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REVIEW ARTICLE
Year : 2013  |  Volume : 13  |  Issue : 2  |  Page : 74-77

Sports dentistry: Role of dentist in protecting a winning smile


Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Golpura, Barwala, Panchkula, Haryana, India

Date of Web Publication20-Dec-2013

Correspondence Address:
Amandeep Chopra
Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Golpura, Barwala, Panchkula, Haryana
India
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DOI: 10.4103/1319-6308.123373

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  Abstract 

Dental injuries are the most common type of orofacial injury sustained during participation in sports. Sports dentistry is the branch of dentistry, which involves the prevention and treatment of orofacial athletic injuries and related oral diseases, as well as the collection and dissemination of information on dental athletic injuries and the encouragement of research in the prevention of such injuries. The complete information about sports dentistry had been collected from various journals, books, online databases and various reports from international conferences for the time period of 1972-2013. This article will give an overview of sport injuries in orofacial region-incidence, evaluation, treatment and their prevention.

  Abstract in Arabic 

تعتبر إصابات الأسنان أكثر أنماط اصابات للفم خلال المشاركة في الرياضية ، طب الأسنان الرياضي هو الفرع من طب الأسنان الذي يشمل الوقاية والعلاج من إصابات الفم والوجه عند الرياضيين وأمراض الفم المتعلقة بذلك ,أيضا جمع ونشر المعرفة عن إصابات الأسنان التي تصيب الرياضيين وتشجيع الأبحاث في مجال الوقاية في هذه الإصابات. تم جمع المعلومات المتعلقة بطب الأسنان الرياضي في الدوريات العلمية ، بالاضافة الى الكتب وقواعد البحث على الانترنت ومختلف تقارير المؤتمرات العالمية للفترة بين 1972 إلى 2013م. تقدم هذه المقالة نظرة عامة عن نسبة حدوث الإصابات الرياضية للفم والوجه مع التقييم والعلاج والوقاية .

Keywords: Dental injuries, mouth guards, sports


How to cite this article:
Chopra A, Rao N C, Gupta N, Vashisth S. Sports dentistry: Role of dentist in protecting a winning smile. Saudi J Sports Med 2013;13:74-7

How to cite this URL:
Chopra A, Rao N C, Gupta N, Vashisth S. Sports dentistry: Role of dentist in protecting a winning smile. Saudi J Sports Med [serial online] 2013 [cited 2021 Jun 25];13:74-7. Available from: https://www.sjosm.org/text.asp?2013/13/2/74/123373


  Introduction Top


Sports means "to carry away from work" is one of the most common forms of recreation practiced by individuals in today's high stressed life. Sports participation is a frequent cause of injury (muscle injuries, torn cartilage, fractured bones, tendinitis, soft-tissue lacerations, contusions and broken teeth), in general to children and adolescents. This occurs because of popularity of organized youth sports and the high level of competitiveness. [1]

Dental injuries are the most common type of orofacial injury sustained during participation in sports. [2] The common orofacial sports related injuries include soft tissue injury and hard tissue injury such as tooth intrusions, luxations, crown and/or root fractures, complete avulsions and dental-facial fractures. [3]

Consequences of orofacial trauma for children and their families are substantial because of potential for pain, psycho-logical effects and economic implications. Dentistry today must respond to these patient's specialized needs, providing them with the quality care which they deserve. In all, there is much to be carried out in the field of sports dentistry. The sports dentistry field is a challenging, yet rewarding one.

In this review, literature was searched using the following parameters: Terms: "sports," "dental injuries," and "mouth guard;" fields: All; limits: Within 1972-2013, humans, English. There were 207 articles that matched these criteria. Papers for review were chosen from this list and from references within select articles. This article will give an overview of sport injuries in orofacial region-incidence, evaluation, treatment and their prevention.

Sports dentistry - had its origins in the 1980s [4] and involves the prevention and treatment of orofacial athletic injuries and related oral diseases, as well as the collection and dissemination of information on dental athletic injuries and the encouragement of research in the prevention of such injuries. [5]


  Sports Injuries in Orofacial Region Top


Incidence of sports injuries in orofacial region

The face is the most vulnerable area of the body and is usually the least protected. The incidence of sports related orofacial injuries serve to depend upon the circumstances of the nation in terms of the number of people involved, the extent of the sports facilities and the sport, which is most popular.

  • The national youth sports foundation for the prevention of athletic injuries, Inc., estimates that during the season of play, athletes have a 10% chance of sustaining an injury to the face or mouth [6]
  • Studies have shown that 13-39% of all dental injuries were sports related and of all sports accidents reporting 11-18% were maxillofacial injuries [7]
  • The most common types of sports related facial trauma are the soft tissue injuries and the fractures of the "T-zone" bones (the nose, the zygoma and the mandible). These injuries often occur in combination [3]
  • Males are traumatized twice as often as females. [8],[9]
  • In children, sports were found to be responsible for 13% of overall oral trauma [10]
  • The majority of sport-related dental and orofacial injuries affect the upper lip, maxilla and maxillary incisors, with 50-90% of dental injuries involving the maxillary incisors. [11],[12],[13]


Evaluation of orofacial injuries

Evaluation of the facial injuries should follow the principles of trauma evaluation and should begin with airway, breathing, circulation, disability and exposed environment control.

After the initial assessment and stabilization, the facial examination is then performed. A systematic approach is followed to efficiently determine the extent of injury and correctly diagnose injuries to the teeth, periodontium and associated structures. [14] Assessment includes a thorough medical and dental history, clinical and radiographic examination and additional tests such as palpation, percussion, sensitivity and mobility evaluation. Intraoral radiography is useful for the evaluation of dentoalveolar trauma. If the area of concern extends beyond the dentoalveolar complex, extraoral imaging may be indicated. [15]

Treatment of orofacial injuries

Treatment planning takes into consideration the patient's health status and developmental status, as well as the extent of injuries. Advanced behavior guidance techniques or an appropriate referral may be necessary to ensure that proper diagnosis and care are given.

Dental emergency kit for sporting events includes-gloves, mouth mirror, pen light, tongue depressor, scissors, rope wax, zinc oxide eugenol, spatula, mixing pad, sterile gauze (2 * 2, 4 * 4), sterile small wire cutters (for removal of broken orthodontic wires), spare commercial mouth guards, emergency tooth preserving solution Save-a-Tooth TM for the avulsed tooth. [6]

Common orofacial injuries and their management is given in [Table 1]. [6],[15],[16],[17],[18],[19] Well-designed and timely follow-up procedures are essential to diagnose and manage complications.
Table 1: Common orofacial injuries and their management

Click here to view



  Preventing Sports Injuries Top


As the intensity, speed, size and even violent behavior of athletes among the majority of professional sports teams continues to grow there is a need for the better preventive dental care.

The major method for preventing oral injuries in sports is wearing mouth guards and headgear consisting of a helmet and face protector. The efficacy of athletic mouth guards for prevention of dental trauma is documented in sports that mandate their use. [20],[21],[22],[23] Three basic types of mouth guards are available.

Stock mouth guards

Stock mouth guards are either made of rubber, polyvinyl chloride or a polyvinyl acetate copolymer. Their main advantage is that these are relatively inexpensive. However, these are available only in limited sizes, do not fit very well, inhibit speech and breathing and require the jaws to be closed to hold the mouth guard in place. [24]

Mouth-formed protectors

Two types of mouth-formed protectors are:

  • The shell-liner type is made of a preformed shell with a liner of plastic acrylic or silicone rubber. The lining material is placed in the player's mouth and molds to the teeth and then is allowed to set
  • The preformed, thermoplastic lining (also known as "boil and bite") is immersed in boiling water for 10-45 s, transferred to cold water and then adapted to the teeth. This mouth guard seems to be the most popular of the three types and is used by more than 90% of the athletic population. [5],[25]


Custom made mouth protectors

Custom made mouth guards are fitted by a dentist and have been demonstrated to provide the greatest protection from dental injuries. This mouth guard is made of thermoplastic polymer and fabricated over a model of the athlete's dentition. The mouth guard is made by the dentist and fits exactly to the athlete's mouth. The advantages include fit, ease of speech, comfort and retention. [5],[24]

Although mouth guards have been shown to be effective and have been advocated for more than 30 years, mouth protectors are not considered as an integral part of protective equipment for most sports. Dentists need to educate patients on the need and benefits of protective devices.

Another method essential for preventing dental injuries include preseason screening and examinations. Examinations should include history taking, at risks dentition, diagnosis of dental caries, maxilla mandibular relationship, loose teeth, dental habits, prosthodontics status and need for extraction. Awareness and knowledge regarding sports dental injuries, emergency management of traumatic dental injuries and use of protective devices amongst athletes, coaches and school teacher may also prevent the injuries. [26]


  Conclusion Top


Sports dentistry is still in its infancy, it should encompass much more than mouth guard fabrication and treatment of fractured teeth. Dentist as a health professional has a responsibility to become and remain educated and pass that education on to the community regarding the issues related to sports dentistry and specifically to the prevention of sports-related oral and maxillofacial trauma.

Sports dentistry can be very rewarding, not only for the good will generated, but for the personal satisfaction derived when it is realized that the dentist has not only treated the injured sportsman, but may have prevented many more potential injuries from occurring. Sports dentistry is certain to be a part of our future as it's rightly said "everyone has a smile worth protecting."

 
  References Top

1.American Academy of Pediatric Dentistry. Policy on prevention of sports-related orofacial injuries Pediatr Dent 2010;32(special issue):55-8.  Back to cited text no. 1
    
2.Scott J, Burke FJ, Watts DC. A review of dental injuries and the use of mouthguards in contact team sports. Br Dent J 1994;176:310-4.  Back to cited text no. 2
[PUBMED]    
3.Saini R. Sports dentistry. Natl J Maxillofac Surg 2011;2:129-31.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.Ranalli DN. Sports dentistry and dental traumatology. Dent Traumatol 2002;18:231-6.  Back to cited text no. 4
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5.Kracher CM, Smith WS. Sports-related dental injuries and sports dentistry. ADA CERP. [Revised 2011 Mar 4]. Available from: http://www.dentalcare.com/media/en-US/education/ce127/ce127.pdf [Last assessed on 2013 Apr 10].  Back to cited text no. 5
    
6.Padilla R, Balikov S. Sports dentistry: Coming of age in the ′90s. J Calif Dent Assoc 1993;21:27-34, 36.  Back to cited text no. 6
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7.Camp J. Emergency dealing with sports-related dental trauma. J Am Dent Assoc 1996;127:812-5.  Back to cited text no. 7
    
8.Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg 1972;1:235-9.  Back to cited text no. 8
[PUBMED]    
9.Sane J. Maxillofacial and dental injuries in contact team sports. Proc Finn Dent Soc 1988;84 (Suppl 6-7):1-45.  Back to cited text no. 9
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10.Meadow D, Lindner G, Needleman H. Oral trauma in children. Pediatr Dent 1984;6:248-51.  Back to cited text no. 10
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11.Kumamoto D, Maeda Y. Global trends and epidemiology of sports injuries. J Pediatr Dent Care 2005;11:15-25.  Back to cited text no. 11
    
12.Takeda T, Ishigami K, Nakajima K, Naitoh K, Kurokawa K, Handa J, et al. Are all mouthguards the same and safe to use? Part 2. The influence of anterior occlusion against a direct impact on maxillary incisors. Dent Traumatol 2008;24:360-5.  Back to cited text no. 12
    
13.Kumamoto DP, Maeda Y. A literature review of sports-related orofacial trauma. Gen Dent 2004;52:270-80.  Back to cited text no. 13
[PUBMED]    
14.Day PF, Duggal MS. A multicentre investigation into the role of structured histories for patients with tooth avulsion at their initial visit to a dental hospital. Dent Traumatol 2003;19:243-7.  Back to cited text no. 14
[PUBMED]    
15.American Academy of Pediatric Dentistry. Guideline on management of acute dental trauma. Ref Man 2011;34:230-8. Available from: http://www.aapd.org/media/Policies_Guidelines/G_Trauma.pdf. [Last assessed on 2013 Apr 10],.  Back to cited text no. 15
    
16.Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 2007;23:66-71.  Back to cited text no. 16
    
17.Flores MT, Malmgren B, Andersson L, Andreasen JO, Bakland LK, Barnett F, et al. Guidelines for the management of traumatic dental injuries. III. Primary teeth. Dent Traumatol 2007;23:196-202.  Back to cited text no. 17
    
18.Andreasen JO, Andreasen FM. Essentials of Traumatic Injuries to the Teeth. 2 nd ed. Copenhagen, Denmark: Munksgaard and Mosby; 2000. p. 9-154.  Back to cited text no. 18
    
19.McTigue DJ. Managing traumatic injuries in the young permanent dentition. In: Pinkham JR, Casamassimo PS, Fields HW Jr, McTigue DJ, Nowak A, editors. Pediatric Dentistry: Infancy through Adolescence. 4 th ed. St. Louis, Mo: Elsevier Saunders; 2005. p. 593-607.  Back to cited text no. 19
    
20.Bureau of Dental Health Education. Mouth protectors for football players: the dentist′s role. J Am Dent Assoc 1962;64:417-21.  Back to cited text no. 20
    
21.Powers JM, Godwin WC, Heintz WD. Mouth protectors and sports team dentists. Bureau of Health Education and Audiovisual Services, Council on Dental Materials, Instruments, and Equipment. J Am Dent Assoc 1984;109:84-7.  Back to cited text no. 21
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22.McNutt T, Shannon SW Jr, Wright JT, Feinstein RA. Oral trauma in adolescent athletes: A study of mouth protectors. Pediatr Dent 1989;11:209-13.  Back to cited text no. 22
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23.Stuart MJ, Smith AM, Malo-Ortiguera SA, Fischer TL, Larson DR. A comparison of facial protection and the incidence of head, neck, and facial injuries in Junior A hockey players. A function of individual playing time. Am J Sports Med 2002;30:39-44.  Back to cited text no. 23
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24.Kerr IL. Mouth guards for the prevention of injuries in contact sports. Sports Med 1986;3:415-27.  Back to cited text no. 24
[PUBMED]    
25.McCarthy MF. Sports and mouth protection. Gen Dent 1990;38:343-6.  Back to cited text no. 25
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26.Ali FM, Bhushan P, Kumari S, Patil S, Sahane D. Dental trauma: Athletes, coaches and school teachers must know - A brief review. Saudi J Sports Med 2013;13:7-9.  Back to cited text no. 26
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Abstract
Introduction
Sports Injuries ...
Preventing Sport...
Conclusion
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