Gridiron Tooth Grief

by Dr. Fred Peck, DDS 4. September 2014 11:41

This was written by a friend of mine in Columbus,  Robert Stevenson, DDS, who expressed his thoughts of mouthguards and injury prevention so well that I asked him if I could use it during the fall sports season to spread the word.

Football season brings juicy opportunities for bumped and broken teeth among helmeted young warriors and marching band musicians. When hits happen victims should get to a dentist, and the sooner the better. Most organized football leagues have a team dentist standing by who can examine dental injuries and decide what to do. Neighborhood or playground touch football games are more casual, but competition is just as intense. Wise athletes always wear mouth protection. Store-bought mouth guards cost less than a fiberglass cup. An ounce of prevention is worth a pound of cure. When players don’t wear a mouth guard, blows to the chin are transmitted from the lower teeth to the upper teeth to the brain. When a mouth guard is worn, it acts like a shock absorber, lessening force to the brain. All US high schools and colleges require football players to wear them, so start now and get used to it. The biggest problem, clear speech, is overcome with practice.

School band musicians often land in a dentist’s chair, especially those playing larger instruments like trombones or sousaphones. Bands learning new field arrangements and changing formations will make occasional mistakes during practice, turning left instead of right, sometimes bumping horns. A heavy mouthpiece pressed against pursed lips can play a pretty distinct tune on nearby teeth when impacted. Mouth guards may not always be an option for woodwind or brass instruments, but percussionists might consider them. As with stroke or heart attack, the sooner treated the better chance of success. Same goes for dental trauma. Much depends on the victim’s age and whether baby teeth or adult teeth are involved.

A child’s first set of teeth is important for many long-term reasons. The second teeth will last forever when properly cared for. Preserving original teeth as long as possible is always the first goal. When an entire tooth is knocked completely out of the jaw, the sooner it’s put back into the socket, the more likely it will heal. Naturally, if the tooth fell into mud or got dirty, it should be gently cleaned with wet tissue or a damp cloth before replacing. If you’re not able to clean it, cold milk is the best possible solution for storing it on the way to a dentist. Recent studies found plain water is not very good for storing teeth. A saline/salt water soak is better than allowing teeth to dry out on the way to the dentist. Teeth broken off near the gum line might bleed from the gum and/or nerve or pulp inside the tooth. Biting on a piece of rolled-up tissue or cloth on the way to the dentist helps. Take any tiny fragments of broken teeth with you. When baby teeth are shoved up into the gum ridge, their roots might bump against the still-forming second tooth. Treatment may be possible, but long-term damage won’t be known until the second tooth erupts. Wiggly teeth that won’t stay put when pushed back into the gum could soon become loose and accidentally swallowed or inhaled. If you can remove it with your fingers, that might be safer, especially when the victim appears dazed or confused. Store the tooth (or piece) as described above while en route to a dentist.

Soccer players use their heads. When they collide, it’s like two flying bowling balls. Whenever secondary teeth are bumped, whether playing sports or against a car steering wheel, the damage may not show for 10 or 20 years. Whenever teeth are hit hard enough to be loose, it can mean serious injury, even when no teeth are chipped or broken. It’s a good idea to see a dentist soon after any tooth injury to document what happened, whatever the origin. Someday the records might be useful. The faintest ink is sharper than the clearest memory, eh?

Reprinted with permission from ODA Today


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