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Traumatic events at an early age may lead to developmental dental anomalies and ectopic tooth eruption. A case is reported in which a traumatic injury at two months of age resulted in the development of supernumerary teeth in the upper right premaxillary region. The maxillary canine ectopically erupted or transposed into the space left by the missing central incisor and eliminated the need for a prosthesis in this region.
Dental services in sports competitions in the Games sponsored by the International Olympic Committee are mandatory. In every Central American, Pan American and Olympic Summer Games, as well as Winter Games, the Organizing Committee has to take all the necessary measures to assure dental services to all competitors. In all Olympic villages, as part of the medical services, a dental clinic is set up to treat any dental emergency that may arise during the Games. Almost every participating country in the Games has its own medical team and some may include a dentist. The major responsibilities of the team dentist as a member of the national sports delegation include: (i) education of the sports delegation about different oral and dental diseases and the illustration of possible problems that athletes or other personnel may encounter during the Games, (ii) adequate training and management of orofacial trauma during the competition, (iii) knowledge about the rules and regulations of the specific sport that the dentist is working, (iv) understanding of the anti-doping control regulations and procedures, (v) necessary skills to fabricate a custom-made and properly fitted mouth guard to all participants in contact or collision sports of the delegation. This study illustrates the dental services and occurrence of orofacial injury at the Central American and Caribbean Sports Games of the Puerto Rican Delegation for the past 20 years. A total of 2107 participants made up the six different delegations at these Games. Of these 279 or 13.2% were seen for different dental conditions. The incidence of acute or emergency orofacial conditions was 18 cases or 6% of the total participants. The most frequent injury was lip contusion with four cases and the sport that experienced more injuries was basketball with three cases.
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Mouthguards are considered by most authorities to be an essential part of equipment for players in any body-contact sports, especially the combative type e.g. Rugby Union, Rugby League, American Football (gridiron), boxing, etc. (Turner, 1977). The qualities provided by the mouthguard are dental protection, especially of the upper anterior teeth, soft tissue protection around the mouth, a reduction in the risk of fracture of the mandible, and a reduction in the concussion force from a blow to the mandible (Clegg, 1969; Upson, 1982; Davies et al, 1977). Of the 28 players interviewed, only 7 (25%) wore mouthguards, the commonest reason for not using a mouthguard being difficulty with breathing, a finding in common with other similar surveys (Davies et al, 1977). In view of the fact that 17 (60.7%) had sustained oral injuries - dental and jaw injuries, intra-oral and circumoral lacerations, in the past, it was a surprising response to find that only 2 (7.2%) stated that mouthguards should be compulsory when playing Rugby League football.
A cohort of 282 elite amateur ice hockey players were analyzed to 1) record the number, type, location, and severity of head, neck, and facial injuries sustained during games; 2) examine the relationship between injuries and the type of facial protection (none, partial, or full) according to individual playing time; and 3) determine whether full or partial facial protection is associated with an increased incidence of concussions, eye injuries, and neck injuries. Fifty-two injuries (158.9 per 1000 player-game hours) occurred in players wearing no facial protection, 45 (73.5 per 1000 player-game hours) in players wearing partial facial protection (half shield), and 16 (23.2 per 1000 player-game hours) in players wearing full facial protection (full cage or shield). Players wearing no protection were injured at a rate more than twice that of players wearing partial protection and almost seven times higher than those wearing full protection. Concussions occurred in four players wearing no protection, five players wearing partial protection, and two players wearing full protection; these differences were not significant. The risk of eye injury was 4.7 times greater for players wearing no protection compared with those wearing partial protection. No eye or neck injuries occurred in players wearing full protection. This study demonstrates that both full and partial facial protection significantly reduce injuries to the eye and face without increasing neck injuries and concussions.
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The athletic mouthguard has been used for the prevention of orofacial injuries in contact sports. In this research, the effectiveness of a mouthguard was evaluated for its protection of the maxillary teeth of a human dry skull through experimental modal analysis. The upper central incisor was excited by an electrodynamic shaker. The frequency response functions of the upper teeth were then recorded on an FFT analyzer in order to identify modal shapes of the maxillary arch with and without a mouthguard. In addition, transient response simulations were carried out and decay rates of transient response waves were compared. As a result, when the mouthguard was in place, the resonance peaks of the frequency response functions were dampened, and the nodes of the modal shapes for the anterior teeth were indefinite in the frequency domain over 1 kHz. In the transient response simulation, the decay rates of transient response waves when the mouthguard was used were significantly higher than those when the mouthguard was not used (p<0.01). The results suggest that the mouthguard relieves the stress concentrated on the anterior teeth in a frontal collision by absorbing and dispersing some of the shock energy, thus quickly stopping the vibration of the maxillary teeth. These findings support the clinical fact that mouthguards prevent orofacial injuries in sporting activities.
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The management and prevention of dental trauma is an integral part of the medical services provided at major athletic events. This paper reviews the organization and delivery of the dental services provided at the 1989 Canada Games. The nature, incidence and management of the dental problems reported in the participant population of 3,411 athletes are also described. During the two-week competition, 15 participants were assessed and treated for various dental conditions, including hard- and soft-tissue injury of the oral cavity, and temporomandibular joint sprain. The sports with the highest incidence of dental injury for the male population were wrestling (one per cent) and basketball (0.8 per cent). For the female population, these sports were basketball (2.5 per cent) and field hockey (1.3 per cent). The dental services provided during the games included emergency assessment and treatment, fabrication of mouthguards, and in-service education to medical team members.
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For splinting traumatically loosened and/or reimplanter remaining front teeth wire splints are used which are fixed by means of composite substance, gluing technique. Kinds of employed splints are disclosed and the steps of the practical carrying out of splinting are described. Indications, advantages and disadvantages of its employment are discussed.
The evolution of rules and regulations governing the development and use of protective football equipment for the prevention of craniofacial and intraoral traumatic injuries to football players have reduced substantially the occurrence of these injuries. Protective football equipment such as helmets, facemasks, and intraoral mouthguards have undergone numerous developmental changes to improve their effectiveness in preventing traumatic injuries to the head, face, and mouth of participants in football during practice sessions as well as in game situations. Unfortunately, however, some of these types of injuries do continue to occur. Various regulatory agencies and football governing bodies have established quality performance standards for equipment and have enacted rulings for their proper use. Penalties have been assessed for rule infractions to aid in curtailing the misuse of such equipment, as occurs for example, when the helmet is used to spear tackle an opponent or when the facemask is grasped, pulled, or twisted by an opposing player. Dentists can contribute significantly to the overall well-being of their patients who participate in football by providing information and advice regarding the proper use of protective football equipment to prevent craniofacial and intraoral traumatic football-related injuries, by fabricating properly fitted mouthguards as one aspect of their total practice of dentistry, and by providing high-quality and expeditious emergency and long-term treatment subsequent to football-related intraoral traumatic injuries. In addition, dentists can contribute on a larger scale to the overall well-being of football athletes by participating in community service activities such as mouthguard days, as consultants to football teams, as team dentists, or as advisors to those interested in research and development to improve protective football equipment, and to those responsible for sponsoring more stringent regulations for player safety in football.
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Dental trauma is a type of head trauma. It is essential that the dentist be able to assess the gross neurological status of the child presenting with head injury and to recognize acute and delayed signs of nerve injury. Time does not permit the dentist a leisurely review of necessary skills at the time of an emergency visit. He or she must be prepared in advance with a consistent and simple approach for the management of head trauma in children. Time of entry into care is critical to the prognosis.
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