September 26, 2016

5 Most Common Sports Related Dental Injuries

Sports are a fun and healthy past-time activity that can help you or your children have fun and stay healthy and fit. It’s well known that physical activity has numerous benefits you’re your physical as well as mental health and well-being. At least 30 minutes of physical activity a day is recommended to avoid serious health consequences, but it is really difficult to go overboard – the more, the merrier.

However, sports, especially if engaged in competitively, do carry a risk of injuries. Some are more notorious for that, while in other sports, they are virtually unheard of. The prevalence is unknown, but in some sports the occurrence of injuries could be close to 80 per cent. Overall, about 5 million teeth become avulsed (traumatically displaced from their socket or knocked out). This leads to half a billion dollars in healthcare expenses. And that’s just per year. Overall cost per avulsed tooth ranges in five figures during a person’s lifetime. About 15 to 40 per cent of dental injuries occur during sports activities.

Generally, the riskiest sports are contact sports. This includes the martial arts, boxing, football, hockey and basketball. Soft tissue traumas are the most common, but when the teeth are affected, some 80 per cent of injuries affect front teeth, thus presenting a significant aesthetic challenge.

That’s why it’s very important to know and understand what the most common injuries are, as well as ways to prevent them. Now we’ll take a closer look at five most common sports related dental injuries. They are usually categorised as traumatic dental injuries, as trauma is usually what causes them.

Dental Avulsions

These are one of the most serious injuries. Avulsion means that, to say it in plain English, a tooth gets completely knocked out of its socket. It’s a very serious injury that must be dealt with immediately, lest a tooth will be permanently lost. Avulsions affecting baby teeth are not that serious and the tooth does not need reattaching, but secondary (permanent) teeth need to be replanted quickly, preferably within 10 minutes.

Otherwise, the process of root resorption begins and it becomes much more difficult to successfully restore the avulsed tooth. If it’s impossible to reattach the tooth immediately, it should be kept in a saline solution, or, if it’s unavailable, in milk. Do not touch the roots, scrape or store the tooth in a dry place, and get to the dentist ASAP. The longer you wait, the less chance there is of saving your tooth. Do not sterilize the knocked out tooth; this is a good way of ensuring you lose it forever!

What causes dental avulsions?

They are usually caused by severe trauma to the tooth, such as when suffering from a fall, getting hit by a ball or unlucky punches, such as elbow to the mouth. Car accidents and biting on hard food can also cause dental avulsions. These injuries can also occur during falls from a trampoline or during gymnastics, although in the latter case chipped teeth are a much more common occurrence (see below). Gymnastics is categorised, though, as a high-risk discipline along with the above mentioned sports – martial arts, hockey, football, basketball…

Cracked teeth

Tooth fractures occur when a person sustains a sharp, strong blow to the facial area. The resulting forces cause the tooth to crack. Cracks in a tooth usually run from the surface of the tooth to the root area. When the fracture spreads to the root, it means that the tooth usually cannot be saved. That’s why it’s important to go seek help early if tooth fracture is suspected. Minor fractures usually don’t cause pain or other symptoms. More serious cracks usually present as pain when biting down and serious sensitivity to hot and cold temperatures. Cracks may not always be visible to the naked eye and determining the exact location can be difficult as the pain need not be particularly localized. Cracked tooth hurt because the pulp gets damaged by all the irritation. Cracked teeth will not heal on their own and require the dentist’s attention.

Cracked teeth occur primarily as a result of trauma, usually when the mouth is struck by other objects, so any sport in which that is a possibility presents a possible risk.

Chipped teeth

This is probably one of the most common dental injuries, but fortunately, it is one of the most manageable as well. Some cases don’t even require treatment, if you can live with the resulting tooth.

Most obvious symptoms are the feeling of sensitivity to hot and cold. The tooth may feel different under the tongue with sharp edges. Of course, an obvious sign is feeling the piece of the broken tooth in one’s mouth. If you can recover the fragment(s), it can be reattached by the dentist. Most cases of chipped tooth are treated with simple fillings, but if the front teeth are affected, then the dentist will use various resins that look like natural teeth because of aesthetic considerations.

Most chipped teeth are results of clumsy falls, blows and accidents.

Displaced teeth

This happens when the force is not strong enough to knock the tooth out altogether, but strong enough to loosen the bond between the tooth and the periodontal ligament. The first thing to do with a displaced tooth is to put it back into its place. If necessary, the tooth should be stabilized with a paper towel or held in place with a hand. It is likely that there will be some bleeding and sensitivity as the pulp gets exposed. Capping the tooth with dental cement provided in a dental emergency kit is a good short-term solution. Generally a period of recovery is short and normal activities can be resumed a week after injury.

Falls and sporting activities cause a majority of these injuries (usually blows to the facial area), but accidents can cause them too.

Dental intrusions

Dental intrusion occurs when the tooth is displaced into the alveolar socket. That means it doesn’t go outwards, but inwards. In the process, it can cause fractures to the surrounding bone. The tooth is visibly displaced inside and cannot move. Very small intrusions are left to resolve spontaneously, but repositioning is needed for more severe cases. Sometimes a surgical treatment to reposition the tooth is necessary; otherwise orthodontic means are used. The condition must be dealt with and assessed as root resorption may cause tooth loss if the intrusion is severe.

It can occur with blows that strike the tooth under the right angle, such as when falling onto an object with front teeth.

Similar blows and strikes cause fractures to the alveolar bone, yet another traumatic injury. Its symptoms are tenderness and several adjacent tooth becoming movable. Both conditions require splints and partial immobilization of the affected area.

Cosmetic Dentistry George Harouni, DDS

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