Sports Dentistry

Although sports medicine is a well-known specialty, sports dentistry also provides athletes with a way to take a bite out of an injury.



When a professional wrestler has a toothache just before a big match in Pittsburgh, who's he going to call, even if it's New Year's Eve? Well, a local sports dentist, of course.

What! You say pro wrestling is not a real sport? Well, that's OK. You could say sports dentistry is not a real dental specialty, either.
No matter. When a wrestling superstar has chipped his tooth during a match in Japan and is flying into Pittsburgh for an upcoming main event, he knows he has to go with someone he can trust, even if it is someone he has never met.

At least that's how the story played out several years ago. Tom Green - who practices dentistry in Washington, Pa., and is listed in the Academy for Sports Dentistry's registry of recommended practitioners - got the call from this wrestler, literally out of the blue. The wrestler - whom Green had never heard of - was still in the air over Pittsburgh when he placed the call to Green for emergency dental work. For privacy reasons, Green is unable to reveal the wrestler's name, although he does say that he was a big enough wrestling star to merit having his own comic book at the time. Back then, the World Wrestling Federation was in its glory, and this man was a headline performer for the WWF. Green also will admit that he was one of the largest human beings he had ever seen.

But mostly what Dr. Green thought was that he was the subject of some sort of elaborate prank. Even when the wrestler showed up in his office later that day wearing a leather jacket and suede pants, Green still didn't know who he was. The man was even reluctant to sign a release form. "Do you know how much my autograph is worth?" he asked Dr. Green.

He eventually signed and got into the chair, and then made one more request. He did not want Novocain. No needles, he insisted. "I'm tough," he said.

Actually, he wasn't all that tough. As soon as he heard the sound of Green's drill, he started to scream: "Numb me!"

That experience gave Green a good story to share, even if it also earned him a fair amount of ribbing from his family for not getting an autograph from a celebrity he had in his chair. (It wasn't until days later when he was watching a WWF event on TV that Green realized who the wrestler was and how big a star he was at that time.)

Just another day in the life of a sports dentist? Hardly. More often than not, their work is more routine.

The Academy for Sports Dentistry defines sports dentistry as something that "involves the prevention and treatment of orofacial athletic injuries and related oral diseases as well as the collection and dissemination of information on dental athletic injuries and the encouragement of research" in the prevention of such injuries.

What that means is for dentists who practice sports dentistry is that most of their time is spent making, fitting and advocating the use of mouth guards. Even when they have athletes - famous and nonfamous - in their chairs, chances are they are doing the same sorts of procedures that they would for a nonathlete.

Dr. Rick Gottlieb, who has been practicing sports dentistry in Oakland for 30 years, says treating a fractured front tooth caused by a sports injury is really no different from treating a fractured front tooth for an elderly person who may have slipped and fell. Both patients need immediate attention and the procedure is essentially the same. And trauma-related mouth injuries are no more complex because they took place during a sporting event rather than, say, a car accident, Gottlieb says.

The lack of glamour in the profession could be one reason the term "sports dentistry" isn't a common one, even among sports fans. Sports medicine, of course, is a different animal. Sports fans can tell you the name of the surgeon who has saved so many pitching careers by creating the famous "Tommy John surgery" (Dr. Frank Jobe). And, many Pittsburgh sports fans know about Dr. Freddie Fu, orthopedic surgeon and founder of the UPMC Center for Sports Medicine, and can even recognize him when he sits courtside at University of Pittsburgh basketball games. By contrast, sports dentists go essentially unnoticed. Not even the American Dental Association recognizes sports dentistry as a specialty.

Which is as it should be, most sports dentists will tell you. Dennis Ranalli, a professor and senior associate dean of the University of Pittsburgh Dental School and a past president of the Academy of Sports Dentistry, doesn't even try to make a case for singling out sports dentistry as dental specialty. What sports dentists deal with are "not identified necessarily as sports-dentistry issues," he says. Ranalli considers himself simply, a "pediatric dentist who does sports dentistry."

There are sports dentists who do get to get a bit closer to the action, however. The National Football League, for instance, requires that two dentists (one for each team) be assigned to each game. At games at Heinz Field, the Steelers are responsible for meeting that requirement.

The sports dentists may be sitting in the stands during games, but they're ready in case of emergency.

The Pittsburgh Penguins have a dentist assigned to games to inspect players' mouth guards in between periods, or, to act faster in emergencies. The Pirates don't have specific dentists on site at games, but the trainers have the names and numbers of trusted sports dentists to go in case of oral trauma.

But most sports dentists spend a majority of their time trying to help players avoid dental injuries rather than reacting to dental crises on site. The primary task of most sports dentists is making or fitting mouth guards, as well as advocating their use in more sports than just football, boxing and hockey.

The National Youth Sports Foundation for Safety says dental injuries are the most common orafacial injury sustained during sports and notes that most dental injuries are preventable. The Foundation estimates that an athlete is 60 times more likely to damage his or her teeth if he is not wearing a protective mouth guard.

"Sports dentistry deals with the prevention of trauma to the oral structures and treatment after injuries during athletic events or endeavors," says Dr. Green of Washington. "It can be any sport." Properly fitted mouth guards not only protect the teeth, Green says, but they also help absorb the impact of the blow, which could possibly protect the brain from concussion in some cases.

As a Pitt faculty member actively involved in Pitt sports, Dr. Ranalli gets involved in all sorts of issues most dentists do not deal with, one of which is educating athletes about the negative effects of chewing tobacco on the mouth. Seems collegiate wrestlers like to chew tobacco to suppress their appetites in order to make weight before a match. And all college athletes need to be reminded on occasion to go easy on the Gatorade, a drink that's loaded with sugar and can cause decay.

Pitt is sort of an unofficial center of sports dentistry in Western Pennsylvania, which is appropriate because Pitt is connected with one of the most famous "sports" dentists of all time: Jock Sutherland.

Pitt's Hall of Fame football coach, who led the school to four Rose Bowl appearances in the 1920s and '30s, was himself a member of the faculty at the Pitt Dental School, teaching crown and bridge work in the mornings and blocking and tackling in the afternoons. His reputation as both a dentist and a football coach created a connection between dentistry and football at the university that lingered for many years.

Historically, many Pitt football teams have been filled with players who would go on to become dentists. At one time, the Panthers even had an unofficial nickname of "The Fightin' Dentists." Often, that was a fairly accurate description of the team's players. For example, Pitt's famed 1963 team, (which finished 9-1 and was ranked fourth in the nation) actually had on its roster 15 players who would go on to become dentists.

As you might suspect, most dentists become interested in sports dentistry through an interest in sports. "When I was a kid, I wanted to be the catcher for the Pirates," says Dr. Ranalli. For Dr. Gottlieb, it was being involved in his children's sports teams that first got him involved.
"My kids were involved with soccer," says Gottlieb. "And my assistant coach was also a dentist. We started making mouth guards for the team, and one thing led to another. It just took off from there."

Gottlieb says sports dentistry is an occupation through which your reputation grows by "word of mouth," and, no, he's not making a pun. If you are listed in the directory of the Academy of Sports Dentistry, you never know who might want your services.

For example, Green remembers once getting a call from a member of the San Diego Chargers on the day before a game against the Steelers at Three Rivers Stadium. The player needed a new mouth guard because he had lost his. So Green was summoned to the Chargers hotel, set up an impromptu dental office in the bathroom of the player's hotel room, took an impression and completed the job.

Ranalli attends all of the home games for the Pitt football team's events, as well as men's and women's basketball, but it's extremely rare that he is ever called to action while a game is in progress. The biggest emergency he can recall is attending to a Pitt women's basketball player who was elbowed in the face near the end of the first half of the last game of her senior year. The blow dislodged the tooth from its socket, and Ranalli had to re-position it. Unfortunately, he couldn't do it in time to get her back in the game. Fortunately, his presence helped save the tooth.

But mostly, sports dentists have to be content with knowing their best work isn't likely to involve dramatic emergencies or unusual surgery. No, their best work is more likely to come on the preventive side. Changing people's attitudes about the need for mouth guards doesn't make headlines, but in the end it could be the most important work a sports dentist can do.

Dr. Gottlieb's favorite sports dentistry story involves his son, whom he was driving home following a soccer tournament in Erie. They were almost back in Pittsburgh before Gottlieb looked in the rearview mirror and noticed his son had failed to remove his mouth guard. "He said it was so darned comfortable, it was like it was part of him," says Dr. Gottlieb. For a sports dentist, no story could have a better ending.
 

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