Introduction: Traumatic dental injuries are sudden and acute events and often require emergency care. Paramedics are very often the first responders on the scene. Through rapid and correct management, they can have a significant impact on the prognosis of the injured tooth. This study aimed to investigate the knowledge and skills of paramedics in the management of dental injuries. Methods: In this cross-sectional observational study, an electronic questionnaire was sent to 541 emergency departments across Germany. The questionnaire contained questions about the characteristics of the paramedics and about their ability to treat dental trauma. For statistical analysis, the Student's t-test, the chi2 test, the ANOVA test, or a regression model were used, as appropriate. Results: Only 6% of the 690 participants reported having at least a good working knowledge, and only 4.5% reported having good dental trauma management skills. Although 79% of participants felt that an intraoral examination was an essential part of the initial examination of trauma patients, only 15.66% were familiar with this procedure. And although 71.9% of participants had heard of a dental rescue box, only 30.7% carried one as standard equipment on the rescue vehicle. Conclusion: Paramedics have only a basic understanding of the treatment of dental trauma. Initial treatment of dental trauma should become an integral part of paramedic training. Dental rescue boxes should be standard equipment on ambulances. In general, a good long-term outcome should be sought for patients with dental trauma. Paramedics could play an important role in the care of dental trauma patients. Keywords: avulsion, dental rescue box, knowledge, paramedics, skills, traumatic dental injury