To our knowledge, this study is the first that investigate the effectiveness of educational intervention in improving the knowledge of Syrian schoolchildren about avulsion. For this purpose, the Arabic version of IADT “ Save the tooth” poster which was translated and validated by one of the authors of this study (MD) was utilized.The IADT poster “save your tooth”is easily accessible and is available for free to public. Therefore, it was translated into more than 40 languages) https://www.iadt-dentaltrauma.org/for-patients.html(.
Several studies have employed various versions from IADT poster to improve the knowledge of teachers, nurses and parents[16, 23, 24].
The current study utilized the Arabic IADT poster “ Save the tooth” as an educational tool, since it contains information about first aid management of avulsion tooth according to IADT guideline. Previous researchers have found this poster to be an effective educational tool, inexpensive, easy to understand and to implement.
Syrian School children between 9-12 years were selected since they would be more cooperative, have more logical thinking, and can realize cause-result interactions when compared to younger children.
The questionnaire administered to the children in this study was carefully planned to enable and facilitate the evaluation of knowledge gained through education.
The findings of the present study showed that the level of knowledge of Syrian primary schoolchildren regarding first-aid management of avulsion was limited and this was similar to other previous studies[10, 11]. The lack of knowledge could possibly mean that the avulsed tooth might not be replanted at all, or not received the optimal urgent management in which poor prognosis might occur. This is regrettable because with simple measures, the outcome can be very different.
The results of follow-up showed that intervention was effective in improving the knowledge of schoolchildren. There was a positive and statistically significant change in awareness from baseline to 8 weeks in all items of knowledge. For example, before distribution of the educational poster, 16.6% of participating preferred milk as storage media for transferring an avulsed tooth. However, after the intervention 74.7% of children selected milk as suitable storage media,which is similar to the findings reported by a study undertakenbyBistrickienė(2019),who reported improvement in the knowledge regarding this issue after educational intervention.
The IADT guidelines  recommended rinsing the avulsed tooth for about 10 seconds under running water for a dirty avulsed tooth. A noteworthy improvement in the knowledge of our study participants regarding this issue was observed after intervention(P=0.02).
AL Sariand co-workers (2019) reported improvement in the knowledge regardinghow to clean avulsed tooth .
Additionally, in the present study, concerning the issue of seeking help within 30 min of an avulsed permanent tooth. The improvement of knowledge in this aspect was demonstrated after intervention (P=0.000).Similar improvement was observed in the study byBistrickienė(2019).
This improvement can be attributed to the health messages delivered interactively to children as a short story, in simple language, with colorful images, so the children could get useful information in an easy and entertaining way.
That poster significantly improved knowledge on the emergency management of (TDI) among primary schoolchildren. This represents an important educational outcome implying that an educational poster including information and pictures of the subject may be an effective material in improving knowledge for a topic such as first aid injury management.
Castilho et al (2009)  confirmed in their studies that the educational campaigns for prevention of accidents involving the dental tissues and for improvement of the prognosis of avulsed teeth are noteworthy as an urgent necessity.
This study provides valuable insight regarding the effectiveness of dental health education among Damascus City’s school-aged children.