Dental Injuries in Hockey Players

Abstract & Commentary

Synopsis: A definite reduction in the incidence of facial and dental injuries was seen when protective face protection was used. Protective face and dental guards are to be encouraged at a minimum.

Source: Lahti H, et al. Med Sci Sports Exer. 2002;34:400-402.

Dental injuries are common in hockey players and are more common in athletes not wearing face or dental protection. The purpose of this study was to determine the incidence and cause of facial and dental injuries in ice hockey games. Age was used to evaluate the effect of mouth or facial guards. A retrospective review of mouth and facial ice hockey injuries in Finland was studied over a 2-year period. Injury data were collected from the insurance company or from the team injury report. A total of 479 injured ice hockey players sustained 650 injuries. The most common injury was a noncomplicated crown fracture, of which 70% occurred in the games. All 6 maxillofacial fractures occurred during games. The most common mechanism of injury was a blow from the ice hockey stick occurring during a game. Ninety percent of injured players did not wear any kind of protective guard. Lahti and colleagues conclude, "mandatory use of mouthguards and face masks or tightened rules for protection to decrease the high number of maxillofacial and dental injuries in the ice hockey games should be considered."

Comment by James R. Slauterbeck, MD

Many studies have shown that face guards reduce the number of face and mouth injuries in ice hockey. Since in Finland all players younger than age 18 wear face or mouth guards, injuries to the face and mouth could be studied by age. This study suggests that the masks provided protection because the number of injured players was less in those younger than 18. This is even more significant because more athletes participate in hockey in the younger than 18-year-old age group.

Additionally, of the face injuries, dental injuries occurred most commonly and were associated with hitting high with the stick. The increased aggressive play in games may account for this. However, athletes sustained less injures in games if protective face wear was used.

In my opinion, athletes participating in hockey should wear masks to protect their face. Rules should be modified to decrease hitting the face with the stick. If our goal is to provide the safest environment for athletes to participate in their sport, then we should consider these modifications to the sport for successful injury prevention strategies. Hockey athletes would in the short-term benefit by participating more effectively during the season. Additionally, long-term dental care resulting from tooth loss in youth would be minimized.

Dr. Slaughterbeck, Associate Professor, Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, is Associate Editor of Sports Medicine Reports.