Young field hockey players risk serious mouth and jaw injuries

By Madeline Kennedy

(Reuters Health) - Almost half of elite field hockey players, and one in eight junior and senior level players will suffer a mouth, tooth or jaw injury, according to a new review of research that also found too many players still don't wear mouth guards.

The study did not directly measure whether players who don't wear mouth guards are more likely to be injured. However, greater use of mouth guards would likely reduce injuries, the authors write in the British Journal of Sports Medicine, online October 28.

Field hockey is gaining popularity in North America and growing worldwide, they note. In the United States, it is particularly popular among women in high school and college.

"Following a serious incident in the Dutch field hockey premier league that involved a major dentofacial trauma," the governing body of field hockey in the Netherlands recruited the study team to investigate this topic, lead author Dr. Strahinja Vucic told Reuters Health by email.

"The evidence in the literature shows that the prevalence of dentofacial injury is quite high, as one out of 10 non-elite players and one out of two elite hockey players reported to sustain at least one dentofacial injury in their gaming career," said Dr. Vucic, a researcher at Erasmus University Medical Centre Rotterdam in the Netherlands.

The study team looked at previous research to determine how common lower facial injuries are and whether players are using protective measures like mouth guards. They included 11 studies that looked at injuries to players' teeth, jaws, lips or cheeks in their analysis. They also included studies on the number of players who own and regularly wear mouth guards and studies looking at players' attitudes towards wearing mouth guards.

The majority of injuries described in these studies, around 575, were caused by a hockey ball, while 38% were caused by a blow from a hockey stick, the researchers found.

Around 13% of junior and senior players had been injured at least once, while over 45% of elite players had been injured. The rates of facial injury were around the same for men and women.

Mouth guard use is improving, with 85% of players currently using them, compared to only 31% 20 years ago, according to the results. Still, players were most likely to complain that mouth guards were unnecessary and uncomfortable.

Players who had experienced a mouth, tooth, or jaw injury in the past were twice as likely as those who hadn't to wear a mouth guard while playing.

Dr. Vucic told Reuters Health that making mouth guards mandatory may be an important solution to the problem of mouth and jaw injuries.

Field hockey may be an especially risky sport for facial injury, said Dr. Jack Taunton, an emeritus professor of medicine at the University of British Columbia.

"You've got a hard stick, a very hard ball, that ball's coming at 70 miles per hour, and you've got no protection," he said.

Dr. Taunton recommends that field hockey players always wear mouth guards on the field and noted that, "If they're complaining, the one they've got doesn't fit right."

Many players who resist wearing mouth guards may be using store bought guards that players boil and shape to their teeth. "If you get a custom one made by a dentist, you can talk and you can breathe," Dr. Taunton said.

"Though previous evidence shows that over the years, there was a huge improvement in addressing the issue of dentofacial injuries in field hockey, the dentofacial injury remains a concern," Dr. Vucic said.

SOURCE: bit.ly/1lqrwWp

Br J Sports Med 2015.

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