Dental Injuries in Sports
The impact of dental injuries sustained from playing sports is tremendous. Of all the traumatic dental injuries seen by dentists and oral surgeons, more than one-third comes by way of sports accidents. In the United States, it has been reported that about one of every five facial and head injuries were from a sports-related injury.
“Facial and dental injuries can occur in any sport or activity with a ball or potential collisions,” said Dr. Ryan Kazemi, D.M.D., an oral and maxillofacial surgeon who is part of the medical team with the D.C. United Major League Soccer team and has practiced for the past 16 years in the Washington, D.C./Bethesda, Md. area.
It’s no surprise that dental injuries are a big part of sports accidents. Children grow up accident-prone. In fact, more than half of all children experience a dental injury. One survey of high school students found that injuries occur more frequently than previously thought, with an estimated 19.9 percent of high school students suffering a traumatic dental injury, 30.8 percent of which were caused directly from participating in sports. Considering that 7.6 million children and adolescents participated in high school sports in the 2009 to 2010 academic year, that’s a lot of broken or damaged teeth.
What Sports Are Dangerous?
It’s no surprise that one-on-one combat sports like boxing, wrestling, or any of the martial arts usually rank high on the list of injuries, with up to an 80 percent injury rate. In these sports, most of the damage comes to the nose and teeth. But contrary to popular belief, basketball also usually ranks very high. In fact, one recent study found that the sports with the most dental injuries were wrestling (83.3 percent), boxing (73.7 percent), basketball (70.6 percent) and karate (60 percent).
“I’m more likely to see the basketball, wrestling, field hockey and lacrosse athletes with injuries,” said Dr. Gerald Fine, D.D.S., an oral and maxillofacial surgeon in the greater Boston area who has practiced more than 20 years. Dr. Fine also sees Boston College and Northeastern athletes. “I’m less likely to see football or hockey players because they’re actually pretty well protected.”
Why is basketball ranked so high? Probably because players don’t wear any heavy equipment, and players are at a constant risk for collisions, falling, and connecting with other player’s guarding hands, swinging elbows, and even the ball itself. Another study of dental injuries that included intercollegiate basketball players found a high percentage of soft tissue damage in and around the mouth, with rates nearly comparable to combat sports.
What Type of Dental Injuries from Sports?
“It’s usually the front two teeth,” said Dr. Kazemi. “We see a lot of tooth fractures, loosening, or complete dislodgement of teeth and of course the cuts to the gums and tongue that go with those injuries,” said Dr. Kazemi. Some studies have reported that tooth enamel fractures may comprise up to 40 percent of all dental injuries, with root fractures being far less common, at less than 1 percent. And most injuries occur to the two central front teeth, or central incisors.
The complete dislodgment of a tooth out of its socket is known as an avulsion. Unlike severe fractures, sometimes the original tooth can be saved. “The tooth must be immediately placed back into the socket within 30 to 60 minutes to save the tooth, otherwise an implant will be necessary,” said Dr. Kazemi.
When a tooth cannot be saved: Dental Implants
Dental implants are specifically designed to replace lost teeth lost in a sports incident. Instead of simply tolerating missing teeth or a partial denture, an implant is a permanent option that looks and feels like a real tooth. Replacing lost teeth will not only make your mouth more comfortable, but it can improve speech quality with less noise.
An implant itself only replaces the root of the tooth, which must then be crowned. A complete artificial tooth includes both the implant and the crown. An oral surgeon or prosthodontist usually place implants and crowns, but general dentists can work with the oral surgeon to place crowns, as well.
“Implants work very well for the injured athlete. They have a high success rate,” said Dr. Fine. Further restorative care, such as a bone graft to ensure the implant has enough bone to be anchored in, is “usually not needed,” especially in younger athletes.
The cost of dental implants fluctuate depending on region of the United States, but they can cost anywhere from $2,000 to $4,000. In some states, insurance carriers may cover up to half of the surgical expenses.
Prevention is the Best Medicine: Mouthguards
“There’s no question that [dental] injuries are prevented when any type of facemask, protective gear, or mouthguards is used in sports like football and hockey where close collisions are possible,” said Dr. Kazemi. Researchers agree. A review of several studies on mouthguard use found that when a mouthguard was not worn, the overall risk of injury was nearly two times greater than the risk of wearing a mouthguard.
Mouthguards were practically advocated to a worldwide audience in the recent NBA finals of the Dallas Mavericks versus the Miami Heat, with superstars Lebron James and other teammates routinely featured in close-up shots obviously chewing their mouthguards in between plays. “It’s great to see players of Lebron’s and Bosh’s caliber wearing mouthguards,” said Dr. Fine. “It tells kids and athletes of all ages that it’s an important issue that even superstars take seriously.”
Sources:
2000. Oral health in America: a report of the Surgeon General. J Calif. Dent. Assoc. 28 (9): 685-695.
2001. Promoting oral health: interventions for preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. A report on recommendations of the task force on community preventive services. MMWR Recomm. Rep. 50 (RR-21): 1-13.
2011. “Emergency treatment of athletic dental injuries.” 2011. Available from http://academyforsportsdentistry.org/Resources/TreatmentCards/tabid/70/Default.aspx.
Andrade RA, Evans PL, Almeida AL, da Silva JJ, Guedes AM, Guedes FR, Ranalli DN, Modesto A, and Tinoco EM. 2010. Prevalence of dental trauma in Pan American games athletes. Dent. Traumatol. 26 (3): 248-253.
Bourguignon C, and Sigurdsson A. 2009. Preventive strategies for traumatic dental injuries. Dent. Clin. North Am. 53 (4): 729-49, vii.
Bryant S, McLaughlin K, Morgaine K, and Drummond B. 2011. Elite Athletes and Oral Health. Int. J Sports Med.
Cohenca N, Roges RA, and Roges R. 2007. The incidence and severity of dental trauma in intercollegiate athletes. J Am. Dent. Assoc. 138 (8): 1121-1126.
dela Cruz GG, Knapik JJ, and Birk MG. 2008. Evaluation of mouthguards for the prevention of orofacial injuries during United States Army basic military training. Dent. Traumatol. 24 (1): 86-90.
Honsik KA. 2004. Emergency treatment of dentoalveolar trauma: essential tips for treating active patients. Phys. Sportsmed. 32 (9): 23-29.
Howard B, and Gillis J. 2010. “2009-10 high school athletics participation survey.” 2011.
Huang B, Marcenes W, Croucher R, and Hector M. 2009. Activities related to the occurrence of traumatic dental injuries in 15- to 18-year-olds. Dent. Traumatol. 25 (1): 64-68.
Knapik JJ, Marshall SW, Lee RB, Darakjy SS, Jones SB, Mitchener TA, delaCruz GG, and Jones BH. 2007. Mouthguards in sport activities : history, physical properties and injury prevention effectiveness. Sports Med 37 (2): 117-144.
Labella C, Smith B, and Sigurdsson A. 2002. Effect of mouthguards on dental injuries and concussions in college basketball. Med Sci Sports Exerc 34 (1): 41-44.
Maeda Y, Kumamoto D, Yagi K, and Ikebe K. 2009. Effectiveness and fabrication of mouthguards. Dent. Traumatol. 25 (6): 556-564.
McTigue DJ. 2000. Diagnosis and management of dental injuries in children. Pediatr. Clin. North Am. 47 (5): 1067-1084.
Rogoff A. 2010. Diving damage. J Am. Dent. Assoc. 141 (1): 15-16.
Salam S, and Caldwell S. 2008. Mouthguards and orthodontic patients. J Orthod. 35 (4): 270-275.
Scott LK, and Ranalli D. 2005. Adaptations of mouthguards for patients with special needs. Spec. Care Dentist. 25 (6): 296-301.
Shirani G, Kalantar Motamedi MH, Ashuri A, and Eshkevari PS. 2010. Prevalence and patterns of combat sport related maxillofacial injuries. J Emerg. Trauma Shock 3 (4): 314-317.
Vaca F, Fox JC, Mai D, Anderson CL, Kwon KT, and Wiechmann WF. 2005. Skatepark-related injuries in a southern California skatepark and their associated short-term disability and healthcare utilization. Clin. J Sport Med 15 (3): 142-147.