Skating dental crisis
 

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Skating dental crisis

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Skating dental crisis

 

Skating dental crisis

Dentist Steve Hill describes how a skating tour of Holland turned into a dental emergency.

With the famous tulip fields in bloom and stretching as far as the eye can see, May is a fine time to visit Holland. Arguably the best way to see this renowned tourist attraction – and indeed the rest of Holland’s scenic landscape - is by the network of cycle paths that criss-cross this cycling-mad country.

It’s well known that Holland is a cycling paradise, but two wheels aren’t the only way of exploring the cycle route network. Experienced cyclists are often surprised to find that, across a flat landscape and given a smooth surface, inline skaters can almost match them for pace and distance.

The SkateFresh foundation, a team of experienced and enthusiastic Dutch skaters, got together to organise a new kind of holiday – a guided skate tour, exploring the highlights of Holland over five days. 93 participants from 15 different countries signed up via the booking form on their website. Having previously been on cycle touring holidays around Europe, I was well aware of the hassle involved in transporting bicycles on planes. So it was a welcome contrast to be able to stow my skates comfortably in the overhead locker on the flight to Schiphol. From Amsterdam, it was a short train journey to Spaarnwoude, just outside the city, where the group was to assemble and the first evening was spent in getting to know each other.

Inevitably there was much speculation about the weather prospects. We were to be staying in tents throughout the tour, and skating around 50 miles each day, so everyone was hoping that the rain would hold off. But overnight the rain did fall, and we awoke to see depressingly damp, slippery tarmac to start our long journey on. By the time we’d had breakfast however, the paths were warming up and beginning to dry out. After receiving a map for the day’s route in case we got lost, we set off in groups of about 15. Each group went at a different speed according to ability and experience, and was led by a member of the SkateFresh team. As part of the organisation, a van followed behind us, carrying all our luggage and tents. We also had a minibus which would wait for us every 10 or so miles, and carried water and various refreshments to keep us going.

The first day’s route started with crossing the North Sea canal,that connects Amsterdam with the sea. After a few slippery miles, the path surface became completely dry and as we all got into our stride, the pace quickened. After 12 miles we reached the popular tourist destination of Zaanse Schans, a re-creation of a 17th century Dutch village. The village comes complete with historic buildings including six working windmills, a clog factory and a cheese shop. Onward through the areas of drained land, we reached a self-service ferryboat operated by cable which we took in turns to haul.

By now we were reaching the bulb field area and were greeted by vast stretches of colour, spanning for miles. Then, following a leisurely lunch, the route took us along an area of coast covered by sand dunes known as the ‘Dutch Mountains’. Once we reached Kamperduin we were skating directly alongside the sea, over a dike with a great view from the top. The day’s tour ended in Petten where a few brave skaters went for a swim in the freezing North Sea. The rest of us retired at the campsite bar after a fairly arduous day’s skating – we’d covered about 50 miles.
The following morning began by crossing the Noord Hollands canal using a strange floating bridge. We followed the canal down to the historic town of Alkmeer which, besides being famous for its cheese factories, has many fine old houses and monuments. But for myself and several others in the group there was an even bigger attraction – the Beatles museum where we spent an enjoyable hour being shown round a huge collection of memorabilia by the owner.
From Alkmeer to the next town, Hoorn, the surface became quite rough. While it was no doubt perfectly fine for cyclists, it presented our group with something of a challenge to stay upright. At the end of this 10-mile stretch, a number of skaters emerged with minor cuts and bruises following falls, though fortunately none was serious. The final stretch of the day’s journey was along the top of the old sea dike; fortunately a strong north wind propelled us towards our resting place for the evening. This was just outside Edam, another lovely old town, where we toured round a cheese factory.

On day three, we continued south towards Amsterdam through the area known as ‘waterland’, which is full of dikes and little bridges. Arriving in Amsterdam at lunchtime, we set up our tents and took off on a skate tour around the city. Most of Amsterdam’s street surface is cobbled and skate-unfriendly, however with the expert guidance of our tour leaders we cruised through the city’s major sights. That evening we joined the Amsterdam Friday Night Skate, an informal weekly gathering of up to 2,000 skaters which follows a 15-mile route through the city and its suburbs. This culminated with drinks and partying in the central Vondelpark, prior to another molto con vivace blast back to the campsite. By this time, we were all so high on adrenaline that we needed to hit the campsite bar for a few more drinks to wind down.

The next day’s route left Amsterdam by following the Amstel river, passing through the South Holland lake district. The destination was Kaageiland, a popular holiday island in the middle of the Kagerplassen lake system, which was reached by yet another ferry. That evening, over an excellent dinner of locally-caught eel, a number of us reflected on how well the tour had gone so far – we’d all managed to skate a total of almost 200 miles through wonderful scenery and without any significant injuries.

The final day’s skating began by taking us through the oldest bulb area of Holland where the tulip industry had begun back in the 17th century. Here, for the first time on the tour, we found ourselves confronted by a fierce headwind. We instinctively grouped into a tight ‘paceline’ formation – a chain of skaters following close behind each other, taking it in turns to move up to the front.

And it was then, just a few hours away from the end of the tour, that the accident happened. One skater tripped and went down, causing everyone behind to trip over her. I was about the fifth person to hit the pile, but fortunately had time to adopt a good landing position (we all had helmets on, as well as wrist, knee and elbow protectors) and I rolled over without suffering a scratch. Relieved, I turned to the girl next to me and was shocked to see that she had hit her face on the ground on falling, causing considerable grazing to her face and a very obvious fracture of her 1 , (the fracture line running from about a third of the way up the crown at the distal edge, down to a quarter of the way up at the mesial edge).

We all see traumatised incisors presenting in our surgeries from time to time, and the management of these cases is often challenging. It’s not often that we are actually present at the scene when these accidents occur, and this was certainly the first time for me! The tour leader and I quickly checked that nobody else had been injured in the pile-up and phoned for the tour minibus, which arrived very quickly. Within minutes the patient and I were speeding off to Zandvoort, some 10 miles away. Within about 45 minutes of the accident, the patient was in the chair.

The fracture was investigated and found to extend diagonally to just beneath the gingiva on the palatal aspect. Following removal of the loose fragment, a digital radiograph was taken which showed that, fortunately, the root of 1 remained intact and undisplaced. Having ascertained working length with a digital apex locator, the pulp was removed and the root canal irrigated and dressed with calcium hydroxide. The cavity was sealed coronally with glass ionomer cement and this was also used to dress the fractures in 2 and 1.

Following gentle cleansing of the skin wounds, clarithromycin was prescribed to reduce infection and promote healing. The patient confirmed that she had had a tetanus vaccine booster within the last year or so.

Half an hour later we were ready to roll again – the minibus took us to just outside Haarlem, where we rejoined the other skaters for a final procession into the historic market square. Here we said our goodbyes and headed off for the bus back to Schiphol airport, after an excellent and truly memorable tour.

The patient saw her own dentist two days later and, following completion of root canal treatment in 1 and placement of a glass fibre post, the damaged teeth have all been restored using a hybrid composite. She is very happy with the result, and is back skating - and smiling - again.

Inline skating is generally perceived as a highly dangerous activity bordering on being an ‘extreme sport’ – and while bruises and cuts are indeed common, particularly among newcomers to the sport, serious injuries are in fact rare.

The importance of wearing wrist, elbow and knee protection, plus a helmet, at all times while skating cannot be too highly emphasised. Whether or not the wearing of a mouthguard is advisable is a matter of debate, but the injury described in this article would of course have been avoided had a mouthguard been worn.

None of the 93 skaters on the tour wore a mouthguard, but, as a result of this accident, a number of them said they would consider acquiring one for future use.

Between the 93 of us on the tour, we had skated some 18,000 miles, almost two thirds of the distance round the world at the equator. So, in terms of injuries per mile travelled, inline skating could, in the light of this experience, be considered a relatively safe form of transport.

Whether or not skate-touring will become popular remains to be seen, but it’s certainly a holiday I would recommend. And I will be taking a mouthguard with me next time.



 Posted on : Thu 10th - Nov - 2005

 

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