Head and neck trauma is treated by many disciplines in medicine.
It’s football season so let the games begin! I am told there are collisions on the football field that equate to a car wreck.
In dentistry, injuries to the head and neck, create for the
athlete, concerns that can last a life time.
In my dental practice, I have treated more injuries to the
teeth from basketball, due to no mouth guard protection.
I’m watching the practice of a junior league and the players appear to
be around age 12. They are hard hitting, true grit kind of guys that
are taking no prisoners during this practice.
A physician on NPR (radio) earlier today, Dr. Lisa Becker, Neptune New Jersey Hospital, discussed how youth sports are
much more competitive these days. Children are getting bigger. Part of the reason is over eating and another reason
may be the processed foods that we eat.
Dr Becker says that she treats sports injuries and there has been a rise in young people receiving concussions over the past 10 years.
When there is a concussion the brain needs to rest. It is not necessary to push our children back out into the gladiator
arena of contact sports until they are up to the challenge of contact sports. When in doubt have the child sit out a few
games. Injuries are a part of the game and there is nothing wrong cheering your team mates on to victory.
During any traumatic episode to the face, head or neck, it it important to seek immediate medical attention.
A patient with facial trauma must be examined for concomitant head and neck trauma.
Mechanisms of head, neck and facial injury include blunt trauma, penetrating trauma and twisting motions of the head and neck, with or without associated blows to the head and face.
The history of a head injury is based on questions common to any medical evaluation. It is of supreme importance that a baseline be established with an accurate initial assessment of neurological function. Then, subsequent change can be
recorded and acted upon.
A dental education gave me the opportunity to study head and neck anatomy. When I dusted off old text books, a review
helped me to freshen up on the basics. I limit my discussion to information that will help you as the bystander, that may
be able to assist a young person in trouble, while waiting on emergency assistance.
Survival is the body’s most important job.
In delivering emergency treatment, there are 4 major concerns regarding injuries of the face and jaw.
1. Control of hemorrhage.
2. Clearance and maintenance of airway for respiration.
3. Control of shock.
4. Stabilization of injured parts.
Hemorrhage must be brought under control promptly. Arterial hemorrhage being the most serious, it should be arrested at
once by digital pressure. In the extremities, bleeding from dangerous wounds can be brought under control by the use of a tourniquet, but wounds of the face and neck require other procedures. Application of pressure to the bleeding site is recommended.
Severe injuries of the face and jaws frequently interfere with respiration. Establishing a patent airway should be the first consideration of treatment. Fragments of bone, fractured teeth, fillings, broken orthodontic appliances, partials, particles
of clothing and other foreign as well as soft tissue and blood, often drop into the posterior part of the mouth and throat.
All too frequently those foreign bodies are aspirated. Obstructions must be removed immediately to assure an adequate air way.
The patient is better transported in a position that allows less restriction of the respiration. Either in a sitting position,
on their side or placed facing downward, in a prone position to keep air passages free and allow mucus and blood which accumulate in the throat to be expelled.
Shock can be more easily prevented than treated. Body heat should be maintained by placing a light sheet, drape, or blanket over the patient.
Syncope, fainting, shows the following signs, ashy gray color of the skin, cold perspiration, small pulse pressure, and a feeling of dizziness, lightheadedness or nausea. If syncope develops, elevate the feet above the head to restore adequate
cerebral circulation and oxygenation.
Isolate and immobilize potential areas of trauma.
Prevention strategies for injuries to the head.
See that the helmet fits securely for adequate protection. An ill fitting helmet does not provide the required protection.
Custom fitting mouth pieces, fabricated by your dentist, provide better protection than over the counter type prosthesis.
Get a good medical examination before entering the sports program and keep the coach and physician aware of changes in your child’s body when an injury occurs.
When in doubt, rest the child to play another day.
Home observation of your child before and after games is a good idea, checking for changes in mood and interaction with others.
The season of contact sports for our children can be one of enjoyment and great memories when we get involved and stay
aware of our children’s over all health. Become aware of what role you can play as a bystander when you witness head and
From the Diary of my enlightenment,
Artis L. Clark, D.D.S. http://dentist4you.biz