsion, crown fracture, subluxation, acute dental pain, soft tissue injury, and jaw trauma. For each scenario, immediate management steps accessible to non-dental personnel are specified, including what to avoid, emergency contact information, and a patient transport decision tree. Expert review by nine paediatric dental and emergency management specialists confirmed the protocol's clinical accuracy and practical usability. Recommendations include distribution of the protocol through the Federal Ministry of Education School Health Programme and provision of basic dental first aid kits in all secondary school sick bays.

Keywords: dental emergency protocol, secondary schools, Nigeria, tooth avulsion, IADT guidelines