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Sports-Related Tooth and Mouth Injuries

With a new football season quickly approaching, and after watching my favorite 10 year old nephew attend his first football camp  I decided sports related tooth and mouth injuries would be an appropriate topic for this week’s blog.          

Injuries to the teeth and mouth are common in sports. Approximately 80% of dental injuries affect one or more of the front teeth and may cause damage to soft tissues – the tongue, lips, and inner cheeks.

Sports injuries are the main source of tooth and mouth injuries in older adolescents and adults. Up to 40% of dental injuries in older adolescents and adults occur while playing sports and 50% of all children and teens will suffer at least one traumatic injury to a tooth by the time they graduate high school. Young men suffer traumatic tooth injuries 2-3 times more often than young women.


Tips to Prevent Sports-Related Tooth and Mouth Injuries

Mouth Guards: When playing sports, the best way to protect your teeth and mouth is by wearing a mouth guard. Athletes are 60 times more likely to suffer harm to the teeth when not wearing a mouth guard.

 

Face cages: This equipment protects against trauma to the face, especially when playing certain sports positions, like baseball catcher or hockey goalie.

  

Helmets: It's always wise to wear a helmet made for the activity that you are participating in. Although most helmets won't protect the teeth and mouth, they will protect another important area – your head, to help protect against a brain concussion.

 

Tooth Injury from Sports

80% of traumatic dental injuries occur to the top front teeth

  • Tooth Intrusion

Tooth intrusion occurs when the tooth has been driven into the bone due to an axially directed impact.  This is the most severe form of displacement injury.  Nerve damage/death occurs in 96% of intrusive displacements and is more likely to occur in teeth with fully formed roots.  Immature root development will usually have spontaneous re-eruption.  Mature root development will require repositioning, surgery, and splinting or orthodontic treatment.  It should be treated relatively quickly since the pulp usually becomes necrotic.

 

  •  Tooth Extrusion

The tooth is displaced partially out of the socket by trauma.  It is usually displaced towards the palate. Treatment is to try to reposition it gently and to use a non-rigid splint for two weeks.  A dentist should periodically monitor the vitality of the pulp and perform root canal therapy if needed.

  

 

  •  Crown and Root Fractures

Crown fractures are the most common injury to the permanent dentition and may present in several different ways.  The simplest form is crown infraction.  This is a crazing of enamel without loss of tooth structure.  It requires no treatment except adequate testing of pulpal vitality.  Fractures extending into the dentin are usually very sensitive to temperature and other stimuli.  The most severe crown fracture results in the nerve being fully exposed and contaminated in a closed apex tooth or a horizontal impact may result in a root fracture. Treatment is determined by the level of injury.


  •  Avulsion/ Knocked-Out Teeth

Yes, knocked-out teeth can be repaired, and the sooner you can get to your dentist's office, the better. Avulsed teeth with the highest chances of being saved are those seen by the dentist and returned to their socket within one hour of being knocked out. If the periodontal fibers attached to the root surface have not been damaged by rough handling, an avulsed tooth may have a good chance of recovering full function. After one hour, the chance for success is greatly diminished.  Statistics show that the patient can have a 90% success rate if the tooth is placed back in the socket within twenty minutes.  Success decreases 10% for each additional 5 minutes that the tooth is out of the socket. The fibers around the root become necrotic and the replaced tooth will undergo resorption and ultimately be lost. A tooth that is completely displaced from the socket may be replaced with varying degrees of success depending largely on the length of time the tooth is outside the socket. 

If a tooth has been knocked out, make sure it is a permanent tooth and not a primary. Pick the tooth up from the crown and not the root. If the tooth is dirty, gently rinse away any debris with cold water for 10 seconds from the root and attempt to place it back into the socket. If that’s not possible, hold it in the mouth in between the molars and the cheek on the way to the dentist. If all else fails, keep the tooth in Hanks balanced storage medium, saline or milk until you get to the dentist's office. Do not store it in water!

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