Written by Arturo Flores, MS, ATC and Moises Azcona, ATC
Athletic trainers encounter a wide range of injuries in their daily practice, from sprains and fractures to concussions and muscle strains. However, one type of injury that might not immediately come to mind is dental trauma. This article will have a special focus on dental injuries—an area that may be overlooked in sports medicine. Additionally, we'll explore preventive strategies to protect athletes from dental trauma and provide guidelines for returning to sport following wisdom teeth surgery.
Tooth Fractures
Losing an adult tooth is a serious situation—once it's gone, it can't be naturally replaced. In the event of a lost tooth, the primary goal is to save and try to reimplant it. Dental injuries like a knocked-out tooth can be common in athletics, and timely and proper care is crucial.
If an adult tooth is knocked out, the first step is to stay calm and handle the tooth carefully, grasping it by the crown (the smooth, white part). If the tooth is dirty, gently rinse it in milk or saline solution for a few seconds, but avoid using water, scrubbing, or drying the tooth. If possible, try to reposition the tooth back into its socket by gently pressing it in with your fingers or by biting down on something soft like a handkerchief. If the tooth can't be reinserted, place it in milk or an emergency tooth preservation kit like Save-a-Tooth. After securing the tooth, seek emergency dental care immediately.
Mandible Fractures
Blunt trauma to the jaw can lead to mandibular fractures, a serious injury that requires immediate evaluation and management by healthcare professionals. Sports like baseball and hockey, where high-speed projectiles are common, pose a significant risk for this type of injury.
Signs of a mandibular fracture in an athlete may include a change in teeth alignment, discoloration along the gumline, swelling, and difficulty opening or closing the mouth. Numbness in the lower lip is another possible symptom, indicating nerve involvement. If any of these signs are present, the athlete should be sent to the emergency room immediately.
X-rays are necessary to diagnose the fracture and determine its severity. In the meantime, applying ice to the affected area can help reduce swelling, and nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken to manage pain and inflammation.
During recovery from a mandibular fracture, patients will need to adjust to a liquid diet, as eating solid foods may not be possible. The healing process can take several weeks, depending on the extent of the injury.
Wisdom Tooth Extraction
Wisdom tooth extraction may be best scheduled during the off-season; however, this option is not always practical. After surgery, physical activity should be limited for about 10 to 14 days, particularly if both lower wisdom teeth are removed. Proper care and rest are crucial for a smooth recovery. A general timeline of wisdom tooth removal recovery and return-to-play are as follows:
- First 48 hours – Avoid physical activity: This period is when discomfort will be most intense, and the initial stages of healing are critical. Resting during this time is essential.
- Days 3-5 – Gradual return to activity: Begin light cardiovascular exercise, then slowly progress to non-contact activities. Your body will continue the healing process for the next several weeks.
- Day 5 – Begin weight training: Weight training can begin but be aware that patients may experience clenching and grinding with heavy exertion during lifting. Facial muscles may be sore. However, if pain persists with activity, rest for a few more days.
- Following days – Gradual return to full activity: Gradually increase activity from light exercise to full-activity and contact.
It is normal to experience some bleeding for up to 24 hours after surgery. As always, follow the postoperative guidelines provided by your doctor to ensure the best possible recovery.
Athletic Mouth Guards
Participating in collision, contact, or high-velocity sports puts student-athletes at risk for dental trauma and orofacial injuries. The use of mouthguards has been proven to reduce the risk of dental injuries significantly. The American Dental Association recommends wearing a properly fitted mouthguard to minimize the severity of oral injuries during sports activities. There are also mail-in kits available for custom mouthguards, such as those offered by the Gladiator brand. It's important to educate student-athletes about the benefits of using mouthguards. However, for mouthguards to be effective, they must be consistently used!
Instructions for Molding Mouthguards
- Prioritize hygiene: Wash your hands and the mouthguard thoroughly with soap and water.
- Trim the mouthguard for length: Place the mouthguard in your mouth and bite down firmly for 3 seconds. Trim the ends as needed to ensure a comfortable fit that doesn’t irritate the back of your mouth.
- Heat the mouthguard: Submerge the mouthguard in boiling water for about 20 seconds to soften it. Quickly place it in a container of cold water for no more than 2 seconds before placing it in your mouth.
- Shape the mouthguard: Position the softened mouthguard against your upper teeth. Using your thumbs, press it up and back against your molars, molding it around your front teeth.
- Bite down to create an impression: Press your tongue against the roof of your mouth to create pressure, and suck the guard firmly against your top teeth for 30-45 seconds. Avoid chewing or moving the mouthguard during this process.
- Cool the mouthguard: Place it in cold water for a minute, then test the fit. The mouthguard should fit snugly against your top teeth. If it feels uncomfortable or doesn’t fit properly, repeat the molding process until you achieve a good fit.
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Resources:
Department of Health & Human Services. (2000, October 23). Dental injuries – tooth loss. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dental-injuries-tooth-loss
Professional, C. C. medical. (n.d.). Think you have a broken jaw?. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/25072-broken-jaw