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Keith Tkachuk of the St. Louis Blues during Game Two of the Western Conference Quarter-finals of the 2009 Stanley Cup Playoffs on April 17, 2009 at General Motors Place in Vancouver, British Columbia, Canada. (Photo by Nick Didlick/Getty Images) (Nick Didlick/2009 Getty Images)
Keith Tkachuk of the St. Louis Blues during Game Two of the Western Conference Quarter-finals of the 2009 Stanley Cup Playoffs on April 17, 2009 at General Motors Place in Vancouver, British Columbia, Canada. (Photo by Nick Didlick/Getty Images) (Nick Didlick/2009 Getty Images)

More on Tkachuk's ordeal <br>(and should mouthguards be mandatory?)</br> Add to ...

Received a great response from Saturday's story about dental injuries in hockey, with a couple links from Deadspin, the Washington Post and elsewhere yesterday. It's been interesting to see the debate spring up over whether mouthguards should be mandatory in the NHL or not, a discussion that rarely comes up.

Every dentist I talked to said they should be, even in leagues where cages are worn, and that the new custom mouthguards are incredibly comfortable and easy to breathe with.

I worked on the story for a few weeks, off and on, and kept in contact with several dentists as we put it together. We had copies of X-rays from some injuries as well as some pretty graphic descriptions of what happened and the work that had to be done.

Below are some quotes, from Keith Tkachuk and his dentist, that didn't make it in the piece.

"That's the weird part -- all those years in front of the net, I never lost a tooth, and it all happened in my last year," Tkachuk said. "It's just been one thing after the other with this.

"[The shot]put a hole through my mouthpiece -- it actually put a hole right through my mouthpiece. So I lost four teeth and one of them I had to yank out because it was so bad and then they killed a bunch of molars. It's just been root canals and different work done to it leading up to the surgery. I lost five teeth, had two or three root canals and just a bunch of work.

"It was pretty much every other day [at the dentist]for a while there. So it wasn't fun.

"It changed everything. I looked like an idiot missing five teeth. I guess it's a blessing in disguise, it could have been a lot worse. I could have got hit in the eye, I would been done. But it was tough. It changed my game, there's no question about it, going back. I went back to the front of the net, but I was definitely a little hesitant and it hurt my game. That's why it's important why guys wear shields -- thank god it wasn't six more inches up. It's scary. It's weird how it doesn't happen more often."

I remarked to Keith how bizarre it was that he scored a goal on the play.

"It wasn't worth it, trust me," he said.

Here's the video of the incident, in case you haven't seen it:

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One of the most interesting parts of the story was talking to the Blues team dentist, Glenn Edwards, who has worked with the club for 20 years. He's also the dentist for the NFL's St. Louis Rams, and said he never sees dental injuries in football.

In hockey, they're every few games.

Edwards had some great stories of various injuries he's dealt with over the years, but the best that I didn't use was probably the tale of Roman Vopat, who had two teeth come out entirely in a game back in 1995-96. Edwards was able to shove them back in and hold them tight using a mouthguard, but when Vopat went back on the ice to avenge the high stick that knocked out his teeth, he got in a fight and the teeth came flying back out again.

"It was amazing. We ended up saving those teeth, but I'm like what are you doing, getting in a fight, teeth barely hanging on by a thread. It's just how it is. He was like a wild animal in some regards. It just got his adrenaline going."

Edwards was also pretty outspoken in the interview about how unfortunate it was that players suffered so many dental injuries.

"I think they should be better protected -- I don't know why they aren't ... I don't understand why they don't wear better facial protection," he said.

"Some have visors, but they don't do anything for the rest of the face. It's going to take maybe a deadly injury before they get serious about it. Someone could take a puck directly in the eye, directly, and I know we've seen a lot of eye injuries over the years, but it could be deadly. You get a superstar get his eye blown out, I think we'll see maybe some changes. Maybe not. I don't know. I don't understand why the NHL still goes against having them having full facial protection."

Edwards talked about Tkachuk's broken jaw and lost teeth, an injury he and two other dentists have been working on for a few months. Tkachuk's mouth won't be fully restored until about a year from now, a year and a half after taking the puck to the mouth.

"I wouldn't call it the worst [injury I've seen]-- there's been similar ones -- but this was the most devastating one," Edwards said. "Because we pretty much knew he was going to retire at the end of the year and he's known for just planting himself in front of the net, tries to tip shots and get rebounds, and all these years he never got one right off the choppers. And to have it happen right with a couple months left in his career was just devastating for him and his family.

"It was kind of depressing. He took it hard. Obviously. He went through it like a champ, didn't make a big deal out of it. Went out and played. Just what you expect from him. He actually embraced it. A lot of people wanted to talk to him about it -- he didn't get tired of it, he just kind of made fun of it, he was great.

"But it was a devastating injury, no doubt."

One Tkachuk played through, which is something Edwards questioned.

"We tried to hold Keith out a little longer because he still had some teeth that were very mobile, loose, that we were trying to save, some remaining teeth," he said. "All it takes is a shoulder or just a normal check and he could be in that much pain again and he could do more damage and set him even further behind. But he played. He said, 'I'm playing.' That's a trait that fans glorify. They really like it.

"I think that hockey fans expect that. It's like going to a Nascar race -- everyone wants to see a good crash. I don't think they want to see one of their favourite players get injured. I think they expect the players to be that tough -- that's part of why they like it so much and get so attached."

As for the mouthguards, team dentists I talked to (mostly those from the Blues, Capitals and Flames) said players who played at the U.S. college level, where cages are worn, generally have a tougher time adapting to using a mouthguard or feel they're unnecessary. Other guys, like Eric Belanger, already have several false teeth and find it harder to use a mouthguard with them in.

They've been made mandatory in all of the junior leagues in the past decade, and more and more NHLers are using them. Some teams have 75 per cent of players who wear one, and they're more common among younger players. On the whole though, most dentists agreed that only a little more than half of players wear a mouthguard, which is very low given injuries like Belanger's are at least partially preventable.

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