John C. Chao, DDS, MAGD

Research Associate Professor, Post Graduate Program in Periodontics, SUNY – Buffalo (University at Buffalo)
Adjunct Assistant Professor, Behavior of Science (Anxiety Management), Ostrow School of Dentistry USC

(626) 308-9104

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John C. Chao, D.D.S., M.A.G.D
Anxiety Management,
Behavior Science,
Faculty, USC School of Dentistry

Sports Will Knock Out One Million Teeth In 2005
Your Dentist Can Re-Implant Them

Over five million teeth are knocked out by sports activities every year, according to the American Dental Association, Council on Dental Materials, Mouth Protectors and Sports Team Dentists. This will not likely be different in 2005. But this does not have to happen to any of your loved ones, if they use the proper mouth protectors.

No matter what the sport, or how young the participants are, mouth protectors, or mouth guards, are beneficial. But they need to be accurately adapted, not uncomfortable to wear, and not interfere with breathing or speaking. Although commercially available mouth guards may be adequate for in some instances, these stock or boil-and-bite brands may not be accurately adapted enough to be wearable. But even more of concern is that these home-adapted mouth guards may not be as able to absorb traumatic forces enough to prevent certain more serious injuries, such as concussions or bony fractures, as custom fabricated ones.

Custom fabricated mouth protectors have been shown to be far more effective than over-the-counter types, according to a number of studies. They are made from impressions taken of the mouth by your dentist. Depending on the sport you are engaged in, your dentist will prescribe a mouth protector with the right thickness of "cushioning" material. For wrestling, volleyball and mountain biking, a relatively thin laminated shock-absorbing material is used, probably 3 mm. thick. For kick boxing or ice hockey, three layers of laminated material may be used.

Considering that thousands of dollars may need to be spent to restore a broken or knocked out tooth, it would be wise to get a custom fabricated mouth protector, rather than a less expensive store-bought brand that may not protect your child as well.

If in the case a tooth is knocked out, what do you do? Immediately immerse the tooth in milk. If milk is not available, use water. Take it to the dentist as soon as possible. The best chance of replanting that tooth is during the first hour. Don't hesitate even if it is much longer than that. Your dentist can re-insert the tooth back into the socket and stabilize it with braces or bonding material. After a time root canal treatment will need to be done, since the nerve of the tooth was severed during the accident. The tooth may turn a dark color over time. Your dentist may be able to do "internal bleaching" of the tooth to correct the problem. This means the tooth is bleached from inside the pulp chamber, where the discoloration originates. If done in time, dental re-implantation can save the tooth for many years.

If the tooth is not knocked out, but broken, some times your dentist can still save the tooth without having to do root canal treatment, if you seek help in time. A new therapeutic agent called mineral trioxide aggregate (MTA) can be placed onto an injured nerve and cause it to regenerate and deposit new dentin. But this must be done before the nerve is irretrievably contaminated by oral fluids. Depending on the severity of the breakage, sometimes bonding can be done to restore the tooth to normal appearance. Other times a veneer or crown may be necessary to restore the tooth to normal appearance and function.

If the fracture is too severe for the tooth to be saved, a dental implant or a fixed bridge should be considered. An implant would not require the cutting down of the adjacent anchor teeth, but may take from three months to a year to make. A temporary one-tooth denture may need to be worn for that period of time. A permanent fixed-bridge can be made in a matter of weeks while the patient is wearing a temporary, fixed bridge.

Of course it is best not to have any traumatic injury at all by using the best possible custom fabricated mouth protector.


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