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The Life of NHL Dentists (espn.com)
173 points by evo_9 7 days ago | hide | past | web | favorite | 82 comments





About 6 months ago I caught a full-swing of a stick to the right side of my mouth/jaw. Cracked my front right tooth in half and broke the next two right-most teeth at the gum-line, and cracked one of my lower teeth off at the top 1/4. Neither top teeth broken at the gum could be saved/or built up so they pulled them. I also had one of my lower teeth, left of center knocked out (yes left of center, I think the top portion of the stick blade came down and slapped that part of my mouth). I picked that one up and washed it off and stuck it back in; it seems to have re-rooted.

The work they did on the top teeth was pretty much the most painful, least fun medical I've ever had to go through. Pulling those two top teeth that were broke off at the gum-line was extremely unpleasant. At one point the dentist had to put her knee on the chair/left side of my ribs to get enough leverage to pull one of the two. My wife couldn't even watch and said it was like a scene from a movie.

This is after playing hockey since the age of 6 (I'm 52) and not wearing a cage for roughly 30 years (since I stopped playing in college).

I had a very strange desire to buy/put on a full cage a few weeks before this happened and even started to research which to buy but got interrupted and lost my traction on the whole idea.

To date this has run me over 10k and I still have to get my final implants.

And yes I do wear a cage now, and it's crazy how often I catch a stick/puck to the face now. I guess I used up all my karma and was getting lucky for years. I attribute this 'luck' mostly to playing with other ex-college and pro players whom generally know how to keep their stick down and in control.

Incidentally the person that hit me was a female defense-men in a co-ed league; she'd played high level college and was groomed for the women's Olympic team on one point, so I don't fault her, it was a freak accident mostly caused by her being tiny (just over 5ft on skates); if she was an average sized guy out there the stick would have hit me in the half-shield or top of the helmet.

Either way, yeah cage on now and I regret not making the transition sooner.

Also - I give USA Hockey Organization high marks, they have so far covered about 90% of the costs and were easy to deal with. I actually lost my previous job because of all this, I also sustained a concussion (and a partially fractured jaw), and they were not very sympathetic to my drop in production so the coverage from USA Hockey has been a huge positive in all this.


"I picked that one up and washed it off and stuck it back in; it seems to have re-rooted."

I am shuddering. This is Cronenberg levels of body horror. I suppose I must have known this was how it worked, but I figured there was more to it than that and that dentists had to do something more dentist-y to make it take.


All a dentist would do would be to wipe off any large debris (as long as noxious chemicals aren't involved, you don't really even want to wash it) and then stick it back in the socket. Maybe pack some cotton rolls around it to keep it in one spot for the first 12 hours or so. Doing this on-scene ASAP is strictly better than waiting until you get to a dentist.

Would it still take root if it was placed in backwards? If it was someone else's tooth? a particularly well shaped rock?

It depends, but there's an issue of biocompatibility similar to any organ transplant. So no, a rock wouldn't work. The backwards tooth though is interesting - my guess is if it would fit it would stick (although it would definitely fuck up your bite).

https://myhillsdentist.com/blog/why-dont-we-do-tooth-transpl...


I wouldn't be surprised if a backwards tooth could remain viable. This is the sort of error that would be noticed immediately by any conscious patient, however. A backwards tooth would mess up occlusion. Few people would ignore the fact that they can't close their mouth completely.

And that's just the beginning of the story.

The same thing happened to me. 10 year down the line the inside of the tooth has been mostly absorbed by the bone leaving it fragilized (which, according to my dentist, is a common occurrence in those cases).

I just spent a year working with my dentist to replace the teeth with an artificial one.


Hearing this, all I can think of is how Zdeno Charing broke his jaw in multiple places in this year's Stanley Cup Final and was back the next game. Hockey players are insane.

Yeah that incident with Chara happened around the same time as mine; I had a playoff game a few nights later and played. I really love hockey so it takes a lot to keep me off the ice, which I guess probably seems pretty 'insane' to non-hockey folks.

One other thing... the night it happened, the game was at 10:30 and there really isn't anything the emergency room visit can do other than provide pain meds etc. So I just drove myself home and my wife kept bugging me to go to the hospital, but I kept telling her there really was no point. The worst part of that night was trying to sleep; I actually slept clinching a rag in my mouth to keep the tooth in position and to absorb blood from the rest of the damage. The pain of the open nerves was pretty hard to deal with too.

Didn't sleep much, easily the worst night of my life that I can think of. Fortunately I have an excellent dentist here in Denver (Icon Dental) and I was able to book an emergency visit for 8AM the next morning that night so I knew I just had to make it to morning.


As someone who's broke their jaw twice from pucks to the face, yours and Chara's had to be a hairline fracture. There's absolutely no way I could have played with a broken jaw. It was over 2 months of having my mouth wired shut ( liquid diet - lost 55 pounds) plus plate in my chin. It's still painful when I get a puck/stick to the cage over 15 years later.

But I’m going to guess you didn’t have a doctor with a briefcase full of Toradol injections in the dressing room, ready to shoot you up and clear you to go back out.

Chars had his jaw wired shut during the games after he broke it.

couldn't have been the same way as mine then, since you can't breath deeply at all with your mouth wired shut (i almost fainted while running after someone).

The dude came back out and sat on the bench for the third period. You could tell he wanted to get back on the ice, too.

Most people think it’s just a game, and are surprised or confused by this.

This isn’t a game to them, it’s their job, and one they fought hard their entire lives for. The system selects for elite talent from all over the globe that is wired to persevere at all costs. For the extremely few who make it to the finals of the top league in their sport, especially late in their career, they know they may never get another opportunity to capstone their life’s work. It’s beyond comprehension for them to just roll over at the finish line and let someone else take what is theirs.


Pro-level athletes are training hard, and spend an awful lot of time being miserable, both due to constant training, and lots of time away from home.

After all that misery now you've got a real shot at a Cup? You bet your ass they're going to stay in the game until they can't.

And then there is the financial incentives for winning the championship...


Ok. That was a roller coaster.

As a hockey fan who only kept playing until the junior years, I don't think I'll ever understand why anyone would play without the cage. Wouldn't you adjust to the vision distraction really quickly?

One thing I notice when googling for hockey cages is that a lot of them incorporate horizontal elements. That doesn't seem like good design to me.

Your eyes are spaced horizontally. This makes it pretty easy to ignore narrow vertical elements: if one eye gets blocked there's a good chance the other eye can still see around it. The same thing doesn't go for horizontal elements. If one eye is blocked the other is likely to be blocked too: you'd need to move your head to see in that blind spot.

It'd make for a pretty neat research project, Make various sight obstructing hats with varying amounts and sizes of horizontal/vertical elements and see what its effects are on reaction speed, tracking a moving target, See if diagonal elements are better than horizontal ones etc etc.

In any case I can imagine a cage like that being annoying, but (to me at least) that doesn't really weigh up to the risk of injury.


I started playing at university (UK) , and always wore a cage. Honestly, it's really only an issue when you first put it on each time, once you start skating you're really not aware of them.

Like wearing glasses, I imagine.

I used to play with a guy that had one of those half cages with visor top half, would be tempted to try that if I needed to replace mine, but not enough to get one before then.


90%... so the total cost was around 100K? Global capitalism is a funny thing, here in my country with that money you could buy an apartment and have enough money left to get the exact same treatment you got there.

"Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents."

https://news.ycombinator.com/newsguidelines.html

Please see also https://news.ycombinator.com/item?id=21477839.


Playing rec league years ago, I had always played with a full cage. I decided to go with a half visor to be one of the cool kids. Went to my local shop and it was a bit more expensive than I had planned so I figured I'd wait until the next week to buy it. That week, I took two pucks to the cage. I never did go back to buy the visor.

Nobody is making the Show from beer league, better to keep a full mouth of teeth.

I too play with a cage in a beer league. I'm used to the more limited visibility. I've seen too many horrors on the ice.

The puck has eyes of its own. It still seems to find my unprotected bits.


I wonder why the 50/50 ones (visor top with cage underneath) aren’t more popular? Juniors/Women I think are required to wear regular cages but for recreational players you’d think more would wear that type?

I got a used pro players helmet from my team for $20 after the season (they sell off all their gear to fans) which is great bargain for a really nice piece of equipment - but I wouldn’t dare playing games with it because it’s a visor obviously. I look like one of the cooler dads at the 4year olds’ skate practice though.


Because visors suck? They fog up and if they get wet you have to clean them.

Visits are basically mandated everywhere now (just the NHL will take 10 more years while everyone else has already made them mandatory)

If you are required to wear a visor anyway it feels like the version with a few bars covering the teeth/jaw can’t fog up that much more than just the visor alone?


Visors are mandatory in the NHL, players not wearing them before the ruling are grandfathered in though.

Sorry, i meant that compared to a cage. I'd take a cage over half and half every single time.

Back in colonial times, a common part of two people getting married was the bride's father paying to have all her teeth pulled and replaced with a set of false teeth -- because the state of dental hygiene was so bad then that it was just assumed that she would lose all her teeth eventually, and that way the husband wouldn't have to bear the expense of dealing with it. It was a kind of dowry.

I look at those photos and wonder if something similar wouldn't be a nice benefit for newly minted pro hockey players.


The barber pole was originally an advertisement for surgery and more.

If I recall, Red meant bloodletting, White meant teeth, Blue meant haircuts.

The Joe Rogan interview with Lindsey Fitzharris was a lot of fun. (also the interviews with elon musk, john carmack)


> If I recall, Red meant bloodletting, White meant teeth, Blue meant haircuts.

I'm not sure that can be right, because I think blue's only used in the USA. (At least, I only see it with blue in emoji; in England they're red and white. Amusing if it is though, and the only still-relevant colour has been lost here!)


Ok here it is...

> In Renaissance-era Amsterdam, the surgeons used the colored stripes to indicate that they were prepared to bleed their patients (red), set bones or pull teeth (white), or give a shave if nothing more urgent was needed (blue).

https://en.wikipedia.org/wiki/Barber's_pole


I thought the barber pole was because shaving involved cutting people up so bad, that the blood soaked rags were hung outside.

My father knew a fellow who was having trouble with his teeth. His dentist convinced him that he'd be better off with all his teeth pulled and use dentures instead.

My father said he was very sorry he'd done that - no matter how bad his teeth were, they were better than dentures.

I remembered that story when I was 21 and the dentist wanted to pull all my wisdom teeth. I asked him what was wrong with them. He said nothing, but they were in a difficult spot to clean and I'd lose them by the time I was 30 from rot.

I changed dentists.

I'm old now, and my wisdom teeth are the healthiest teeth in my mouth :-)


That makes absolutely no sense. Chewing with dentures, especially dentures in colonial times, is painful and awkward as heck. George Washington had trouble with his teeth for well over 20 years. You really think people willingly went in for that trouble?

> You really think people willingly went in for that trouble?

I have no trouble believing anyone went to any lengths to look good


Dentures back then were ill-fitting, uncomfortable, and expensive. Check out Washington's portraits in his later years. They are, by no means, the definition of "looking good".

Source? That's an amazing fact

I've heard this before, but about England and only as something relatively rare: https://www.independent.co.uk/news/uk/home-news/smile-a-perf...

In 'Road to Wigan Pier', George Orwell found that many working class people saw their teeth as an inconvenience to get rid of as soon as possible.

> Several dentists have told me that in industrial districts a person over thirty with any of his or her own teeth is coming to be an abnormality. In Wigan various people gave me their opinion that it is best to get shut of your teeth as early in life as possible. 'Teeth is just a misery,' one woman said to me. In one house where I stayed there were, apart from myself, five people, the oldest being forty-three and the youngest a boy of fifteen. Of these the boy was the only one who possessed a single tooth of his own, and his teeth were obviously not going to last long.

http://www.george-orwell.org/The_Road_to_Wigan_Pier/5.html


Yes, the rate of dentures in England was astonishingly high: many, if not most, people would get out most or all of their teeth at some point in their life. There's no question of that, the national dental surveys show that. The question is one of bridal customs.

That article is so evocative and well-written, I feel I'll be coming back to it just to steal some expressions.

Always a casual sports fan, I recently started reading ESPN daily after getting into fantasy football/basketball, and their writers are really good. And they have sport specific RSS feeds https://www.espn.com/espn/news/story?page=rssinfo

Last I checked, college and professional women's leagues mandated face protection. Why don't men's?

There's a flipside in another sport.

In Men's Lacrosse at the college level they wear helmets... in Women's Lacrosse helmets are not allowed, they wear ridiculous eye-cages instead.

Their argument is that they have less contact allowed and don't need them. I think the real thing is trying to look better and/or culture like hockey.

Women's college Lacrosse apparently is #2 for concussions after Men's Football.

Men's Lacrosse apparently has far fewer concussions even though it allows contact.

My wife had 3-4 concussions playing Lacrosse in College.. I definitely worry about some effect of it coming back as we age. Her concussions were apparently bad enough the effects lasted and messed up her schoolwork for quite some time.

I played a lot of pond hockey as a kid.. we somehow managed to not knock each other's teeth out or get head injuries without helmets but there was no contact and the level of play was very low.

First time I suited up in a rink with a helmet I got hit in the head by the puck coming around the boards. I was totally fine cause of the helmet but it scared the crap out of me, I don't think I ever really played pond hockey again.


It is women’s soccer that is second only to mens football for concussion rate - see this article: https://www-m.cnn.com/2019/10/15/health/concussion-high-scho...

Having played men’s lacrosse and coached both boys and girls, my observation is that concussion-risk events in girls lacrosse are extremely rare, and not affected by helmets. The head trauma in the mens game is usually from intentional body contact and collisions, which are not allowed in the womens game. The occasional stick to the head happens but those are not (usually) violent enough to be a concussion risk. I would expect concussion rates in womens lacrosse to be similar but lower than a sport like basketball) and uncorrelated with the rate in mens lacrosse which is a much different game


I played high school lacrosse, & I always thought it was strange women's lacrosse didn't require helmets.

Sure, they aren't allowed to stick or body check like mens lacrosse, but it's really beside the point if you ask me. The point is you are hurtling a heavy rubber object through the air at high velocity. Same as hockey, of you don't have face protection and catch a full strength shot in the face/ head, you're going to get fucked up.

I never played hockey, but lacrosse is just hockey on grass. I'm sure its fun as hell. But there is no way in hell I could ever be talked into playing without a full facemask. I don't care reduced vision or not.

NHL players are straight up savages... and god bless them for it. They put on a hell of a show.


Women's college lacrosse is effectively a different game, as different as baseball is from softball.

Trying to play attack with no pocket is a fool's errand. I honestly don't know how they manage to play.

Well, they turnover a hell of a lot more for one...

Not only that, but the NHL BANS full face protection unless you're recovering from an injury. (Ex-all star Dany Heatley spent most of his career wearing a comically big half-visor after suffering a serious eye injury, I wonder if he would've opted for a full visor if given the choice.)

Some players already dislike the currently mandated half-visors (visors can distort vision, or fog up, etc.) and do weird shenanigans like having small or tipped-up visors.

There's also a fighting culture in North American professional hockey which would be destroyed by mandatory full face protection.


The “fighting culture” in the NHL (perhaps more in the AhL and college leagues?) can’t die soon enough. It’s already better than it used to be in the 80s and 90s but there is some way to go. A good first step would be actual match penalties for proper fights. It has worked elsewhere.

There is a theory that fighting actually prevents serious injuries and concussions.

Teams have goons and enforcers. It’s the goon’s job to hurt star players. A skilled goon can lay a clean, legal, but devastating hit on your top scorer and go unpunished. If he gets him when his head is down or not paying attention, he can take him out of the game, the series, or potentially the season. It’s those hits that cause injuries and end careers.

An enforcer is hired to send a message that if you plan to incorporate injuring the star player as part of your strategy, he’s going to beat the living hell out of you.

Fights are by mutual consent, and almost never result in serious injury. But they hurt physically, and losing one hurts morale.

The league actually introduced an instigator penalty a while back, which means whoever initiated the fight is penalized. Concussions went up, because now the enforcer couldn’t do his job, or his own team suffers even more. So it was open season with cheap shots on stars.


> There is a theory that fighting actually prevents serious injuries and concussions.

I think that theory is BS. Fighting is a well known cause of concussions. https://www.nhl.com/news/concussion-panel-recommends-hockey-...

> Teams have goons and enforcers. > An enforcer is hired to send a message that if you plan to incorporate injuring the star player as part of your strategy, he’s going to beat the living hell out of you.

This sounds like the NHL in 1999, not 2019. Enforcers are mostly gone thank god.

> A skilled goon can lay a clean, legal, but devastating hit on your top scorer and go unpunished. > If he gets him when his head is down or not paying attention, he can take him out of the game.

The rules are very different now (or compared very differently at least) compared to 20 yeears ago too. 20 years ago you saw people glorify open-ice blindsidee hits saying "heads up!". Now hitting someone when their head is low invariably is a suspension. The responsibility is on the tackling player. An attacker with his head too low is not a valid target.

> and almost never result in serious injury

The figures range from 5 to 10% of concussions coming from fighting. It's not a lot, and probably not the most serious ones - but they are all unnecessary unlike the others which are part of the game.

My theory is that glorifying violence is bad full stop. I don't care whether NHL players get a few more concussions. They make millions and have great healthcare. The problem is my kid who watches this and thinks that's how you play hockey. Fighting doesn't disappear because it results in match penalties. It just stops the glorification. Linesmen should never back off two fighting players, crowds cheering with their popcorn. It's disgusting.


> Now hitting someone when their head is low invariably is a suspension. The responsibility is on the tackling player. An attacker with his head too low is not a valid target.

The rules are way more strict now, but this isn’t accurate. It has to be intentionally targeting the head, or feet leaving the ground. There is no responsibility on the player unless contact with the head was deemed to be avoidable. That doesn’t apply to the hit overall, as there is never an obligation to avoid contact - just that if you do make contact, and you have the option of where to hit them, you aren’t allowed to choose the head.

The rule states:

In determining whether contact with an opponent’s head was avoidable, the circumstances of the hit including the following shall be considered:

(i) Whether the player attempted to hit squarely through the opponent’s body and the head was not “picked” as a result of poor timing, poor angle of approach, or unnecessary extension of the body upward or outward.

(ii) Whether the opponent put himself in a vulnerable position by assuming a posture that made head contact on an otherwise full body check unavoidable.

> I don't care whether NHL players get a few more concussions. They make millions and have great healthcare.

That’s the biggest issue in professional contact sports, particularly football and hockey, so any argument that dismisses it is not going to be very compelling.

There is no such thing as good health care for concussions. It’s permanent brain damage.


I’m obviously not in favor of increasing concussions - but luckily I don’t buy into the argument that fighting increases concussions, so it’s not even a tradeoff in my view. Reducing fighting can cut the 5-10% of concussions that come from fighting in pro leagues and help reduce them elsewhere as an added bonus. A less ridiculous sport is icing on the cake.

Read the stats. Concussions and missed games due to injuries are on the rise, with a jump immediately following the rule changes that made traditional enforcers no longer a viable option. You are trading that 10% for a much larger number due to bullies and pests getting away with cheap shots.

It could be just a long transition phase, but stats show that fighting was the mitigation, not the problem. They removed the mitigation and unleashed the real problem. They are trying to address the real problem now, but so far, the evidence suggests that they have not yet found a more effective solution than allowing stars to have bodyguards. It would be great if they can solve both.

Good intentions can have unintended side effects. You know, like time the time the US toppled that brutal Saddam guy and accidentally made ISIS.


If that’s the case then the increase would be seen in the NHL where there is a history of fights and enforcers but not e.g in the Swiss or Swedish leagues where there isn’t. But concussions are up across the board.

The more reasonable explanation for more head injuries is the game is faster (much fewer hookings, for example) and a focus on speed and skill over size and strength.

There just is no “I can’t punch this guy in the face so I’ll give him a cheap blindside to the head”. The stats doesn’t support the hypothesis.


Teams have goons and enforcers

They don't, really, and the stats show a fairly steady decrease in fighting. There might be a 'theory' but the evidence is fighting is on the way out.

You could make the argument that removing players who specialize in fighting and the ceremony and ritual surrounding it it makes fighting more dangerous - a recent case in point would be Ovechkin knocking out Svechnikov earlier this year. But that's also an even better argument for eliminating fighting altogether.


Yes it’s definitely on the decline, and nothing like before the rule changes, but it’s still an issue. Crosby has been punished heavily his whole career and suffered several concussions, so the Penguins had to make changes to give him more protection.

The theory is backed by the evidence. It’s correlation, but the link seems obvious. Concussions went way up after the original instigator rule. They went up even more after the “no hits to the head if you can hit somewhere else rule”.

The number of man games lost in the playoffs has also gone up steadily.

So by all metrics, outcomes have gotten worse. Pests and cheap shots have no deterrent, and compared to fighting, those are what cause real damage.

Your arguments sound plausible, but the numbers tell a far different story, and the coaches who have star players vocally disagree with you.

https://thehockeywriters.com/nhl-instigator-penalty-needs-to...

”The instigator rule may be limiting fights, but it isn’t protecting the players. It’s allowing dirty players to thrive. And that has to be worse for hockey than two players facing off in an effort to guard their teammates.”

Don’t get me wrong, I get the moral argument and the issue with glorifying violence. I don’t have an opinion on fights, but I find the change in outcomes to be interesting in the behavioral economics sense.


Care to back that up with an argument or should we all just accept that your preferred culture is the "correct" one?

This is all covered in the book, The Code: The Unwritten Rules of Fighting and Retaliation in the NHL.

Or just search YouTube for:

"The Code" AND "NHL"

I love hockey, and I used to play sled hockey (a disabled sport--I cannot safely skate on my feet). I really only use my sled to skate for fun now. But, I won't be able to skate for awhile due to an injury.


It's glorification of violence. (Which is an argument only if you don't like glorification of violence.).

>There's also a fighting culture in North American professional hockey which would be destroyed by mandatory full face protection.

Having grown up playing hockey in a pretty rough league that's not true. You just hook your hand under the back of the helmet and pull, it'll pop right off.


With a full cage? Either the wearer has deliberately made that possible, or it'll hurt.

I was kept mine so that I could get it on and off without unclipping the cage, but as snug as possible while still allowing that. So pulling it off isn't quick, and I wouldn't fancy someone else doing it.


There was a recent rule change that bans players from removing their own helmet (but not their opponent's) before a fight and the threat of punching hard plastic doesn't seem to have stopped anyone.

The cage makes it harder to see the game at your feet. There's also just the culture of hockey. The last un-helmeted NHL player didn't retire until 1997. Referees often didn't wear them for some time thereafter. I remember one ref, Kerry Fraser, who retired in 2010, who refused to wear a helmet so as to not mess up his famously coiffed hair.

The NHL did recently mandate visors for all new players entering the league; it seems quite possible cages will come before too long.


If you're looking at your feet, you're gonna get run over, no one in the NHL looks at their feet.

Sure they do. Not while stick handling or skating normally, but while receiving a bad pass, sending a puck between their skates while trying to out-maneuver a defender, etc. Cages affect your peripheral vision, as well.

Tradition and machismo.

Coincidence - I'm watching Slap Shot right now.

I'm amazed that only the goalie wore head gear.

https://en.wikipedia.org/wiki/Slap_Shot


I suspect they didn't because the players need to be recognizable to the film goers. It's the same thing with movies about military pilots - they are filmed with the oxygen mask off.

(Top Gun helpfully had the name of the pilot stenciled on the front of the helmet! Sort of like why knights had a coat of arms so you could tell who was who and not hack off the limb of your buddy.)


Good point. I looked it up.

Slap Shot is from 1977. Helmets weren't compulsory in the NHL still 79/80. And that only for new players. Most were wearing them by 78, in the NHL. Slap Shot is about a minor league, so probably a lot fewer wore helmets.

Apparently some were still playing without helmets in 1996/97 !


What's truly unbelievable is that even the goalie used to not wear any headgear, as any good Canadian can tell you having watched one of our Canadian Heritage Moments: https://www.youtube.com/watch?v=rcolbkAAgag

I always thought that the dentists would have a lot of work, but has someone asked to the massagists? lol

I was going to correct you, but apparently "massagist" is a standard term; I'd only ever heard masseur(m.)/masseuse(f.).

https://en.wiktionary.org/wiki/massagist


Haha I've never heard that either. 'Massage therapist' is the best term I think.

Here I am complaining about my recent gum grafting surgery...

Goalies didn't use to wear masks. Terry Sawchuck's face: https://images.app.goo.gl/noYBCaJAYkVWKLeG9




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