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Extreme dental injuries also occur well away from the NHL.



While children in minor hockey wear full cages and almost never lose teeth, at the junior hockey level, the cage comes off and the half visor goes on, exposing players' mouths. Mouthguard usage is mandatory in the majority of junior leagues, but teenage players still suffer dental injuries.



Adults who play recreational hockey, meanwhile, are often able to play without any facial protection at all. Players at that level may not shoot as hard or check as fiercely as in the big leagues, but dentists say falls into the boards, errant sticks and wayward shots are far more common.

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"I've seen some very serious injuries at the recreational level," said dentist Bill Blair, who works with the Calgary Flames and is a member of the Academy for Sports Dentistry. "You are less in control in beer-league hockey than you are in the NHL."



Blair said recent studies linking mouthguards to concussion prevention has meant that usage has shot up in recent years, but that he still sees 10 to 15 per cent of players who don't wear protection.



He argues players at lower levels should all wear cages and that anyone playing hockey should invest in a good mouthguard. He added that more players at the junior and pro levels are catching on, but that it's been a slow process.



"Change takes a long time," Blair said. "It would be great if you could make mouthguards mandatory at every level, including the NHL.



"Custom-made mouthguards are something anyone can get used to."



If recreational players need further incentive to wear cages and mouthguards, there is the cost of damage repair. In Canada, a single implant costs in the range of $3,000 to $5,000 and is generally not covered by dental insurance. OHIP would cover only the bone repair.

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