When we think of injuries related to jiu-jitsu, we think of sore joints, maybe a dislocation, a hyperextension, bruising, etc. One thing we don’t often think about is getting a tooth knocked out. I’ve seen it happen first hand. At the very least, an unforeseen impact can cause a loose tooth or chipped tooth. If you’ve been reading the magazine for any length of time, you’re probably aware that our editorial position on mouthguards is that they’re a good thing. But let us say you’re not wearing a mouthguard and you have an injury that involves a tooth, what should you do? We sat down with Dr. Robert Kim DDS; not only is he a great dentist, he’s a jiu-jitsu practitioner training under Don Kim, a Saulo Ribeiro Black Belt.
The easiest way to reduce the risk of tooth injury is to get a mouthguard. It doesn’t matter if it’s a boil-and-bite or custom fitted, anything is better than nothing at all. If you damage a tooth, it could end up costing thousands of dollars over the life of that tooth. A tooth injury is going to affect your function, and it could affect your aesthetics. You can easily lower these risks by wearing a mouthguard every single time you roll
Soft Tissue Damage
How many times have you rolled and you get crossfaced? How many times have you rolled and you just bit your lip? This is soft tissue damage. It takes a long time to heal. It doesn’t feel good. It could be a lot worse than just your normal lip bite. You could bite your tongue off. Worse case scenario, you could get a really bad cut on your lip, where you’ll need stitches. Wearing a mouthguard helps prevent this.
Another possible injury is an embossed tooth or a cracked tooth. How many times have we rolled and caught an elbow in our face? How many times have we rolled and hit our mouth on the floor, or even a knee? This happens a lot of times and the person doesn’t feel much pain, so they don’t pay it much attention. But that chipped tooth can turn into something worse down the road. A chipped tooth, if not properly treated can lead to infection, which can spread to the head and neck. In some rare cases, an untreated broken tooth can become life threatening. Typically a chipped tooth will continue to chip more easily than an intact tooth.
Another type of trauma that can occur is a broken jaw. How many times have you watched the UFC? You’ll see a fighter get hit so hard their mouthguard flies out. What does the ref do? They stop the fight. The fighters pick up the mouthguard and put it back in their mouth. That shows that it is pretty important. We don’t want any jaw damage. Granted, it’s much more common in striking situations, however knees and elbows can sometimes fly pretty fast in competition.
Losing a Tooth
Can you imagine your dentist telling you “Hey, we need to put an implant in your mouth. You’re not going to be able to roll for six to eight months.” If a tooth is unsalvageable after it gets knocked out, the most likely form of treatment will be a tooth implant. This is big deal and will keep you off the mats for an extended period of time. Failing to properly treat the tooth will lead to bone loss that can eventually cause other major problems. Even Nick “The Tooth” Gullo had to get an implant recently.
Doctor Kim likes to tell his patients that teeth are structured like M&Ms. That outside part is hard like a shell, the middle part is softer like the chocolate. Then, there’s an inside part, that’s the pulp, or the peanut. If an injury is just an enamel fracture, that’s the outside shell. That’s going to be more of a cosmetic situation. Go to your dentist, get that fixed. You want to be looking your best. You probably won’t feel any pain.
If the tooth is broken into the dentin, you will have a little bit of sensitivity, but there will be no bleeding. It is a little bit more of a severe fracture. In that situation, you may need a veneer or you may need a crown. Depending on which tooth it is, you may lose some function. Other teeth may have to compensate for the injury. Which usually means the other teeth will take the damage in the long run. If there is bleeding from the tooth, this means that the fracture has reached the pulp of the tooth within the inside of the root, which means it’s broken into the nerve. In a situation like this, if it’s saveable, you’re going to need a root canal and then a crown and it’s going to hurt like hell.
There is another type of fracture where the tooth is fractured underneath the bone. This can be caused by a hard hit to the gums. Many times in these situations, the tooth is not saveable. If the tooth gets hit, always go see the dentist. Don’t wait. If they can save the tooth, you’ll have a higher chance to save it sooner rather than later.
What About a Loose Tooth?
If after an impact your tooth feels loose, always go to your dentist. If it’s loose, you’re going to have one of two situations. The worse situation is the tooth is cracked. If the tooth is cracked, you are going to need to see a dentist to fix it. If you are lucky, the tooth may be avulsed meaning it’s loose in the socket. That’s going to be a better scenario. If it feels dislodged, try to put it back into place, don’t eat with it, just go see your dentist as soon as possible.
Your dentist will take an x-ray and if it’s just loose in the socket, they can do something called “splint the tooth.” They can actually connect the tooth to another tooth. Our teeth actually have ligaments around the root. If it’s this type of trauma, it will heal on its own and you’ll likely have a really good prognosis. On the other hand, if the tooth is fractured in any sort of way like we went over before, you’re going to need some sort of dental treatment, whether you are going to lose the tooth, a root canal,crown, or just a filling- you’re going to have to go see the dentist.
What About a Knockout?
Let’s say you don’t have a mouthguard on, somebody goes for a flying something or other and they knock a tooth out. Boom! – the tooth is on the mat. What should you do? If it’s after hours, you might try Urgent Care, but they’re probably going to tell you to go see your dentist. As soon as you can, put the tooth in some milk, put it in the fridge and then see if the dentist can save it. That will at least give it a better prognosis, rather than just holding the tooth in your pocket and having them try and put it in. This betters your odds that the dentist can even attempt to put it back in so they can splint the tooth to try and save it.
Keenan On Mouthguards
More and more high-level pros can be seen wearing mouth guards. Keenan Cornelius is one pro that’s been wearing a mouth guard as long as we can remember. We asked him a couple quick questions on the topic.
How long have you been using a mouth guard?
I have been using one for a while, because I felt I could fight harder if I didn’t have to worry about biting my tongue. I wasn’t as worried about my teeth. But if you have ever taken a knee to the jaw while your tongue is in the way…. Well you would wear one too
Do you think it’s ever saved you some dental work?
The only time I’ve had a significant dental injury was while wearing a mouth piece. I ate a solid knee to the face from an enthusiastic blue belt. It broke off my front tooth about half way up. I have temporary replacements every couple years as the bonding weakens if I get hit again it will break. The most recent time the broken tooth broke off was after biting into a taquito at a baby shower last year.
Mouthguard For the Win!
Along with protecting your chiclets, a mouthguard can aid in your ability to recover after intense resistance exercise. Recently a study was published in the Journal of Strength and Conditioning Research. The study tested the effects of mouthpiece use on cortisol levels during an intense bout of resistance exercise, sort of like a jiu-jitsu training session. Previous research had suggested that use of a mouthpiece during exercise resulted in increased muscle strength and endurance but the findings were difficult to replicate. This new study tested the amount of cortisol present in athletes saliva before, during, and after exercise. The results revealed that across the board the athletes that had worn a mouthpiece during their workouts had significantly less cortisol in their saliva 10 minutes after their workouts. Cortisol reduces protein synthesis by reducing the uptake of amino acids into muscle cells. It also decreases calcium absorption into the intestine and inhibits bone formation. Basically, it screws up your recovery from a difficult workout.
Putting a Crown On It
Okay, we get it, some of you don’t like to wear mouthguards, and that’s okay. At least now you’re aware of what to do in the event of an injury to your mouth during training. When you get the bill, don’t say we didn’t warn you. Hopefully you never have to make a trip to the dentist because of jiu-jitsu.