Tip Sheets

‘Back-to-school’ a good time to focus on sports-related dental injuries

By Mary Otto

With millions of school athletes headed back to playing fields across the country, protecting teeth from loss and damage should be on the minds of parents, coaches, teachers and players too.

Ray Padilla spends plenty of time thinking about sports-related dental injuries.

He’s the team dentist for the Los Angeles Galaxy Major League Soccer team, for athletes at the University of California, Los Angeles, and is a consulting dentist for U.S. national and Olympic soccer teams.

A featured speaker at the recent annual meeting of the California Dental Association, Padilla shared his expertise with other dentists, and DrBicuspid.com assistant editor Therese Pablos, who caught up with him for an interview.

More than 80 percent of dental injuries involve the top front four teeth, Padilla noted. Properly-fitting mouth guards offer effective protection, research has shown. The American Dental Associationrecommends their use for at least 29 different sports, from acrobatics to wrestling.

According to Padilla, children should start wearing mouth guards at age 11, when sports start becoming more intense. However, he told Pablos, he has his own children start wearing the protective devices at age 5 so they become accustomed to them.

Even when precautions are taken, however, injuries may occur, Padilla said.

If a permanent tooth is avulsed – knocked out – action must be taken right away to save it, experts advise.

“If the tooth has been out of the mouth for more than five minutes, it will never be the same again,” Padilla told Pablos.

For guidance on specific injuries, Padilla recommends the Dental Trauma Guide, created by the nonprofit International Association of Dental Traumatology.

The database, which offers specific guidance for different types of trauma, advises that avulsed primary (baby) teeth should not be replanted. In cases where permanent teeth are knocked out, the following steps are recommended:

  • Keep the patient calm.
  • Find the tooth and pick it up by the crown (the white part). Avoid touching the root.
  • If the tooth is dirty, wash it briefly (10 seconds) under cold running water and reposition it. Try to encourage the patient or a parent to replant the tooth. Bite on a handkerchief to hold it in position.
  • If this is not possible, place the tooth in a suitable storage medium, e.g. a glass of milk or a special storage media for avulsed teeth if available.
  • The tooth can also be transported in the mouth, keeping it between the molars and the inside of the cheek. If the patient is very young, he/she could swallow the tooth- therefore it is advisable to get the patient to spit in a container and place the tooth in it. Avoid storage in water!
  • Seek emergency dental treatment immediately.

Last year, the American Academy of Pediatrics published new guidelines for handling dental trauma in primary care settings in the journal Pediatrics. Unless the child has other injuries, it is best for the parent or guardian to take him or her straight to a dentist, according to the guidelines’ lead author, Martha Ann Keels, chief of pediatric dentistry at Duke University Children’s Hospital & Health Center.

“The success of healing is time dependent in many trauma cases – so you want to have a dental home and not rely on the local Emergency Department,” Keels told Reuters Health in an article offering a useful summary of the guidelines for parents.

Maybe now is a good time to remind readers about the best ways of preventing dental injures, and coping with them if they occur.

Helpful resources

These guidelines, developed by the International Association of Dental Traumatology and endorsed in 2013 by the American Academy of Pediatric Dentistry, deal specifically with the management of injuries to the primary (baby) teeth.