Key Points

• Dental trauma is common in many sports and can be largely prevented with a custom-molded mouth guard.

• Avulsed teeth or tooth fragments should be wrapped in saline-soaked gauze, with urgent transport to a dentist and luxated teeth repositioned if possible.

• Facial and nasal injuries requiring immediate referral include those with prolonged loss of consciousness, visual abnormalities suggesting orbital fracture, malocclusion of the teeth suggesting maxillary or mandibular fracture, facial paresthesias suggesting infraorbital nerve injury, open or significantly displaced nasal fractures, and uncontrollable epistaxis.

• Acute auricular hematomas should be fully evacuated to avoid chronic fibrosis and deformity (cauliflower ear).

• Eye trauma is usually preventable using appropriate eye protection.

• Loss of visual acuity, evidence of globe rupture or leaking aqueous humor, limitation or asymmetry of extraocular movements, persisting pupil abnormalities, and evidence of hyphema all require urgent ophthalmologic consultation.

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