Children who play hockey, football or lacrosse in school or in organized leagues know all about mouth guards. They're required to wear them.

But a steady parade of children with chipped or broken teeth through pediatric dentists' offices suggests that not enough children wear the protective devices when they're playing other sports. And though more than half of sports-related mouth injuries occur during baseball and basketball prac-tices and games, no one has called for mouth-guard requirements in those sports.If the junior athlete is lucky, he or she will just lose a few teeth if an injury occurs.

Dr. Hans Reinemer, a doctor of medical dentistry who specializes in caring for children, has seen more injuries than the average parent could imagine. Most were preventable; all were expensive and painful. That's why he's joining the American Academy of Pediatric Dentistry in a call for other sports to require mandatory mouth guards.

Pediatric dentists estimate that 200,000 injuries are prevented each year with mouth-guard use. Now they hope to create the kind of awareness that was raised by car-seat safety campaigns. The stakes are just as high, they say, because sports injuries can be fatal.

"I think the biggest issue for the dentist is preventing dental injuries in kids and adults. And we see a lot of injuries relating to sports activities," he said. "Most of the time we're seeing fractured teeth and, hopefully, that's the extent of it. Sometimes we see displaced teeth - knocked out of normal position."

And pediatric dentists also see injuries that lead to a complete loss of teeth.

What most people don't realize, Reinemer said, is that mouth guards can also help protect against concussions and neck injuries. "When you're hit in the chin, the force is transferred right up to the head and neck region. Mouth guards can help cushion the blow."

Mouth guards aren't expensive, according to the academy. A pre-formed, boil-to-fit model costs less than $5 and is available in most sporting goods stores. A custom-made one, created in the dentist's office, sells for $25 to $50 and "fits exactly to your mouth and teeth. You can talk with it and it's more comfortable."

And both costs are "a lot less expensive than an emergency visit to the dentist."

There's also a serious gender gap in the use of protective mouth guards, according to the academy. That probably goes back to the attitude that the knock-'em-down sports are played only by boys and men. That's not reality today, Reinemer said.

The academy recommends mouth guards for any sport or activity that can lead to falls or head or mouth contact. Gymnastics, baseball, basketball, soccer, martial arts and skateboarding should be added to the list of sports where the guards are routinely used, according to Reinemer.

The need for the mouth guards, he said, extends to informally organized versions of the sports, as well as other high-risk activities at home.

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Additional Information

Call dentist if child knocks out or injures tooth

The American Academy of Pediatric Dentists offers parents, coaches and teachers this advice when a child receives a mouth injury:

- If a baby tooth is knocked out, a dentist should be consulted immediately.

- When a permanent tooth is knocked out, find it and rinse it gently in cool water.

Never scrub the tooth. Instead, replace it in the socket, if possible. Otherwise, place it in a clean container with milk, saliva or water and go to the dentist immediately. After hours, don't wait. Call the dentist's emergency number.

- If a tooth is cracked or chipped, remember that quick action can save the tooth and prevent infection. Rinse the mouth with water and apply cold compresses to reduce swelling.

- If you can find the broken tooth fragment, take it to the dentist with you.

- In case of a severe blow to the head or jaw, go to the emergency room immediately.