Say 'ahh': A look inside the grisliest job in sports

Ben Bishop was in the net for the Tampa Bay Lightning on Oct. 25 when a shot by Toronto's Peter Holland ricocheted off his facemask so violently that it snapped the chinstrap into the goalie's mouth and knocked out two front teeth.

Bishop flopped over. His teammate Brian Boyle scooped up his incisors off the ice.

"The camera zoomed in on Ben's face and I took a picture and texted it to a trainer on the bench," Gil Rivera, the Tampa team dentist, says. "I asked him, 'Am I really seeing this?'"

In response, Rivera quickly received three photos – one of Bishop's missing teeth sitting on top of a table in the dressing room at Air Canada Centre, and two of the gaping space left behind.

"When I see a player touch the top of their mouth and start to count with their fingers, I wonder, 'Geez, what have we got?'" Rivera says. "I hold my breath. You never quite know what it is going to look like when you peek in there."

Rivera joined the Lightning's dental practice in 2002, and five years later took over the business. He then became a member of the small fraternity whose responsibility it is to fix the fractured bicuspids and crushed canines of hockey players.

It is the grisliest job in sports.

"I have seen violent, gruesome, trauma from a puck that has become a missile," Rivera says. "There are images in my head that I will never forget. There are a lot of things that I would never see outside of a hockey rink. I could never even dream of them.

"I have seen guys who have cut off nearly one-third of their tongue."

In December of 2007, shortly after Rivera became the Lightning's principal dentist, Craig MacDonald was smashed in the face by a wrist shot from Toronto's 6-foot-7 defenceman Hal Gill.

"The puck came directly into my mouth and there was a tremendous amount of pain," MacDonald says. "I knew I was in trouble right away."

Now an investment consultant in Nova Scotia, MacDonald talks about the night as if it were yesterday.

Despite wearing a mouth guard, the blow smashed nine of MacDonald's teeth and tore his lips and gums so badly that he needed 50 stitches. A cut on his tongue required 25 sutures.

"It was one of the worst nights of my life," MacDonald says. "[Gil] stitched me up at the rink, but I couldn't sleep a wink. All the nerves were exposed along my gum line. It hurt tremendously whenever I would breathe."

MacDonald met Rivera at his office early the next morning and had three root canals – procedures where the nerve and pulp are removed to save a tooth. It took Rivera 30 to 40 hours over four months to fix the damage. Six of MacDonald's broken teeth were saved.

"When I looked in his mouth that morning, the anatomy didn't register with what I was supposed to see," Rivera says. "It was such a mess I didn't know where to begin."

Rivera recalls rinsing out MacDonald's mouth and seeing the nerves flopping out of four of his broken teeth.

"At first it was like, 'What in the hell am I looking at?'" Rivera says. "I had never seen anything like it."

A centre who concluded his NHL career in 2009 with two more goals (11) than broken teeth, MacDonald missed only one game. He says wearing a mouth guard likely prevented a severe concussion.

"It was a matter of me dealing with the pain, but that's just what we do as hockey players," the Harvard graduate says.

When things get gruesome, dentists come to the rescue

The NHL boasts about the toughness of its players, and a rogue's gallery of gap-toothed characters illustrate that. That has been true from the days of Gordie Howe, Bobby Hull and Stan Mikita to Brent Burns's toothless grin of today.

The use of mouth guards, helmets with partial face shields and a reduction in fighting have helped limit the number of serious injuries. It's no longer a daily occurrence, but losing teeth remains a hazard for the 700-odd players who toil for 30 teams. Once in a while, it can be a catastrophe.

Sidney Crosby broke his jaw and damaged 10 teeth when he was struck by a teammate's slap shot on March 30, 2013. The Penguins star crashed to the ice, spilling blood and teeth, and it took months of medical and dental work to restore the sport's most famous face.

Now an assistant coach, Ian Laperrière of the Flyers lost eight teeth – four on the top and four on the bottom – when he was hit by a puck in 2009. He sat out the second period while receiving between 50 and 100 stitches, but returned in the third.

Ryan Callahan of the Rangers got pieces of a stick imbedded in his jawbone once when he was unintentionally stabbed by the Kings' Anze Kopitar. Tomas Tatar of the Red Wings has now lost the same three teeth four times.

When things get gruesome, dentists come to the rescue, often treating players on the fly using gear packed in emergency kits. Usually, they include a syringe with a numbing agent, temporary fillings, composite material, pliers and tools for making stitches.

"Nobody wants to be off the ice," says Gene Solmundson, a dentist in Winnipeg whose history with the Jets dates to 1972 and the World Hockey Association. "Sometimes I just assess the damage, numb them up and send them back out to battle."

Solmundson treats players in dental chairs installed in the dressing rooms at MTS Centre. Over the past four decades, he has seen hundreds of teeth shed.

Initially, he bought his own ticket to games at the old Winnipeg Arena. Then Bobby Hull, who was no stranger to dental woes, heard about it, and paid for a seat for Solmundson near the blueline.

Solmundson established the Assiniboine Dental Group with four partners in 1966, and has since seen his practice expanded to 22 dentists. He and his associates examine players at the beginning of training camp and create moulds for mouth guards for each.

"In terms of how many players use them, it's almost a total reversal," he says. "It was unheard of when I started."

In his office on Portage Avenue, Solmundson has a photo from the 1950s of the Winnipeg Warriors of the WHL. Something other than the picture's historic nature caught Solmundson's eye the first time he saw it.

"Of the eight players, there was one with a tight-lipped grin," he says. "The rest of the guys were all missing teeth. They looked like halloween characters."

Solmundson is a founding member of the NHL Team Dentists Association, and tells stories about players losing teeth the way soldiers talk about war.

"What I have found is that players are really common, decent people," Solmundson says. "No matter what their role is on the ice, off of it they aren't anything like that."

He once treated the Oilers' chippy Esa Tikkanen after a minor injury. From watching him, Solmundson had developed such a dislike for the Finnish forward that he joked that he hoped to have him in a dental chair one day so he could hurt him.

Tikkanen, who played on a line with Wayne Gretzky and Jari Kurri, was chatty and respectful as Solmundson treated him.

"When I was done, he rolled off the examining table, clicked his heels together and stuck his hand out and told me what a pleasure it was to meet me," Solmundson says.

'You have to hurt somebody before you can make it better'

The dentist's chair is the ultimate equalizer. Fear is universal.

"I had guys who were renowned as the toughest people on the planet that were reaching to hang onto a ceiling light as soon as they came into my office," says Tony Sneazwell, who spent two decades as the Oilers dentist. "They were ready to twitch before anything happened.

"That is why one of the reasons why dentistry is a tough occupation. You have to hurt somebody before you can make it better."

Now a professor of restorative surgery at the University of Alberta, Sneazwell turned down an invitation when Glen Sather, who was one of his patients, asked if he would take on a role with the Oilers. Some NHL teams keep a dentist on the payroll, some are paid per procedure and a few do it pro bono or for perks such as tickets.

"I said no at the time, but I thought about it and realized I did a lot of the same surgical things in my practice that I would do for a hockey team," Sneazwell says.

Originally from Melbourne, Sneazwell competed in two Olympics as a high-jumper and was a dentist for an Australian Rules Football club before he came to Edmonton. He became the Oilers' dentist shortly after Gretzky was traded in 1988, and retired in 2011.

"You see guys get hit with a puck and you get up out of your seat and go straight downstairs and a player comes in bleeding from the mouth and with a trainer trailing behind them with teeth in their hand," Sneazwell says. "They look at you and say, 'Where would you like them?'"

Famous for his mullet and gritty play around the net, Ryan Smyth lost three teeth while playing for the Oilers in 2006 during the Stanley Cup semi-finals. He was struck in the face on a routine clearing attempt by Oilers teammate Chris Pronger.

"I was just up the ice from him a little bit and looked back and boom!" says Smyth, who retired in 2014. "My teeth were gone, and I had three lips."

As he hurried down the tunnel between benches, Smyth blasted through a door, toppling an usher standing on the other side and breaking her wrist.

"I was worried about what happened to the lady but I didn't have time to check on her right then," Smyth says. "I felt terrible when I found out she was hurt, and signed her cast the next day."

In 19 seasons in the NHL, he sustained a knee injury, a broken ankle, several separated shoulders, broke his nose, and needed plates and screws inserted in one hand.

"When it comes to the pain I felt, nothing compares to that night when the dentist inserted a needle into my gums," he says.

Smyth was stitched up during an intermission, and set up the winning goal in triple-overtime.

"I look at all the scars and the teeth that are gone now, and am happy that I am married," Smyth, 40, says. "I'm not getting any prettier."

Often teeth go missing before a player even reaches the NHL.

Zack Kassian, Edmonton's hard-nosed forward, has a gap dead centre. He was 14 when he caught a skate in the face, and needed a root canal. He then lost the tooth for good in a collision in 2011, his first season in the NHL.

"It looks a lot worse than it is," he says. "It happens so fast that you don't even feel it, and then you are holding a tooth in your hand. The worst part is the root canal."

Connor McDavid lost two top front teeth in a childhood accident, and had root canals on his bottom front teeth after getting hit in the mouth by pucks while playing for the Erie Otters in the OHL.

"With hockey players, injuries primarily occur to the front four teeth," says Bill Veihdeffer, the Otters dentist for nearly a decade. "It's like the grill of your car. You keep banging on the grill and something happens.

"Front teeth breaking and root canals are almost standard. The puck wins every time."

'You guys are going to make me rich'

A former member of Canada's national water polo team, Jean-Luc Dion founded the NHL Team Dentists Association in 1992. At the time, he had been the dentist for the Quebec Nordiques for 12 years, and felt the need to organize.

He started by calling NHL teams and getting the name of each's dentist.

"I did it between two fillings and two crowns," Dion, who works out of the Centre Dentaire Montcalm in Quebec City, says. "We started like that and grew and grew."

Dentists from about 15 teams attended the association's first meeting that summer, and now all team dentists convene each year during the all-star break to swap horror stories, attend lectures and share trade secrets.

A network has been created through which the home team's dentist treats their own and visiting players, coaches and officials, and then passes the information on to counterparts in other cities in case a follow-up is necessary.

When a tooth is broken and the nerve is exposed, the dentists often perform an immediate pulpectomy. That entails freezing the tooth, using an instrument to remove the pulp, and then capping it with a temporary filling.

Dion wants everyone to wear a mouth guard. Store-bought ones provide only a minimum of protection, he says, and pro players need ones fashioned for them individually.

"Twenty or 30 years ago, I would tell players, 'You don't want to wear a mouth piece? That's okay,'" Dion says. "'You guys are going to make me rich.'"

The dentist for the Boston Bruins since 1995, Edwin Riley III had a seat six rows behind the home team's bench for years. He has since been moved to a row where he is surrounded by other members of the team's medical staff, including an oral surgeon, endodontist, orthopedic surgeon, internist and emergency physician.

After the Bruins won the Stanley Cup in 2011, he received a ring like everyone else, and rode in the victory parade.

'Sometimes what I do is gruesome, and sometimes it is just little things'

During the day, Gil Rivera tends to patients with routine problems at the Smile Studio, his family practice in Tampa. Forty-one nights a year, he is on hand during Lightning home games in case a dental emergency erupts.

When the team returned from its road trip in October, Ben Bishop dropped by his office to have the two front teeth he lost against the Maple Leafs reattached.

Unlike the Bruins' David Pastrnak, who took a high stick in November and broke off his front teeth, Bishop wanted to have his smile restored.

Pastrnak wanted to look like an old-time hockey player.

"All he wanted to do was smooth out the rough edges," says Riley, the Bruins' dentist. "Some guys like the look."

Like Riley, Rivera got a Stanley Cup ring for his work with the Lightning.

"It wasn't as big as the ring that the players got, but that thing was worth more than the car I was driving at the time," he says. "Sometimes what I do is gruesome, and sometimes it is just little things.

"Most often I am treating guys and sending them back out there knowing whatever I did may have to be redone an hour later. It's like fixing Humpty Dumpty and putting him back up on the wall."

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