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Year : 2013  |  Volume : 13  |  Issue : 1  |  Page : 7-9

Dental trauma: Athletes, coaches, and school teachers must know-A brief review

1 Department of Oral and Maxillofacial Surgery, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra, India
2 Department of Public Health Dentistry, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra, India
3 Department of Conservative and Endodontics, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra, India
4 Department of Pediatric and Preventive Dentistry, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra, India
5 Department of Orthodontia, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra, India

Date of Web Publication28-May-2013

Correspondence Address:
Fareedi Mukram Ali
Department of Oral and Maxillofacial Surgery, Sau. Mathurbai Bhausaheb Thorat Dental College, Sangamner, Ahmednagar, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-6308.112206

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Sports injuries are injuries that occur in athletic activities. In many cases, these injuries are due to overuse or acute trauma of a part of the body when participating in a certain activity. Sports Dentistry is the treatment and prevention of oral/facial athletic injuries and related oral diseases and manifestations. In sports, the challenge is to maximize the benefits of participation and to limit injuries. Prevention and adequate preparation are the key elements in minimizing injuries that occur in sport. Treatment of oral/facial injuries, simple or complex, is to include not only treatment of injuries at the dental office, but also treatment at the site of injury, where the dentist may not have the convenience of all the diagnostic tools available at their office.
Preseason screenings and examinations are essential in preventing injuries. Examinations are to include health histories, at risk dentitions, diagnosis of caries, maxilla/mandibular relationships, orthodontics, loose teeth, dental habits, crown and bridge work, missing teeth, artificial teeth, and the possible need for extractions for orthodontic concerns or wisdom teeth. These extractions should be done months prior to playing competitive sports as to not interfere with their competition or weaken their jaws during competition. Determination of the need for a specific type and design of mouthguard is made at this time.

Keywords: Dental Injuries, Sports, Tooth fracture

How to cite this article:
Ali FM, Bhushan P, Saujanya KP, Patil S, Sahane D. Dental trauma: Athletes, coaches, and school teachers must know-A brief review. Saudi J Sports Med 2013;13:7-9

How to cite this URL:
Ali FM, Bhushan P, Saujanya KP, Patil S, Sahane D. Dental trauma: Athletes, coaches, and school teachers must know-A brief review. Saudi J Sports Med [serial online] 2013 [cited 2023 Oct 1];13:7-9. Available from: https://www.sjosm.org/text.asp?2013/13/1/7/112206

  Introduction Top

Sports-specific injuries in young athletes are seen more frequently than ever before because of increased and more rigorous participation in sports by today's youth; moreover, the training and performance demands on contemporary young athletes have intensified dramatically in recent years. In effect, young athletes are now expected to play adult sports inside still-developing and skeletally maturing bodies.

Dental injury is a distressing event, often causing psychological as well as physical problems, since it normally involves the highly visible front teeth. And, it is particularly common among athletes, with sports-related dental injuries said to account for nearly 40% of the total. [1]

Traumatic dental injuries occur either at home or at school mostly while playing sports. Most of the time, these traumatic injuries in athletes are referred to physician, dentists, or to the hospital emergency departments without giving appropriate emergency management at the site of accident. The resulting complications can be costly and time-consuming and many teeth are subsequently lost. Coaches and school teachers can play an important role in managing and improving the prognosis. Awareness and knowledge regarding the dental trauma among athletes' coaches, and school teacher may prevent loss of teeth.

  Prevalence of Sports Injury at Schools Top

(Emerich and Kaczmarek, 2010) reported as many as 31% of all orofacial injuries are caused by sporting injuries. [2] According to study conducted by (Fasciglione et al. 2007). [3] the most common sport injury is tooth fracture. A study done in India by (Navin AI 2010) reported 15% of sport injuries of total dental trauma in school-going children. [4]

  Discussion Top

A multitude of teeth are knocked out every year in India. The main causes in the permanent dentition are fights and sports injuries. Researchers have developed methods of saving most of these teeth. These knocked out teeth can often be reimplanted under favorable conditions. If the tooth can be replanted within minutes after the accident, there is a greater chance that the tooth will be retained for life.

Commonly occurring dental injuries are as follows:

  1. Tooth avulsion (complete tooth knocked out),
  2. Luxation (tooth in socket),
  3. Tooth fracture, and
  4. Soft tissue laceration.

1. Tooth avulsion is the complete displacement of a tooth from its socket due to accidental or nonaccidental injuries and may cause loss of healthy teeth. [5] Tooth replantation should be performed in these cases. If the tooth is replanted within 5-30 min after avulsion, there is a chance for successful healing and the tooth can be saved for the future. Ideal recommended time limit is 20 min or less. [6] If a tooth cannot be replanted within 30 min, it can be temporarily stored in a suitable storage medium during the transport to the clinic.

After the accident, the tooth should be located and picked up by the crown or enamel portion and not the root. If the tooth is dirty or contaminated, it should gently be rinsed with milk or water. Do not store the tooth in water.

Emergency management for avulsed tooth

  1. Avoid additional trauma to tooth while handling.
  2. Do not handle tooth by the root.
  3. Do not brush or scrub tooth.
  4. Do not try to sterilize tooth.
  5. If debris is on tooth, gently rinse with water.
  6. If possible, reimplant tooth and stabilize by biting down gently on the towel or handkerchief. Do only if athlete is alert and conscious.

Storage media: If unable to reimplant

Best: Place tooth in a physiologic transport medium (e.g., Hank's balanced saline solution) [2],[6],[7]

2 nd best: Place tooth in milk.

3 rd best: Wrap tooth in saline-soaked gauze.

4 th best: Place tooth under athlete's tongue. Do this only if athlete is conscious and alert.

Time is very important: Reimplantation within 30 min has the highest degree of success rate. Transport immediately to the dentist. [2],[6],[7]

2. Luxation (tooth in socket, but wrong position)

There are three positions in luxation:

2.1 Extrusion: The tooth may be extruded.

2.2 Intrusion: The tooth is pushed into the gums (it looks short).

2.3 Lateral displacement: Tooth pushed back or pulled forward.

2.1 Extruded tooth: Upper tooth hangs down and/or lower tooth raised up. Reposition tooth in socket using firm finger pressure. Stabilize tooth by gently biting on towel or handkerchief. Transport immediately to dentist.

2.2 Lateral displacement: Tooth pushed back or pulled forward. Try to reposition tooth using finger pressure. Athlete may require local anesthetic to reposition tooth; if so, stabilize tooth by gently biting on towel or handkerchief. Transport immediately to the dentist.

2.3 Intruded tooth: Tooth pushed into gum--- looks short. Do nothing---avoid any repositioning of tooth. Transport immediately to the dentist.

3. Fracture (broken tooth)

If tooth is totally broken in half, save the broken portion and bring to the dental office as described under Avulsion, Item 4. Stabilize portion of tooth left in mouth by gently biting on towel or handkerchief to control bleeding. Should extreme pain occur, limit contact with other teeth, air or tongue. Pulp nerve may be exposed, which is extremely painful to athlete. Immediately, transport patient and tooth fragments to the dentist.

4. Soft tissue laceration

Soft tissue laceration, most commonly the lips and the gingiva. All types of traumatic tooth injuries are often accompanied by soft tissue injuries including hemorrhage, swelling, and lacerations. Frontal impacts absorbed by the upper lip can result in displacement of the tooth from its socket as well as laceration on the lip and on the gums. The emergency management is to give pressure pack with sterile gauze or sterile cloth to control the bleeding and then send the athletic to the dentist.

Precautions for athletes to prevent injury to mouth

1) Mouth guard: Mouth guard is a special type of prosthesis which protects the teeth from all injuries. It covers all the teeth and does not allow direct impact on the teeth.

2) Do not ignore even minor injuries like fracture of the tip of the tooth or gum injuries. Always consult a dentist for needful treatment.

3) Do not leave fracture restorations or faulty restorations as it is. If you find any carious lesion in teeth, always get it restored as early as possible.

4) Always prefer removable prosthesis rather than fixed prosthesis. After retirement from sports, you can switch to fixed prosthesis.

  Conclusion Top

Coaches and sports teachers working with athletes should know the importance of emergency management and how to manage cases of dental trauma. Use of properly fitted, custom-fabricated athletic mouth guards for the prevention of dental injuries is recommended strongly.

  References Top

1.Banky J. Sports dental injuries. Endod Traumatol 1990;6:208.  Back to cited text no. 1
2.Emerich K, Kaczmarek J. First aid for dental trauma caused by sports activites: State of knowledge, treatment and prevention. Sports Med 2010;40:361-6.  Back to cited text no. 2
3.Fasciglione D, Persic R, Pohl Y, Filippi A. Dental injuries in inline skating - level of information and prevention. Dent Traumatol 2007;23:143-8.  Back to cited text no. 3
4.Navin AI. Prevalence and factors associated with traumatic dental Injuries (TDI) to anterior teeth of 11-13 year old school going children of Mathuravoyal, Chennai. J Oral Health Commun Dent 2010;4:55-60.  Back to cited text no. 4
5.Abu-Dawoud M, Al-Enezi B, Andersson L. Knowledge of emergency management of avulsed teeth among young physicians and dentists. Dent Traumatol 2007;23:348-55.  Back to cited text no. 5
6.Usha M. Displacement Injuries: Famdent Practical Dentistry Handbook. 1 st ed, vol. 9. Mumbai: Famdent publications; 2008. p. 84-94.  Back to cited text no. 6
7.Yamada T, Sawaki Y, Tohani I, Takeuchi M, Ueda M. A study of sports-related mandibular angle fracture: Relation to the position of the third molars. Scand J Med Sci Sports 1998;8:116-9.  Back to cited text no. 7

This article has been cited by
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Gautam Nandita,KK Shivalingesh,Kushwaha Anushtha
Journal of Dental Problems and Solutions. 2021; : 052
[Pubmed] | [DOI]


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