Professionally-made, properly fitted Custom Mouthguards are recommended for all contact and collision sports. We have advocated the use of a double laminated mouth-guard to prevent oral injury and probably reduce the possibility of a concussion. But in the advent that there is damage to your child’s tooth I have tried to put together a short flow chart on how to deal with either a tooth knocked out or moved in the patient’s mouth. This is a proposed approach endorsed and formulated by the Academy for Sports Medicine.

 

Sports related tooth injuries

Entire Tooth Knocked Out

  1. Avoid additional trauma to tooth while handling. Do Not handle tooth by the root. Do Not brush or scrub tooth. Do Not sterilize tooth.
  2. If debris is on tooth, gently rinse with water.
  3. If possible, re-implant tooth and stabilize by biting down gently on the towel or handkerchief. Do only if athlete is alert and conscious.
  4. If unable to re-implant:
    1. Best – Place tooth in a physiologic transport medium (e.g. Hank’s Balanced Saline Solution)
    2. 2nd best – Place tooth in milk.
    3. 3rd best – Wrap tooth in saline-soaked gauze.
    4. 4th best – Place tooth under athlete’s tongue. Do this ONLY if athlete is conscious and alert.
  5. Time is very important. Re-implant within 30 minutes has the highest degree of success rate. Transport Immediately to Dentist.

A custom mouthguard

Tooth in socket, but wrong position

Three Positions are possible

  1. Extruded Tooth – Upper tooth hangs downs and/or lower tooth raised up.
    1. Reposition tooth in socket using firm finger pressure.
    2. Stabilize tooth by gently biting on towel or handkerchief.
    3. Transport Immediately to Dentist.
  2. Lateral Displacement – Tooth pushed back or pulled forward.
    1. Try to reposition tooth using finger pressure.
    2. Athlete may require local anesthetic to reposition tooth; if so, stabilize tooth by gently biting on towel or handkerchief.
    3. Transport Immediately to Dentist.
  3. Intruded Tooth – Tooth pushed into gum – looks short.
    1. Do nothing – avoid any repositioning of tooth.
    2. Transport Immediately to Dentist.
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