How to handle dental traumas from winter sports
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Drs. Dan Martin and Rachel Appelblatt at Tahoe Oral Surgery and Implant Center are your local dental implant and oral surgery specialists. They are experienced and board certified oral surgeons who specialize in customer care using state-of-the art equipment and techniques. If you have any questions or concerns about oral surgery or dental implants, please don’t hesitate to contact them at TahoeOralSurgery.com.
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The Tahoe and Truckee area is a paramount destination for winter recreation and sports. Unfortunately, along with the enjoyment of winter recreation comes injuries associated with alpine skiing, snowboarding, sledding, snowmobiling, ice skating, hockey, and being on the ice or snow.
Wear Head and Face Protection
The best way to avoid injury during winter sports is to wear a full-face helmet if sports are getting more extreme or aggressive. If not, even wearing a standard helmet will offer some protection from a direct hit to the face. However, if you or your child suffer an injury to the teeth or jaw despite head protection, it is important to assess the situation quickly and come up with an appropriate plan, starting with the steps below:
Begin With A Dental Injury Assessment
Condition: It is important to start with ruling out a head concussion. Symptoms of a concussion include headache, dizziness, nausea or loss of consciousness. Signs of a concussion include change in vision, hearing and balance, along with memory, concentration or ability to recall information. If a concussion is suspected, or if the rider sustains significant damage or is in critical condition, dial 911. It is important to seek medical care immediately.
Assessment: Once a concussion is ruled out, you can move on to a facial and dental assessment. Facial assessment includes looking for soft tissue injuries such as lacerations (cuts), bruising and swelling. A large facial laceration should urgently be evaluated and closed by medical professionals. Bruising and swelling may simply be soft tissue injuries or could be indicative of bony injury underneath.
Exam: Next, a quick dental exam. Do the teeth come together appropriately? Any change in how the teeth come together is a sign of dental or bony injury. Next in the assessment is looking inside the mouth and at the teeth themselves. Observe any fractures or misplaced teeth. Also be on the lookout for lacerations in the mouth.
Types of Dental Injuries To The Teeth
Chipped, fractured teeth
A chipped tooth can involve different layers of the tooth which require different treatment. A relatively simple chip of a tooth through the outer layer (enamel) may be rather easily repaired by your dentist at a time convenient for you.
A bigger fracture of the tooth, down to the yellow dentin or into the pink and often bleeding pulp of the tooth, often occurs. Immediate care should be taken to stop the associated bleeding. Next it is best to get in touch with your dentist. If the injury happens outside of a time when you can see the dentist, contact your dentist for pain pills and antibiotics. Treatment by your dentist will depend on the severity of the injury. This may include a relatively simple filling, a crown, a root canal or in very complicated fractures, removal of the tooth and placement of a dental implant by an oral surgeon.
Sometimes a fracture of the tooth root can happen where the crown itself appears relatively normal, though the root is fractured. If the pain in the tooth doesn’t resolve after 2-3 days it would be best to see your dentist for evaluation. A simple x-ray can usually rule out a root fracture. In most cases, if the root is fractured, it will be necessary to remove the tooth and replace it with a dental implant.
Tooth is Knocked out
First thing: find the tooth.
Pick up the tooth by the crown (the whiter, shiny part) — try not to touch the root!
Rinse the root of the tooth with cool water for 10 seconds (again do not touch the root).
Place the tooth back into the socket as best you can. Ideally the tooth will go back into its original location, but don’t worry if the tooth doesn’t fit perfectly. Bite on cotton or gauze to help stabilize the tooth.
If you can’t place the tooth back into the socket store in milk or ask the patient to spit into a cup with enough saliva to cover the tooth completely, or store the tooth in the patient’s cheek until you can get dental care.
Seek immediate dental treatment from your dentist.
Tooth is Displaced
If the tooth is displaced it will be moved from its normal position and it will be difficult to bite or chew.
The injury may be displacement of the tooth from the socket (without completely knocking it out) or from a fracture of the supporting bone around the tooth.
If it is relatively easy to manipulate the tooth back into position, do so.
Seek immediate dental care.
Trauma to Primary (Baby) Teeth
In some cases a displaced “baby” tooth can simply be left in place; other times, the damaged tooth needs to be removed and an evaluation of possible trauma to the underlying “adult” teeth needs to occur.
Contact your pediatric dentist as soon as possible for an evaluation.
Trauma to the face due to collision is a more common winter sports injury than many people are aware; therefore, a helmet, especially a full-face helmet, should be a mandatory piece of sports equipment.
If dental trauma occurs, an accurate assessment, diagnosis and appropriate treatment are the keys to avoiding long-term dental complications. If you do sustain a dental injury, our staff at Tahoe Oral Surgery and Implant Center are here to help. We wish you and your family a safe and happy winter recreation season.
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