Emergency Treatment

Due to the high incidence of sports-related dental injuries, it is vital that primary health care providers such as school nurses, athletic trainers, team physicians and emergency personnel are trained in the assessment and management of dental injuries. Interested dental team members can assist these providers by offering to speak to schools, so that the primary health care providers who will deliver immediate treatment at sporting events understand the proper protocol for orofacial injuries, such as displaced teeth, avulsed teeth, lacerations, and crown fractures. The ADA has urged its members to work together with schools, colleges, athletic trainers and coaches to develop mouthguard programs and guidelines to prevent sports injuries.

The main method for preventing orofacial injuries in sports is the wearing of mouthguards and headgear, consisting of a helmet and face protector. Yet, a study by the National Institute of Dental Research reported that children do not consistently wear mouthguards and headgear during organized sports. Even in football, a sport that requires the use of mouthguards, as earlier noted, only about 75% of students are in compliance.15

Parental perceptions of children’s risks to injury, expenses associated with protective gear, and peer pressure may influence use of mouthguards. Interestingly, lower socioeconomic parents are reported to be more aware of threats to their children’s safety than are affluent parents.16 The observed patterns of mouthguard wearing by males and females can represent cultural differences, peer pressure, and/or nature of sports played, including the following:

  1.  Perceptions that females are less aggressive and thus, a reduced risk of injury may exist,
  2.  Perceptions regarding the absence of long-term commitment to a sport may result in a differential willingness to devote resources to females,
  3.  Aesthetic appeal may influence protective orofacial gear usage,
  4.  Females may play in non-league-based sports with fewer or less stringent rules or may play less combative sports than males.15

The literature indicates the use of mouthguards by athletes is most influenced by their coaches.17 However, studies indicate mouthguard compliance by athletes is usually not insisted upon by their coaches or referees.35 Coaches may feel they do not have sufficient knowledge of mouthguards. Coaches report most information about mouthguards comes from sales representatives (72%), educational materials (33%), and dentists (11%).18

In 1995, the ADA House of Delegates revised their policy recognizing “the preventive value of orofacial protectors” and endorsed their use “in sports activities with a significant risk of injury at all levels of competition.”19