Advise on Sports-related Orofacial Injuries

The tremendous popularity of sports and the high level of competitiveness have resulted in a significant number of dental and facial injuries. All sporting activities have risk of orofacial injuries due to falls, collisions, contact with hard surfaces and contact from sports- related equipment.

Dental and facial injuries can be reduced significantly by introducing mandatory protective equipment. Injuries by the participation in baseball, basketball, soccer, softball, wrestling, volleyball or in gymnastics, skateboarding, inline or roller skating, and bicycling can be considerably reduced by wearing protective eqipment.

Consequences of orofacial trauma for children and their families are substantial because of potential for pain, psychological effects and economic implications. Children with trauma to permanent teeth need  follow up care over a lifetime. Traumatic dental injuries have additional indirect costs that include children's hours lost from school and parents' hours lost from work.

Risk factors

Risk factorshave been defined that predict the chance of injury including demographic information (age, gender, dental occlusion), protective equipment (type/usage), velocity and intensity of the sport, level of activity and exposure time, level of coaching and type of sports organization, whether the player is a focus of attention in a contact or non-contact sport, history of previous sports- related injury, and the situation (eg, practice vs game).

Behavioral risk factors(eg, hyperactivity) also have been associated significantly with injuries affecting the face and/or teeth. The frequency of dental trauma is significantly higher for children with increased overjet and inadequate lip coverage.A dental professional may be able to modify these risk factors.Initiating preventive orthodontic treatment in early- to middle- mixed dentition of patients with an overjet >3 mm has the potential to reduce the severity of traumatic injuries to permanent incisors.

Although some sports-related traumatic injuries are un-avoidable, most can be prevented. Helmets, face masks, and mouth guardshave been shown to reduce both the frequency and severity of dental and orofacial trauma. Initially used by professional boxers, the mouth guard has been used as a protective device since the early 1900's. The mouth guard, also referred to as a gumshield or mouth protector, is defined as a "resilient device or appliance placed inside the mouth to reduce oral injuries, particularly to teeth and surrounding structures.

The mouth guard was constructed to "protect the lips and intraoral tissues from bruising and laceration, to protect the teeth from crown fractures, root fractures, luxations and avulsions, protect the jaw from fracture and dislocations and to provide support for edentulous space.The mouthguard works by "absorbing the energy imparted at the site of impact and by dissipating the remaining energy.