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Steps to Take for Dental Injuries

Kenneth A. Honsik, MD

Practice Essentials Series Editors:
Kimberly G. Harmon, MD; Aaron Rubin, MD


Many active patients may experience dental (tooth and jaw) injury while participating in contact sports or other activities. Injuries can range from minor to severe, so it is important to be aware of the kinds of injuries and what to expect in treating them. Although activities are never risk-free, patients and their doctors can take steps to reduce—and, more important, to prevent—injury.

Q. What should I do if I think I injured my tooth while playing sports?

A. Have an athletic trainer or team physician examine your teeth and mouth before returning to play. Some tooth injuries can be serious, and those injuries will require you to see a dentist immediately.

Q. If a tooth is knocked out, what should I do?

A. First, find the tooth. If you can't find it, don't forget to look for it in your clothes and on the ground where the injury took place. You can even have your opponents check their clothes for the missing tooth if they collided with you.

Second, after finding the tooth, do not handle it by the root. Hold the tooth only by the part that you can see when it is in the mouth: the hard enamel surface or "crown." Do not scrub the tooth. If it is dirty, gently rinse it with clean water.

Third, have an athletic trainer or team physician examine your mouth for other injuries and, if possible, place the tooth back into socket. If help is not possible, seek immediate attention at your local dentist or emergency room. Transport the tooth in sterile saline (not contact lens solution), milk, or, as a last resort, tucked in your cheek. If the tooth is out of the socket for more than a couple hours, it has a low chance of surviving.

Q. Should "baby" or first teeth be put back in if they get knocked out?

A. No. Baby teeth should never be reimplanted.

Q. Should I be worried about a loose tooth?

A. Yes. Loose teeth can be caused from simple loosening of the ligaments holding the tooth into the socket. But, occasionally, loosening can be caused by a fracture (break) through the tooth root or the bones supporting the teeth. You should see a dentist, who will have x-rays taken to determine the cause.

Q. How can I best prevent injuries to my teeth?

A. Mouth guards (figure 1) can help avoid injuries. Many types of mouth guards are available for athletes and other active patients. The most common ones are off-the-shelf models, which are the cheapest and easiest to find but, unfortunately, do not provide the best protection. The mouth guards that offer the most protection are custom-made models fashioned by dentists. This type is formed to match your teeth and provides the best fit. Custom mouth guards are more expensive, but they are worth it to protect your teeth and avoid large dental costs and pain from an injury.

Q. Which sports usually require mouth guards?

A. Mouth guards should be worn in any sport or activity in which one might expect a dental injury. The American Dental Association recommends mouth guards for many common sports, including football, basketball, boxing, field hockey, ice hockey, lacrosse, volleyball, water polo, wrestling, racquetball, and skateboarding.

Remember: This information is not intended as a substitute for medical treatment. Please consult your physician if you have medical concerns.

Dr Honsik is a staff physician in the department of family practice and sports medicine at Kaiser Permanente in Fontana, California.

© 2021, by the McGraw-Hill Companies, Inc. Permission to photocopy is granted for educational purposes.