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Taking it on the Chin: Quick Treatment Can Save Damaged Teeth

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WebMD Health News

Feb. 8, 2000 (Atlanta) -- According to the National Institute of Dental Research (NIDR), one in 10 athletes -- including weekend types -- will get whacked in the face or mouth at some point. To put this in perspective, in a basketball game with the typical 10 players, one of them will likely suffer a tooth-jarring injury. Too often, that injury will be a broken, loosened or knocked-out tooth. While many oral injuries occur in violent sports like football, boxing, and hockey, an alarmingly high percentage of teeth get knocked out during bike riding, baseball, soccer, volleyball, and basketball.

Writing in the January issue of The Physician and Sportsmedicine, William O. Roberts, MD, says that tooth injuries can be divided into three categories: 1) fracture, which can be a broken or chipped tooth; 2) luxation, or displaced tooth; and 3) avulsion, or knocked-out tooth. Roberts is a family physician at Minnesota Health Family Physicians in White Bear Lake, Minn.

With a fracture, Roberts recommends gently biting into a towel or gauze to help control the bleeding. "Tooth fragments should be handled on their enamel surfaces, saved, and sent with the athlete to the dental office," he says.

For a displaced tooth, Roberts recommends quick dental care because a tooth out of place can interfere with and harm surrounding teeth. Roberts tells WebMD that the victim can try to move the tooth back into place. "If the procedure is too difficult or too painful, the tooth should be left as is for the dentist to reposition," he says.

Knocked-out teeth should be held by the crown to avoid further damage to the root and then gently teased back into the socket and held in place until the patient can reach the dental office. If a knocked-out tooth can't be placed back into its socket, Roberts says it should be stored in a moist environment and immediately sent to the dentist. The best results are obtained by reimplanting the tooth within 30 minutes; after 2 hours, the chances of saving the tooth are slim.

There are special solutions on the market such as Save-a-Tooth -- which cost around $15 -- designed for sideline medical kits. Other excellent possibilities for storage include cold milk, cold normal saline solution, saline-soaked gauze on ice, or in the athlete's cheek.

The best solution, according to Roberts as well as the American Dental Association, the NIDR, and virtually every other dental authority, is for athletes to wear mouthpieces. A properly fitted mouthguard relieves the stress concentrated on the front teeth by absorbing and dispersing some of the shock energy throughout the mouth.

But not everyone who should be is using them. A study by NIDR found that while 72% of youths playing football wear mouthguards, the numbers drop significantly in other sports. Less than 10% of youths wear mouthguards while playing soccer, softball, and baseball. The fact that many mouth injuries occur in non-contact sports has led dentists to recommend wearing a mouth protector during any activity in which physical contact might take place.

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