Dental injuries

Anatomy

Baby teeth are replaced during childhood, after which the permanent teeth come through. The front teeth are usually replaced around the age of 6–12. Traumatic dental injuries occur at all ages, but are most common between the ages of 8 and 12 and most often affect baby teeth.

Cause

A direct blow to the teeth can cause damage to the hard tooth tissue (enamel, dentine, cementum), the tooth’s nerve (pulp) or the supporting tissues of the tooth (periodontium). The teeth may be so badly damaged that they break, fall out or suffer damage to their blood supply, resulting in permanent damage.

Symptoms

Looseness of the tooth, bleeding from the gums, pain in the tooth, altered bite, feeling new sharp edges on the teeth with the tongue.

Examination

If, after a trauma, the athlete reports a sensation of changes in the bite, looseness of one or more teeth, bleeding from the gums or tooth pain, an assessment should be made by a specialist (possibly the dental emergency service). The outcome of the treatment depends on how quickly you get to the appropriate examination.

Treatment

Dental damage to baby teeth is often not treated, but may be indicated in cases such as fractured baby teeth. Tooth damage to permanent teeth usually requires treatment. If permanent teeth are knocked out (or larger pieces of the tooth are knocked off), the tooth is cleaned with running water only. The knocked out tooth can then be tried to be put back into the bone or stored in clean water or milk and taken to the dentist (dental emergency). Treatment should be initiated as soon as possible.

At the slightest doubt, the athlete should therefore consult a dentist for an assessment. The dentist will then assess the number of teeth involved in the trauma, the colour, location and vitality of the teeth, assess the need for observation, possible tooth replacement, indication for tooth reconstruction with plastic or tooth fragment or tooth removal and appropriate control (Mordini L, et al. 2021).

Rehabilitation, specific:

You can usually resume normal sports activity shortly afterwards.

Complications

The tooth may fall out or become discoloured.

In particular

Mouthguards significantly and well-documented reduce the risk of tooth damage. It is advisable to increase the use of mouthguards in many contact sports (Grillo R, et al. 2023). For dental injuries requiring treatment, consider waiting to start contact sports until the tooth has healed to avoid re-injuring the tooth while it is trying to heal.

Dental injuries should be reported to your insurance company as there may be sequelae that require further treatment.

Rehabilitation