"Slam dunk" can be harmful to teeth

Dear Alan,

Many children emulate the moves of Mike, Shaq, and other basketball stars. Unfortunately, the urge to slam dunk can lead to serious dental injuries.

One study entitled "Tooth avulsions resulting from basketball net entanglement", was published in the September 1997 edition of the Journal of the American Dental Association. Results show that teeth can be torn out when portable or adjustable basketball rims are lowered below regulation height so children can slam dunk. Case studies from the midwestern United States suggest the momentum carries the child into the nylon net where teeth become entangled and subsequently evulsed (torn out) as the child returns to the ground. Ouch! I know children that jump from tables or trampolines to get the "air" required to slam dunk on regulation height basketball rims.

The top central incisors (front teeth) are most commonly lost, chipped, fractured, or loosened. Sometimes several teeth are removed. If the teeth can be recovered, stored in saliva or milk, and replanted by a dentist within about two hours after the injury, the teeth may be saved. Depending on the extent of the injury, medical costs associated with this type of dental trauma can be several thousand U.S. dollars. Ouch again!

Kumamoto et al. (1997) suggests that:

1. Basketball rims should not be lowered to a point where the face may contact the net;
2. Players should not hang on the rim;
3. Players should not raise the take off area under the basket; and
4. A mouth guard should be worn when participating in any contact sport.

It is estimated that one out of every four people will suffer an oral injury during their lifetime. Most of these injuries occur while operating motor vehicles or participating in contact sports. Currently, boxing and football are the only professional sports where mouth guards are regularly worn. I am, however, encouraged to see more guards worn by high school and collegiate athletes. New materials make mouth guards comfortable, attractive, and affordable.

Additional sources of information:

• Sports Safety from the American Association of Oral and Maxillofacial Surgeons
• California Dental Association: Mouth Guards
• ADA News Releases: Mouth Protectors: Don't Play Without One
• Flanders et al., "The Incidence of orofacial injuries in sports: A pilot study in Illinois" J. Am. Dent. Assoc. (1995) pp.491-496.
• Kumamoto et al., "Tooth avulsions resulting from basketball net entanglement" J. Am. Dent. Assoc. (1997) 128(9):1273-1281.
• Walker et al., "A survey on the use of mouthguards and associated oral injuries in athletics" J. Dent. Res. (1993) 72:277.