Oral injuries account for 30% of sports injuries and each athlete participating in a contact/collision sport has a 10% chance of such an injury.1 Intrusive displacement of the anterior teeth as a result of falls is the most common injury in children with primary dentition, whereas fractures of the crown are the most common injuries in adolescents and adults.1–10 More than half of dental injuries involve maxillary incisors. The highest incidence of oral injuries has been reported in baseball and biking.1–10 The American Academy of Pediatric Dentistry definitions of dento-alveolar injuries are summarized Table 33-1.
Table 33-1. American Academy of Pediatric Dentistry Definitions of Dental Injuries |Favorite Table|Download (.pdf)
Table 33-1. American Academy of Pediatric Dentistry Definitions of Dental Injuries
Incomplete fracture (crack) of the enamel without loss of tooth structure
An enamel fracture or an enamel–dentin fracture that does not involve the pulp
An enamel–dentin fracture with pulp exposure
An enamel, dentin, and cementum fracture with or without pulp exposure
A dentin and cementum fracture involving the pulp
Injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth
Injury to tooth-supporting structures with abnormal loosening but without tooth displacement
Displacement of the tooth in a direction other than axially. The periodontal ligament is torn and contusion or fracture of the supporting alveolar bone occurs
Apical displacement of tooth into the alveolar bone. The tooth is driven into the socket, compressing the periodontal ligament and commonly causes a crushing fracture of the alveolar socket
Partial displacement of the tooth axially from the socket. The periodontal ligament usually is torn
Complete displacement of tooth out of socket. The periodontal ligament is severed and fracture of the alveolus may occur
Studies over several decades have looked at the factors involved in facial and dental injuries and their epidemiology.1–11 It must be remembered that over the past 20 years many amateur and professional sports organizations have encouraged and/or mandated the use of protective equipment which has resulted in significant reductions in such injuries. Many experts have been quick to point out, however, that as there is no mandatory reporting of such injuries, the true incidence is almost certainly much higher than what is reported in the literature.
Trauma to the face during sports participation may result in several common outcomes. The first of these involves fractures of the facial bones; i.e., the maxilla, the mandible, and/or the dental alveolar ridge. Whenever injuries to the face and dental structures occur there is a possibility for life-threatening injury and the examiner should always follow the ABCs of basic life support.4,12,13 The extent of such an examination depends on the nature of the injury and the clinical presentation of the athlete. One should remember that ...