First aid for dental trauma caused by sports activities: state of knowledge, treatment and prevention.

In view of the widespread lack of knowledge of first aid procedures in cases of dental trauma, this article describes the current state of knowledge and highlights the need for education of those likely to witness or be victims of dental trauma while practising sports. Dental and oral injuries, the commonest type of orofacial injuries, are often sustained by athletes playing contact sports; indeed, they represent the most frequent type of sporting injury. Studies of a large group of children and adults have shown that as many as 31% of all orofacial injuries are caused by sporting activities. Furthermore, current literature on the subject emphasizes that awareness of appropriate triage procedures following dental trauma is unsatisfactory. Delay in treatment is the single most influential factor affecting prognosis. What should we know and, more importantly, what should we do? Immediate replantation of an avulsed tooth is the best treatment option at the site of the accident. If replantation is impossible, milk is the preferred transport medium for the avulsed tooth. There is a general low level of awareness about the need for prompt triage of traumatic dental injuries sustained in sports, despite their relative frequency. When a cohort of Swiss basketball players was interviewed, only half were aware that an avulsed tooth could be replanted. Cheap, commercially available tooth storage devices containing an isotonic transport medium (so-called 'Save-a-Tooth boxes'), can maintain the viability of an avulsed tooth for up to 72 hours, prior to replantation. More readily available storage media such as milk, sterile saline or even saliva may be used, but knowledge of this information is rare among sports participants. For example, just 6.6% of the Swiss basketball players interviewed were aware of the 'Tooth Rescue box' products. Sporting organizations seem to offer very little information about sports-related risks or preventive strategies for orodental trauma. Having an attending dentist at sports events - amateur or professional - is clearly a luxury that is neither practical nor affordable. The solution must lie in extending the knowledge of management of orodental trauma beyond the dental profession. Educational posters, when displayed prominently in sports clubs, gym halls and dressing rooms of swimming pools, are a clear, accessible and low cost method of presenting the appropriate procedures to follow after orodental injury. When the potentially avoidable financial burden and discomfort of protracted restorative or cosmetic dentistry are taken into account, rarely can such significant morbidity be so easily prevented.