13 Lessons

Dental and orofacial injuries can occur in football and are of particular concern because, unlike lacerations or fractures, they will not “heal”. They often require an artificial or prosthetic replacement (filling, crown, implant or denture) on a permanent basis. Dental injuries can also be expensive. The lifetime cost of an avulsed tooth in a teenage athlete can easily exceed USD 20,000.

There are a number of common statistics regarding dental injuries that cross most sports, including football. These include:

  • Approximately twice as many injuries happen in men than in women
  • Most dental injuries involve a single tooth
  • 80% of all dental injuries occur in the four maxillary incisor teeth
  • Slightly more injuries happen to the teeth on the left side
  • There is a high incidence of repeat injuries

Dental and orofacial injuries are very common in football. Football is the second leading cause of orofacial and dental injuries in sport, preceded only by basketball. 1-3 Many injury reporting systems (IRS’s) do not reflect these injury rates because of their definition of injury. If the IRS requires the loss of a game or practice to be reported as an injury, then a high percentage of dental injuries will not be reported because the athlete was able to return to play.

Aside from injuries, there are also concerns with the overall oral health of athletes because of issues such as travel, finances, acidic or erosive sports beverages, dehydration and high-carbohydrate foods and snacks.

There is no greater disappointment for an athlete than to train for years for a major competition and then be unable to participate because of a fully avoidable incident such as a tooth infection or impacted wisdom tooth. This module is designed to help clinicians identify, manage and – most importantly – prevent dental and orofacial injuries and avoid any unexpected dental emergencies.

Dr Paul Piccininni

Sport, Cosmetic and Restorative Dentistry

Presented by

Learning outcomes

By the end of the module, you should:

  • Have an understanding of the PCMA as it relates to dental issues
  • Be able to identify and manage tooth fractures, luxations and avulsions
  • Know how to approach soft-tissue injuries around the mouth
  • Understand the different types of mouthguards available and be able to advise athletes regarding their use


  • Read the relevant section in the FIFA Medical Manual and other required reading
  • Review the suggested reading
  • View, or listen to, any relevant multimedia content
  • Complete the course quiz

Suggested Reading

Brukner & Khan’s

Clinical Sports Medicine – 4th Edition

Chapter 19 (Pages 300-312)


  1. Kvittem B., Hardie N.A., Roettger M., Conry J. Incidence of orofacial injuries in high school sports. J Public Health Dent. 1998; 58(4): 288-293.
  2. Teo C.S., Stokes A.N., Loh T., Bagramian R.A. A survey of tooth injury experience and attitudes to prevention in a group of Singapore schoolboys. Ann Acad Med Singapore. 1995; 24(1): 23-25.
  3. Yamada T., Sawaki Y., Tomida S., Tohnai I., Ueda M. Oral injury and mouthguard usage by athletes in Japan. Endod Dent Traumatol. 1998; 14(2): 84-87.
  4. Fuselier J.C., Ellis E.E., 3rd, Dodson T.B. Do mandibular third molars alter the risk of angle fracture? J Oral Maxillofac Surg. 2002; 60(5): 514-518.
  5. Tevepaugh D.B., Dodson T.B. Are mandibular third molars a risk factor for angle fractures? A retrospective cohort study. J Oral Maxillofac Surg. 1995; 53(6): 646-9; discussion 649-50.
  6. McCrory P., Meeuwisse W.H., Aubry M. et al. Consensus statement on concussion in sport: The 4th international conference on concussion in sport, Zurich, November 2012. J Athl Train. 2013; 48(4): 554-575.