By David Rogers. April 14, 2012. BLOWING ROCK -- Stephanie, age 22, was hiking with her boyfriend along Rough Ridge on the slopes of Grandfather Mountain last year. It was a beautiful, sunny day, not a cloud in the sky. The couple alternated between navigating the rocky terrain, challenging each other with "what play is this line from" because of their shared interest in Shakespeare, and every once in awhile stopping to hold hands and gaze out at the world, together. Then their idyllic world...

Well, then their idyllic world collapsed.  Stephanie stepped on what appeared to be a solid rock-step up to the next level of the trail, only the rock was loose. It gave way, Stephanie lost her balance, arms flailing hopelessly as she crashed all-too-suddenly into the unforgiving boulder in front of her -- face first.

In a single moment of misjudgment, an innocent, romantic and carefree world was shattered into bloody and painful mayhem. Her parents would not recognize that beautiful, confident smile for which they had paid $5,000 three years earlier, thanks to 18 months of orthodontic care and braces. In one moment...crushed confidence, broken beauty, and a lost investment. Could the injury be repaired? How long would it take?

William's Story

Johnny, Phil and William were lucky friends, they always said. Each of them shared the same birthday, 15 years ago, and they spent nearly all of their spare time together. Johnny and William were more athletic, Phil a bookworm who nonetheless enjoyed the outdoors and throwing a ball around with his buddies, who seemed to tolerate his less than coordinated physical abilities.

One day in late February, with what appeared to be the early arrival of springtime in the High Country, the boys were anxious to get outdoors. Johnny and Phil played football and baseball, and both had participated in an off-season strength and conditioning program. William had sprouted two full inches in the past 12 months. Three strapping young boys-becoming-men, telling jokes and stories, talking about girls, and wondering about next year when they had to start considering whether or not to go to college. And of course, playing "burn out" as they threw a baseball around their triangle.

Casual, carefree fun on a Saturday afternoon in the park -- that is until Phil told a joke that made William look quickly to his left and laugh, just as Johnny zipped a fastball, about head high, catching William off guard, blood and teeth spurting from his mouth in one of those tragically "oops" moments.

Missy's Story

Missy had just turned 12 when she made the travelling team to play soccer. A budding star with an easy smile off the field, the young center-forward turned into every goalkeeper's nightmare on the field with her deft footwork and lightning quick shot at goal. The coaches marvelled at "abilities beyond her years," they said.

Then she got in this "situation". In a game, Missy and a teammate both rushed for a ball at the same time, their feet tangled, and Missy fell violently forward, her jaw striking the referee's knee. The poor ref just couldn't get out of the way fast enough, but he was the lucky one compared to what happened to Missy's knocked out teeth and mouth lacerations...

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Seven million sports and recreation-related injuries every year in the U.S

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Tragically, these are not uncommon stories as we approach and get into the spring and summer seasons. According to the Centers for Disase Control, more than half of the seven MILLION sports and recreation-related injuries in the U.S. every year are sustained by youth as young as age 5. In 2011, the National Youth Sports Safety Foundation forecast that more than three million teeth would be knocked out in youth sporting events.

Even with this acknowledged risk, a survey commissioned by the American Association of Orthodontists (AAO) revealed that 67% of parents admitted that their child does not wear a mouthguard during organized sports -- and virtually never when playing casually.

Blowing Rock News recently interviewed Dr. Michael Mayhew, a Boone-based orthodontist who travels around the world lecturing on oral healthcare and treatment issues. We raised the question: If something so simple as a mouthguard offers a simple and inexpensive solution that would dramatically decrease the risk of oral injuries, why aren't more kids wearing them?

In response, Dr. Mayhew cited the AAO survey, which found that 84% of children and young adults do not wear mouthguards while playing organized sports because they are not required to wear them -- even though they ARE required to wear other protective equipment such as helmets, shoulder pads, knee pads and shin pads.

"Mouthguards," Mayhew noted, "can be one of the least expensive pieces of protective equipment available. A simple, over-the-counter version of a mouthguard costs as little as $5. Not only do mouthguards save teeth, they help protect jaws. Every year, I see a significant number of children in both our pediatric dental office as well as our orthodontic practice with dental injuries that resulted from a failure to wear a protective mouthguard.

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84% don't wear mouthguards because they aren't required.

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"When I was a young guy playing sports," Mayhew continued, "I was one of those guys who thought it was too inconvenient and cumbersome to wear a mouthguard -- until I got my teeth broken and nearly knocked out playing football. For me, that was a seminal moment because it got me interested in oral healthcare and led to my career in orthodontics and dentistry. But I don't recommend a kid going through trauma to find a career path. There is no amount of machismo that justifies not protecting your teeth and jaw."

Dr. Mayhew added that mouthguards are a good idea in a wide range of the High Country's outdoor recreation activities, too, especially among adults. "Up here in the mountains, we are generally an active population. That includes our many tourists, as well as our year-around residents. We hike, we go spulunking, we ski, we climb rocks, we do mountain biking and road biking. Slip and fall, and you can break your teeth, if not knock them out. Just like I urge parents and coaches to require mouthguards as part of their child's uniform -- for every practice and every game -- I also suggest that even the casual outdoors enthusiast should wear a mouthguard.

"At the very least," Mayhew said, "go to your local Boone Drugs, Walgreens, CVS, or other pharmacy to get the over-the-counter, inexpensive kind of mouthguard. For something  custom-fitted, more comfortable, more durable and even more protective, go see your dentist or orthodontist."

Dr. Mayhew, who serves as a consultant to Appalachian State athletic teams, observed to Blowing Rock News, "You know, Armanti Edwards wears a mouthguard. In fact, when he played football for Appalachian State he was constantly getting his mouthguard knocked out and nobody could seem to find it.  So we ended up making sure we had a supply of spares on the sideline, because he would not be without one.

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There is no amount of machismo that justifies not protecting your teeth.

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"A mouthguard is as important to an athlete as any other kind of protective equipment," Mayhew noted, "and it doesn't matter if you are playing football, basketball, softball, field hockey, or another sport. Whether you are competing against the University of Michigan in a football game or the face of Grandfather Mountain on a Saturday hike, a simple mouthguard can save you pain, time, and money.

"When you have oral trauma," Mayhew concluded, "it is important to get the injury treated correctly. There are ways of saving teeth, and there are ways of preserving or restoring your teeth's alignment. Here in the High Country we have a wonderful referral network of dentists, orthodontists and oral surgeons, each of whom is increasingly aware of his or her role in treating an oral injury."

As a public service, Mayhew suggested that where an oral injury occurs, victims or their parents should:

For a Broken Tooth

• Clean the injured area and apply ice
• Save the tip of the tooth (for possible reattachment) and call your dentist or orthodontist right away

For a Knocked Out Tooth

• Locate the tooth, holding it by the crown (the wide part, NOT the pointed end or root)
• AVOID RUBBING THE ROOT OR TOUCHING IT
• Rinse the tooth ONLY if there is a need to remove debris
• Put the tooth back in its socket; cover with gauze or tissue, and bite down to stablize it
• OR briefly store the tooth in cold milk or salt water, or between the cheek and gum
• Do not let the tooth dry out.
• See your dentist or orthodontist immediately

"A tooth may be saved," Mayhew reported, "if it is properly cared for and reimplanted within an hour."

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