DEPARTMENT of

PEDIATRIC DENTISTRY

SPORTS DENTISTRY

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 Definition:-
Sports dentistry is the treatment &
prevention of oral/ facial athletic injuries
and related oral disease and manifestation.

In sports the challenge is to maximize the

benefits of participation and to limit injuries
sports dentistry has the major role to play
in this area. Prevention and adequate
preparation are the key elements is
minimizing injuries that occur in sports.

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CATEGORIZATION OF SPORTS
 Contact/ Collision:- Hockey (bath
field & ice), football, wrestling, boxing
Judo, Karate.
 Limited contact /Collision:-
Basketball, baseball, gymnastic,
skating ( both roller & ice). Squash,
hand ball volleyball, skiing, horseback
riding, bicycling, driving high jump.

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 Non- Contact/ Strenuous
:-Swimming, running, lawn tennis
weight lifting, acrylic dancing, javelin,
Shot-put.
 Non-contact/ Moderately Strenuous :-
Badminton, table- tennis.
 Non- Contact/ Non strenuous:-
Archery, Golf, Riflery

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 ETIOLOGY
The development etiology of traumatic dental
injuries varies accordingly to the patient
chronological age, level of activity & state of
maturity.
Eg.
In Primary dentition: The most frequent &
often devastating type of trauma is the
intrusive luxation of primary anterior teeth.

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- In permanent dentition = The most
frequent type of dental injury is a crown
fracture.
- Dental injuries associated with child abuse
are more likely in the primary dentition of
young children.
Eg. Smokeless Tobacco

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 SPORTS RELATED INJURIES
RISK ASSESSMENT:-
 The dentist is in a key position to identify who
may be at risk for sustaining sports related
dental trauma.
 The dentist should include the question
“Do you participate in sports?
A positive response allows a detailed discussion
of the type of sports, level of participation &
appropriate recommendations for protective
athetetic equipment.

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 Predictive Index
To letter enable clinicians to determine
the likelihood of a patient experiencing
a sports– related dental injury a
predictive index has been developed.
The index identifies risk factor in light
categories:-
 Demographic information (Eg: Age,
Gender, dental occlusion)
 Type & use of protective equipment.

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 Velocity & intensity of the sport.
 Level of activity & exposure time
 Level of coaching & type of sports organization.
 Player position in a contact or non- contact sport.
 History of sports – related dental trauma.
 Practice or game situation.
An analysis of these factors can be used to identify
an athlete who is at light risk for an oro-facial injury
and more importantly to recommend specific
preventive strategies, such as properly fitted
athletic mouth guard.

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 Assessment of the Trauma
patient
Physical Assessment:- Before initiation of dental treatment
it is essential to determine the physical status of the
trauma victim. The dental injury may be relatively minor
compared with a serious head injury. Thus the patient
should undergo individual triage so that the most serious
problem are prioritized for immediate attention.

Health History:- A trauma victim who is new to the dental

practice required a complete health history including vital
statistics and vital signs. Current patient should already
have a complete record may require only update of the
health of reassessment of blood pressure of pulse.

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Dental evaluation of the trauma
patient
 Includethe :-
- Accident history
- Intra oral examination
- Radiographic
- Treatment plan
Based on the healthy history of the clinician &
radiographic examination, the dentist is ready
to establish a diagnosis & develop an
appropriate treatment plan to maintain &
traumatize tooth.
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 Emergency Management of
Dental Trauma
Emergency Management is described
in terms of
 Crown fracture
 Root fracture
 Luxation injuries
 Avulsed teeth
 Mandibular fracture
 Soft tissue trauma.

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 CROWN FRACTURE
 Enamel Only :- involve only enamel and usually
are not painful.
 Enamel & dentin:- Crown fracture involve the
enamel & dentin are sensitive to air, touch & cold.
 Treatment :
 To protect the pulp from chemical or thermal insult
and bacterial contamination.
 To prevent the effects of potentially painful stimuli
for the patient.
 To prevent tilting of adjacent teeth.
 To restore appearance and function.

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 Enamel, Dentin & Pulp:- Crown
fractures that involve the enamel,
dentin & pulpal tissue of vital teeth
represent a complex arrangement of
diagnostic and treatment possibilities.

Treatment :-
 Direct pulp capping :
 Minimal pulpotomy
 Cervical pulpotomy
 Pulpectomy.
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 Root Fracture
 Apical One- Third:- If a root fracture occurs in the
apical one third of primary or permanent tooth.
There is no mobility, it should be observed clinically
and radiographically.
 Middle One – Third:- If the segments of a middle on
third root fracture of a permanent tooth are
displaced the segments should be repositioned and
splinted for approx 12-16 weeks.
 Coronal One – third:- Fracture of the root at the
coronal one third are the most difficult to manage.
Treatment include= Root canal therapy
Periodontal crown elongation

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 LUXATION INJURY

The primary and permanent teeth may

be displaced in lateral, intrusive or
extrusive direction. It leads to the
major damage to underlying
developing permanent successor.
Treatment:-
Displaced tooth should be
respositioned and splinted for approx 2
weeks.
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Laterally luxated. The crown
of the teeth are locked in a
palatal position and are in
reverse overjet with the
lower teeth.

Intrusive Luxation
The tooth is displaced
apically with little or no
deflection
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 AVULSED TEETH
Primary teeth that have been completely
luxated out of the alveolar socket should
not be reimplanted.
Permanent teeth can be replanted under
favourable condition. If the tooth can be
replanted in 15-30 minutes after the
accident there is greater than 90% chance
that the tooth will be retained for life.

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 Mandibular Fracture
The mandibular fracture may occur at
the condyle, gonial, angle,
mentalforamen region or mandibular
symphysis.

Emergency management = Removal of

any intra oral debris to maintain the
airway.

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 Soft Tissues Injury
 Emergency Management :-
 Hemorrhage control
 Wound cleansing
 Suturing
 Antibiotic
 Tetanus immunization.

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PREVENTION OF SPORTS –
RELATED INJURY

MOUTH GUARDS:-
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 IDEAL PROPERTIES OF MOUTH
GUARD
It should be :-
 Protective
 Comfortable
 Resilient
 Tear resistant
 Odourless
 Tasteless
 Not bulky
 Cause minimal interference to speaking and
breathing.
 Should have excellent retention and sufficient
thickness in critical www.fourthmolar.com
area.
 Stock Mouth Guards

These are popular because they are – inexpensive

Are readily available in most sporting goods stores.

DISADVANTAGES:-
Because they are performed and worn directly as
manufacture, they are the least retentive, most bulky and
interfere with breathing and speech.
They must be held in place by clenching the teeth together
because they offer the least protection.

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 Boil & Bite mouth guard
 These mouth guard range in price &
some retention may be achieved if
proper fitting is performed by a
dentist.

 These mouth guard offers good

retention. The more rigid mouth guard
shell is lined with ethyl methacrylate
material.
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Pressure Laminated custom
Mouth guard
 These are far superior then the other
in terms of adaptation, retention &
protection. They are the most
comfortable & interfere least with
breathing and speech. These are
fabricated over a dental model using
sheets of thermoplastic material.

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 VACCUM CUSTOM MOUTH
GUARD
 Vacuum forming technique for custom
fabricated mouth guard as with all
dental procedures, universal precaution
for infection control must be followed
precisely.

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 Benefits of properly fitted &
worn mouth guard
 Helps to reduce chance of concussion.
 Allow to compete more competitively & perform
with more confidence.
 Reduce the risk of cuts, bruising & disfigurement
to mouth & face.
 These are more comfortable to wear & make it
easier to breath & speak.
 Reduces the chance of the teeth being fractured.
 Reduced the jaw fracture & dislocation.
 Reduces risk of neck injures.

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 PEDIATRIC SPORTS MEDICINE
 Participationin games & sports is vital for physical
fitness, psychosocial development decision
making and self confidence and over all health
and personality of the child. At times and in some
children specific advice from the pediatrician
becomes mandatory regarding the magnitude of
restriction type of recommended. Sports activity &
fitness for return to normal activity and
participation in sports.

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 INDICATION FOR
RESTRICTION
The pediatrician must use a balanced
restraint in advancing advice for
restriction of sports activity the major
indication for such a restriction are:-
1. A definite need
Eg. Fracture, major illness in which physical
exercise may worsen the patient condition.
2. A relative need
Atlantoxial instability in which contact
(collision) sports are not permitted but
non- contact sports are allowed.
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 THE PEDIATRIC SPORTS MEDICINE
PROGRAM & PEDIATRICIAN
RESPONSIBILITIES
 To assess the frequency, type & duration of
physical activities during health supervision
visit.
 To develop the capacity to perform body
composition analysis by skin fold testing.
Obese children who require to lose weight
should be monitored.
 To teach the importance of regular physical
activity (moderate to vigorous) as a mean of
safeguard against illness during adult –
hood.
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 To encourage parents to serve as role
models by participating in regular
physical activity along with the child.
 The work with community school, to
support daily physical education in
these school to promote moderate to
vigorous activity tasks in physical
education classes.

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 CONCLUSION
 Sports have a significant role in child’s
normal growth and development
although it may have some traumatic
effects on the developing dentition it
can not be avoided. But efforts can be
made to prevent the adverse effects
and provide safety to the child because
“ Prevention is better then cure.”

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 REFERENCES
 Pediatric Dentistry – Pinkham
 The short textbook of pediatric – Suraj Gupte.
 Oral & dental trauma in children adolescents –
Graham Roberts and Peter Longhurst.
 Mosby’s Dental hygiene – Daniel & Harfst

SITES:

WWW.suwaneedental.com
www.buystate-dental.com
www.dentalimplants–usa.com

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