Sports-related dental injuries – not just boxing!

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You don’t have to be a professional athlete for your teeth to be at risk of injury. All it takes is a scooter ride, a football game or a skiing trip. It’s not that uncommon at all, as up to one in three adults will experience some kind of tooth injury in their lifetime. If we think this only applies to boxing and hockey, we might be surprised, because the list of traumatic sports is much wider. How do you avoid an injury and what should you do when one does occur? – suggests the dentist.
How do you lose a tooth? Contrary to appearances, it is not difficult at all. On the podium of the causes of tooth injuries are accidents in private life (home, school), closely followed by sports, and closing the lead are road accidents. Among the sports, boxing, football, basketball, volleyball and hockey are cited as the ones most frequently causing injuries. Although seemingly different, they have a common denominator – a large force that can reach our face. In the case of boxing it will be an opponent’s fist, in basketball it will be the ball or arm of a fellow competitor, and in hockey it will be the puck. Surprisingly, the list of sports that can have potential effects on oral health is substantial.

– In fact, all types of sport carry a risk of craniofacial injury. Of course, this varies and depends on many factors, but those areas of physical activity where the chance of falling, contact with a hard surface or opponent is high, carry the greatest risk. On the one hand this could be squash and on the other rugby. These risks are moderated by safety measures such as pads, but not everyone uses them, hence the still high number of dental emergency patients, warns FreshMed – dentysta z Katowic.

And a box, and a scooter
Inconspicuous in appearance, made of vulcanised rubber and weighing as much as a cup of yoghurt, i.e. less than 200 grams. Hockey puck. It travels at speeds of up to 160 km/h and can cause considerable harm, so proper protection for the hockey player is essential. But it is not only this sport that carries danger.

– In sports with a high risk of injury or trauma, protectors are commonly used. Their purpose is to cushion and disperse the force of an impact. However, they are not used in every sport. They are rarely seen in football players, squash players or even skateboarders. One group that has been visiting dental surgeries with increasing frequency recently are scooter users. Among them, the lack of a helmet, not to mention a mouth guard, is common,” describes the expert.

Electric scooters are becoming increasingly popular in many European countries, including Poland. Their users can already be numbered in the hundreds of thousands, which is a result of increasingly widespread access to the equipment, which does not even need to be purchased. This raises the problem of proper protection of structures important for life and health, such as the brain and sense organs, most of which are located on the head: sight, hearing, smell. In addition, the very nature of a vehicle such as a scooter predisposes to more frequent injuries in the upper half of the body, i.e. the arms, chest and head, including the teeth. Considering that the head with the face makes up about 9% of the body surface, they are involved in injuries in 50% of accidents! Another sport in which we have to reckon with a considerable risk of injury is boxing.

Boxing and other combat sports are unique in that they are based on direct combat with a live opponent. In most cases, both are equipped with suitable protectors: head, teeth, forearms, shins, as well as gloves. Despite all the protective measures, the punching power of a professional heavyweight boxer can reach up to 450kg. The result? Dental injuries in this sport affect up to 80% of fighters. In combat sports, the wearing of a mouthguard has been common and compulsory for several decades. It protects the lips, teeth but also the tongue. It also has another function: by cushioning the force of the blow, it partly protects the brain, which is extremely sensitive.

Are there sports that are completely safe for teeth? When looking for ones to avoid problems, skiing might come to mind. Unfortunately, here too we are in for an unpleasant surprise. Tooth damage is common among ski enthusiasts, but – interestingly – not caused by skiing alone.

– One of the most common causes of craniofacial injuries, including in sport, is simply falls. With skiing, this can be much more frequent and severe. When we are in motion, moving at high speed, the forces acting on us will be correspondingly greater. Other risks are people on the slope with whom we may collide, but also minor infrastructure and elements of nature, such as stones or trees, as well as our own equipment, warns the Freshmed clinician from Katowice.
When skiing, we should have appropriate protectors and a helmet, which can be retrofitted with a guard and even a mouth guard. The same applies to other disciplines where we move at high speed and may encounter obstacles.

The ways in which we can injure ourselves during sport are many. Their direct cause does not always have to be an external factor, such as a ball approaching our face or an opponent’s arm being inadvertently extended. In some cases, the unconscious clenching and grinding of teeth also leads to undue strain, resulting in hypersensitivity, chipped enamel or pain in the temporomandibular joints.

First aid for a knocked-out tooth
Injuries happen and will continue to happen, which is why it is important to keep a cool head and handle the incident correctly. The first thing to do is to recognise the situation and protect the injured person, who may often be ourselves. If the injury has happened in a busy place, such as a pavement, street, ski slope or sports field, it is important to go to a place where we can sit calmly and organise first aid.

– In the case of a completely dislocated tooth, or colloquially speaking: knocked out, the matter is relatively simple. In the case of a deciduous tooth, there is no possibility of re-implanting it in the alveolus, but the opposite is true for permanent teeth. In this situation, the tooth is found, grasped by the upper part, i.e. the crown – never by the root – and then rinsed under clean water and placed either in the mouth between the cheek and the teeth, or in saline, or preferably in milk. Such a tooth can then be placed back into the alveolus by the dentist,” advises the doctor.

Time is of the essence when it comes to reimplantation. We have a few tens of minutes to do this, and the later the worse, because the cells die and such a tooth will simply be rejected by the body. This situation leaves only one option, which is to clean the wound, apply a dressing and perform diagnostic X-rays to show whether there is more serious damage to the jaw or mandible.

The spectrum of other injuries is as wide as the factors causing them. One of these is intrusion, when there is, as it were, an intrusion of the tooth deep into the tissues towards the alveolus. Here, depending on the depth of the displacement, one can count on so-called reeruption, i.e. the spontaneous return of the tooth to its proper place, and if it is larger, orthodontic or surgical treatment is applied, but only after a few weeks, when the surrounding tissues have healed. For injuries characterised by tooth displacement, referred to by specialists as partial dislocation, a diagnostic X-ray is carried out, the patient is interviewed about the circumstances of the incident as well as his or her general health, and then treatment is carried out.

– Common injuries include a fracture of the crown of the tooth, which can involve the enamel alone, the enamel and dentin or even the pulp. Here, too, we have the option of fixing the broken off part, but in the case of pulp damage: only after root canal treatment has been carried out. The viability of the pulp is an important parameter here,” explains the dentist.

A tooth can also be broken at the root, but then the most common treatment is its removal. This leaves us with prosthetics: a bridge or a crown on an stomatolog implant.

Choosing a mouthguard
Mouthguards are widely available commercially. The most popular are those designed for martial arts athletes, but it is possible to successfully find one that is more suitable for a specific discipline (for boxers, they also cover the mouth). The list of disciplines in which it is recommended to wear a mouthguard, compiled by the American Dental Association, includes boxing, acrobatics, skateboarding, martial arts, skateboarding, weightlifting and gymnastics, among others.

Tooth guards are divided into three types: universal, self-prepared models and those from the dentist’s office. The first are flexible enough that, once placed in the mouth, they should fit over the dental arches and provide minimal – basic – protection. The second type of braces, on the other hand, are designed to be moulded in-house. This involves immersing the protector in hot water and later on the dental arch. As the plastic cools, it will retain its fit to our anatomical conditions. The last type of mouthguard is one that the dentist will prepare in the office on the basis of an impression taken or a computer scan. These are recommended for people who play sports professionally, but a commercial mouthguard also causes a vomiting reflex or various abrasions to the soft tissues of the mouth.



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