How to prevent and treat dental injuries

Dental trauma is common in Australian children – 13% of children were reported to have experienced an injury to their teeth or gums.¹ The most common is injury to the upper front teeth, occurring without the use of a mouthguard.

Dental injuries range from fracturing of the teeth to a change in position within the bone (including knocked out teeth) to fractures of the jawbone, as well as lacerations and tears to the lips and gums. These injuries can be painful and can take substantial time and cost to treat.

If you’re a parent, this information is highly relevant to your children.

Yes, you should wear a mouthguard

To protect your teeth, mouthguards should be worn when playing sports, including during training. When a mouthguard is not worn, the likelihood of fracturing or having the tooth leave the mouth is doubled.

There are two main types of mouthguards:
 

• Custom-fitted mouthguards made by dental professionals
• Over-the-counter (boil-and-bite) mouthguards, which are not custom-fit

Sports Medicine Australia  recommend custom-fitted mouthguards. These mouthguards are more comfortable and provide sufficient and consistent thickness (4 mm) around the teeth.

Most people have the top front teeth in front of the lower front teeth, and hence, mouthguards are worn on the top to protect the top teeth. People who have the lower front teeth in front of the top front teeth (an ‘underbite’) can sometimes benefit from a mouthguard worn on the bottom teeth instead of the top.

If you have braces, a new mouthguard can be made with extra spacing around them, so it fits while the braces are in place. Do not assume that just because you have braces, you can’t wear a mouthguard. Imagine spending a few years wearing braces, only to lose a tooth and ruin your smile.

How to care for your mouthguard

Keep your mouthguards clean and in good condition with these simple steps:
 

• Rinse mouthguards under water after each use and leave in a well-ventilated plastic box. If it becomes smelly, the mouthguard can be submerged in vinegar to disinfect the mouthguard. Wash off the vinegar with water when you’re done.
• Avoid heat, as that will warp the mouthguard. That means avoid warm water, direct sunlight or leaving the mouthguard in hot cars.
• Replace mouthguards that no longer fit or are damaged. New mouthguards are likely to be needed every year in growing children as the shape of their jaw is changing.
• If a mouthguard is uncomfortable, talk to your dentist as adjustments are possible. Custom mouthguards have been shown to be more comfortable than over-the-counter mouthguards, making custom mouthguards more likely to be worn.
• It takes time to become comfortable with mouthguards. Try wearing it at home before wearing it for training and at sporting events.

Dental injury first aid

If a dental injury does occur, act immediately:

• Contact your dentist as soon as possible. Whether your tooth has moved position or had a chip, your dentist needs to see you to determine if management is urgent. Earlier assessment and management improve outcomes. If your tooth is chipped and you can find the piece, keep it stored in milk or water, as it may be able to be glued back in. If you delay seeing your dentist when your tooth is out of position, the ability to move it back into its original position can be reduced. If the tooth is chipped and left chipped, this increases the chance of the tooth becoming infected. Some injuries may not feel severe, but left unchecked, can result in the tooth dying, becoming infected, and the body resorbing the tooth.
• Consult medical help ASAP if the injury resulted in changes in vision, changes in consciousness or memory, nausea, vomiting, or fluid leaking from the nose or ear. These can be signs of brain injury. Make sure your brain is OK before you consider your tooth.

What if a tooth is knocked out?

If a tooth is knocked out, find the tooth and hold it by the crown, but not the root.

If the tooth is dirty, rinse it in milk or medical saline. Tap water is less ideal, but it is better than nothing. Don’t scrub the tooth, as you can remove important structures from the tooth.

Place it back into its socket. Biting on a clean cloth can help it stay in place.

If it cannot be replanted, transport it in milk and see your dentist as soon as possible. Coconut water and non-dairy milk alternatives are less ideal but are better than nothing.

Get tooth savvy

The free app ToothSOS (created by the International Association of Dental Traumatology) provides further information on dental injury and mouthguards. For useful learning purposes, it should be read in advance rather than waiting for an injury.

ToothSOS is available for free on iOS and Android.

The International Association of Dental Traumatology provides great information for the public.