Traumatic dental injuries are a major cause of morbidity among children. Investigation of risk factors of dental trauma is important to take preventive measures in patients at high risk for tooth accidents. The aim of this work was to conduct a pilot study in twins, assessing concordance of suffered traumatic dental and facial injuries. Comparison of concordances between monozygotic and dizygotic twin pairs was performed in order to investigate possible genetically determined accident-proneness. Standardized interviews were conducted focusing on the frequency of orofacial accidents and their circumstances. In addition, the front teeth of all participating twins were clinically examined. A total of 104 twins (52 twin pairs) were surveyed: 31 of the 52 twin pairs were DZ and 21 pairs were MZ. 36 (34.6%) of the 104 interviewees had already suffered from a tooth injury, whereas 53 (51%) of the participants had experienced a facial injury. Investigation of concordances of suffered traumatic dental injuries revealed that 66.7% of the MZ twin pairs and 58.1% of the DZ pairs were concordant. With respect to facial traumata, 52.4% of the MZ pairs compared to 58.1% of the DZ pairs were concordant. Differences between zygosity were not statistically significant (P >/= 0.05). With the present pilot study, no statistical evidence of genetic risk for dental and facial injuries could be displayed. On the contrary, environmental factors seem to dominate in determining an individual's risk for orofacial traumata.