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SPORT'S DENTAL INJURIES
Loss of Teeth and Serious Injury

Five million teeth will be knocked out this year. Will your child contribute to these statistics? Sports injuries account for the majority of lost teeth due to trauma. Although there are other sports related injuries, knocked-out teeth are very numerous. A knocked-out tooth begins to die within fifteen minutes outside its oral environment. If it is abraded, rubbed, scrubbed, dried, rinsed with water or touched improperly, it looses its chance of survival. Research has shown that a very high success rate of re-implantation can occur if proper care is provided the knocked-out tooth even if the patient is not seen by the dentist for up to twelve hours!

Traditional re-implantation of knocked-out teeth have a poor prognosis; about 10 percent success. By following critical procedures, this can be changed to a 90 percent success rate. The following steps should be followed:

1. Re-implant the tooth immediately (within fifteen minutes of the accident.) Do not clean the tooth unless debris is on the root. Gross debris should be very gently cleaned. Hold the tooth by its crown (do not touch or scrub root) and very briefly (3-5 seconds) rinse the tooth with water or milk. Immediately insert the tooth into the socket, press into place and hold. There will be little pain, as the tissue will be in shock during this short time after the accident. Immediately proceed to a dentist.

2. Store the tooth, if it can not be re-implanted, in a tooth-preserving system containing Hanks Balanced Salt Solution. Do not clean the tooth, just handle the tooth by the crown and place it into the solution. Take the patient and protected tooth to a dentist before 12 hours elapse; the sooner the better. It would be advisable to call in advance to alert the dentist of the emergency.

3. In the absence of the ability to re-implant or store the tooth in the above-mentioned solution, the prognosis diminishes greatly, depending upon the treatment of the knocked out tooth and the amount of elapsed time. If the first two options are not possible, the following procedures will only provide up to 25% success:
1. Touch only the crown of the tooth. Do not touch the root any time.

2. Place the tooth in cold, fresh milk for quick transport, with patient, to the dentist. Second choice of fluids is a saline solution, third choice is saliva (held between the patients cheek and gum.) If none of the above is available, then use water. Water and saliva can be very destructive to the root cells and should be avoided if possible. Minimize agitation to the tooth.

3. If the tooth is dry-stored for more than 60 minutes, there is less than a 10 percent chance of success.
The best solution is to have a sealed "Save-A-Tooth" system available for such an emergency. One may consider having this emergency system at home and carry it to sporting events. You should help assure that the coach of any contact sport has one system in his first aid kit.

Other injuries include: fractured teeth, abrasions (skinned facial structure), contusions (severe bruising), lacerations (cuts), jaw dislocations, jaw fracture, and concussion due to sharp force on the chin.

Fractured teeth, abrasions, contusions and lacerations can be treated with first aid by a lay person, followed by professional care. Jaw fractures, dislocation and concussion require trained emergency care with professional follow-up. Call 911 or defer to a qualified care provider, if present.

In all of the above, PREVENTION IS THE KEY AND IS VERY EFFECTIVE. A properly fitted and worn mouth guard will prevent or greatly reduce damage (broken or avulsed teeth and some concussions) caused by trauma. The absolute best injury prevention measure is wearing protective devices during all potentially harmful activities. You may read about mouth guards in a separate article provided by this office. The next-best preventive measure is to be prepared for accidents, being trained in first aid and have proper equipment and materials such as the "Save a Tooth System".




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