Sports Medicine: Just the Facts

170 SECTION 3 • MEDICAL PROBLEMS IN THE ATHLETE

Roberts WO: Sideline airway access.Phys Sportsmed28(4), 2000.
Shaikh ZS, Worrall SF: Epidemiology of facial trauma in a sample
of patients aged 1–18 years.Int J Care Injured 33:669, 2002.
Swinson B, Lloyd T: Management of maxillofacial injuries.
Hosp Med64(2):72, 2003.
Truman B, Gooch B, Sulemana I, et al: Reviews of evidence on
interventions to prevent dental caries, oral and pharyngeal can-
cers, and sports-related craniofacial injuries. Am J Prev Med
23(1 supp):21, 2002.

BIBLIOGRAPHY

Lane SE, Rhame GL, Wroble RL: A silicone splint for auricular
hematoma.Phys Sportsmed26(9), 1998.
Mahmood S, Lowe T: Management of epistaxis in the oral and
maxillofacial surgery setting: An update on current practice.
Oral surg Oral Med Oral Pathol Oral Radiol Endod 95:23,
2003.
Sander, R: Otitis extera: A practical guide to treatment and pre-
vention.Am Fam Phys63(5):927, 2001.
Stackhouse T: On-site management of nasal injuries. Phys
Sportsmed 26(8), 1998.

30 DENTAL

Elizabeth M O’Connor, DDS

INTRODUCTION

• There are many benefits to participating in athletic
  activities, such as enhanced physical fitness and the
  enjoyment from competition. Sport, however, also
  increases the risk of sustaining an injury, especially
  injuries to the teeth and mouth.


• Sports medicine physicians are in an ideal position to
  facilitate early intervention to preserve dental health,
  and promote proper preventative strategies.

EPIDEMIOLOGY

• An oral injury can be defined as dental avulsions,
  dental fractures, dental luxations, lacerations or con-
  tusions to the gum, cheeks, tongue, lips and jaw
  injuries (fracture, locked open or closed, temporo-
  mandibular joint pain, and chewing difficulty). A con-
  cussion from a blow under the chin can also be
  included (Kvittern et al, 1998).
  
  
  • Contact sports, such as basketball, hockey, and foot-
    ball have a great risk of orofacial related injuries.
    According to a study by Soporowski, based on 159
    injuries reported by pediatric dentists during a 1-year
    period, the sports receiving the most orofacial injuries
    were baseball and biking followed by hockey and bas-
    ketball (Tesini and Soporowski, 2000).
  
  
  • Noncontact sports such as golf, billiards, and bowling
    have a much lower incidence of orofacial injury.
    Although not a contact sport, biking, as previously
    noted, has a great risk of orofacial injury (Tesini and
    Soporowski, 2000).
  
  
  • The literature suggests that more boys than girls (3:1)
    are involved in orofacial sports related injuries.
    Parents additionally seem more inclined to have their
    sons wear mouth-guards as opposed to their daughters
    (Tesini and Soporowski, 2000).
  
  
  • Studies have also shown that by the time a student grad-
    uates from secondary school, one out of three boys and
    one out of four girls will have suffered from a traumatic
    dental injury (Tesini and Soporowski, 2000).
  
  
  • Injury rates appear to be highest from about 7 to 14
    years of age (Douglas and Douglas, 2003).
  
  
  
  

ANATOMY

• The tooth is composed of three layers: enamel, dentin,
  and the pulp chamber (see Fig. 30-1).


• The enamel is the most external layer of the three.
  Enamel protects the crown of the tooth because of its
  hardness and structure.

FIG 30-1 Anatomy of the tooth.