Emergency Tooth Extraction and Athletes

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When there's a collision between players or an athlete gets smacked in the face with a stick or ball, parents on the sidelines may gasp. Are the kids OK? Will an emergency tooth extraction need to be performed on any damaged teeth?

The National Journal of Maxillofacial Surgery reports that 11 to 40 percent of all sports injuries involve the face, thus the teeth are in the line of fire. If a tooth gets knocked out, can the athlete's smile be repaired? Is there a way to prevent dental injury?

What Are the Most Dangerous Sports?

Football, girls' soccer, boys' wrestling, girls' basketball and boys' ice hockey were the sports with the highest concussion rates, according to a study published in the American Journal of Sports Medicine. Girls suffered more concussions than boys. The concussion rate may correlate with the number of dental injuries among athletes.

Sports Health reported the results of a PubMed search conducted from 1960 through April of 2012 to determine the most frequently seen sports related dental injuries in the mouth. These dental injuries included tooth intrusion (displacement of tooth into bone), tooth extrusion (partial displacement of tooth out of socket) and tooth avulsion (complete displacement of tooth out of socket) and temporomandibular joint dislocation.

When Is a Tooth Extraction Necessary?

An emergency tooth extraction may have to be performed when there is dental pain from a tooth that can't be repaired or a tooth that interferes with oral function. The main two indications to extract the tooth would be that the root is fractured or the crown of the tooth is fractured deep below the gumline. Traumatic injury usually involve an upper front tooth, the most common being a central incisor.

Injury from trauma does not necessarily lead to an emergency extraction of a tooth, though other forms of emergency dental treatment may be needed. Fracture of the crown of a tooth is the most common severe injury. A dental concussion is the most common injury secondary to trauma, according to a study published in BMC Oral Health. This is from a force hitting the tooth without fracturing or displacing it. Next, a tooth can suffer luxation or displaced either deeper under the gum or in another direction.

The first concern with trauma to the mid-facial region is that are there broken bones or a concussion. The jaw joint should be evaluated for damage. Look for limited ability to open the mouth, deviation to one side on opening, or pain on opening and closing. Soft tissue injury to the lips, gingiva and tongue are possible. The injury that requires the most immediate attention is an avulsed tooth, followed by a displaced tooth.

Is a Knocked-out Tooth Salvageable?

With a tooth that has been completely knocked out of the socket, it's important to get it back in as fast as possible. If you don't feel confident placing it back into the socket yourself, then it has to be preserved outside the mouth until you see the dentist. Do not scrape it or wash it off. Placing the tooth in milk, salt water or saliva is a quick temporary fix for preserving a knocked out tooth; however, the tooth needs to be inserted in less than an hour to give it the best long-term prognosis.

The tooth, depending on how developed its roots are, may require a root canal treatment. The tooth will need to be splinted to the other teeth for several weeks. If the roots aren't broken, it's worth it to place it back into the socket and see how it heals. A tooth that has been shifted into the wrong position should be repositioned as soon as possible and stabilized with a splint for several weeks. The repositioning may also require some future orthodontic care to move it into the original position.

Can You Prevent Dental Injury?

Sports injuries to teeth can be prevented or the trauma minimized with the use of a mouth guard. Coaches need to insist that players wear them. The better the quality and fit of the guard, the more protection it provides. An impression is taken by a dentist and then sent to a dental laboratory which will professionally manufacture the best-fitting and highest-performing mouth guard. A poll published in Dental Traumatology reports that athletes prefer custom-made mouth guards over boil-and-bite models. Custom-made forms were more comfortable, didn't affect breathing and provided the best protection; though any type of guard is better than no guard at all.

Before the start of every sport season, see your dentist to discuss how to best protect your child's teeth.