Although several regional studies in Saudi Arabia have documented the prevalence and patterns of TDIs, limited information exists on treatment timelines, management outcomes, and contributing risk factors in pediatric patients treated at Riyadh Elm University (REU) clinics. To determine the prevalence, types, risk factors, management patterns, and clinical outcomes of TDIs among pediatric patients treated at REU dental clinics over a five-year period and to evaluate the association between demographic, anatomical, and injury-related factors and treatment outcomes and complications. A retrospective observational study was conducted using electronic dental records of children aged 2–15 years who presented with TDIs at REU clinics between January 2020 and December 2024. Most injuries occurred at school (42.9%) and were primarily sports-related (71.4%). Permanent teeth were involved in 71.4% of cases, with upper anterior teeth being the most affected (39.6%). Enamel-dentin fractures were the predominant injury type (46.4%), followed by complicated fractures (25%). Soft-tissue injuries were present in 48% of patients. Immediate management included pulp capping (46.4%), splinting (42.9%), and extraction (10.7%). Follow-up was completed in 75% of cases, and overall treatment success was recorded in 83%. Significant gender-related differences were found in injury type, soft-tissue involvement, radiographic findings, immediate management, and healing status (p < 0.05). TDIs among pediatric patients at REU clinics were most common among school-aged boys, frequently related to sports activities, and primarily affected the permanent anterior dentition.
