Spittin' chiclets: What happens when hockey players lose their teeth on ice?

They were the lost teeth heard around the world.

Jack Hughes lost parts of at least his two front teeth after taking a high stick to the mouth in the third period of the U.S. men’s hockey team’s gold medal game vs. Canada on Sunday in Milan. By the end of the game, Hughes — after "spittin’ chiclets" — was the hero, scoring the overtime goal that delivered the U.S. its first gold medal in 46 years.

The postgame visual of Hughes’ altered smile with the American flag draped over his shoulders provided an iconic image.

"In hockey, if you lose your teeth, it’s not even a question of coming back and playing," Hughes told reporters in Miami on Monday. "That’s like an automatic. I just was feeling around my mouth and I was just disappointed I lost my teeth, but it is what it is now ... I’m going to fix these things. I want my good smile back."

Leonard Patella, the Islanders’ team dentist for the last five years who also works for Northwell Health, said that by looking at the picture — which does not detail the full severity — it appears Hughes suffered a fractured central incisor and possibly a crack pretty low on another tooth. Like Hughes said, it’s not a huge deal for hockey players. And for the team dentists, it’s not an everyday task, either.

"I think the thing to take home from this, really, is that it's not common," Patella told Newsday. "It doesn't happen all the time, as most people think. And when it does, we take care of it immediately."

Patella said that when a player gets hit in the face and there’s a tooth injury, he has to look for a couple things. The first would be any lacerations, because sometimes the tooth goes through the lip. Then he will look if the nerve is exposed.

There are three types of fractures in teeth, Patella said. One involves just enamel, and another involves enamel and dentin, the hard, dense bony material beneath enamel. In both cases, he would be able to just smooth the tooth out. The third circumstance would be if the nerve or pulp tissue are exposed, which he said is "quite painful" and requires immediate action. He could numb the player’s tooth then do something immediately after the game — potentially a root canal, covering it with a composite material or splinting a loose tooth to stabilize it, depending on the scenario. If a tooth falls out, he has to put it back in within 30 minutes to save it.

"In almost every case, I can get them back out there," Patella said.

The only time a player hypothetically would not be able to return is if they fracture their jaw or the supporting bone of the tooth. But ...

"Sometimes, with these guys, they’re just bulls," Patella said. "They just want to go back out."

Islanders defenseman Adam Pelech has had teeth knocked out before, but he said "nothing really happens. You just keep playing, and then you go see the dentist the next day."

He added: "The injuries that — knock on wood — are possible out there, I think losing a couple teeth is no big deal, honestly."

Islanders fourth-line center Casey Cizikas surprisingly is an anomaly in that he hasn’t lost a tooth on the ice. But he did get a chance to see his linemate, Kyle MacLean, go through it in Washington on Feb. 2. Cizikas and Marc Gatcomb, his other linemate, were uncontrollably laughing upon seeing the "perfect triangle" between MacLean’s teeth.

"No one would have saw it. [MacLean] just came back to the bench, he's like, ‘Can you believe this?’ ” Cizikas said. "And me and Gats just started [expletive] dying. But it's just the way it is."

MacLean said it happened after getting elbowed in a scrum, and he was not wearing a mouth guard. Between periods he saw a dentist — not Patella, who only works home games — who smoothed out the chips in his teeth. He went to the dentist’s office upon returning to Long Island.

"I had two kind of like fangs going right in my front teeth," MacLean said. "I got it fixed now, which is nice. But it was goofy looking for a little bit."

Rangers defenseman Braden Schneider has had teeth knocked out. He has a "flipper," a removable partial denture. He wears it for formal events, but not on other normal days. How does his wife feel about it?

"She's got used to it," he said. "I feel like, for me, it just makes my lisp worse than normal. It's not really anything that really affects much. It’s definitely a thing that I feel like you got to expect to happen at some point when you're playing hockey."

Newsday’s Andrew Gross and Colin Stephenson contributed to this story.