Sports Dentistry

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Description of different mouthguards and the importance of a team dentist in all sports

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Sports Dentistry

  1. 1. SPORTS DENTISTRY Family Dentistry David L. Burns D.D.S. 4616 West Jefferson Blvd. Fort Wayne, IN 46804 260-432-8596 e-mail: drdlburns@comcast.net web: www.davidlburnsdds.com 1
  2. 2. The old saying, “ An ounce of prevention is worth a pound ofcure” provides the theme for the treatment phase of thispresentation. Our studies at the University of Notre Dame, plus countlesshigh school studies made throughout the United States, clearlyindicate that injuries to the teeth and jaws can be virtuallyeliminated if adequate preventive measures are taken. Thesolution lies in the development of the Team Dentist concept. 2
  3. 3. The Logical individual to assume full responsibility for prevention ofinjuries to the teeth and jaws would be a dentist. In order for the teamdentist to function advantageously he should have official status. Theteam dentist should assume a position alongside the team physiciansand the trainer for the benefit of the entire squad. The primary duty of the team dentist is to provide each player onthe squad with an adequate mouth guard. He must make the finaldecision as to which type of mouth guard is to be used. A mouth guardprogram that is not under the specific direction of an individual dentistis doomed to failure. Usually a team of dentists cooperate in theoverall effort, but every team needs direction and a team of dentists isno exception. 3
  4. 4. There are three basic types of mouth guards.1.Stock type- ready made and simply places onthe dental arch of the player.2.Mouth formed-molded directly over the archin the mouth of the player.3.Custom-made over an impression of the dentalarch of the player. 4
  5. 5. In 1993 the American Dental Association conducted a study designedto see which type of mouth guard was most acceptable to the playersthemselves(1). Players from several high schools in the Chicago,Illinois area were given the opportunity to wear all three types ofmouth guards for an extended period of time. They were then asked tochoose one of the three to wear for the remainder of the season. Theoverwhelming majority selected the custom-made type. Ourexperiences substantiate these findings (3). Prior to 1958, an attempt was made to introduce mouth guards tothe Notre Dame football team, but because the mouth guards providedwere bulky and ill fitting, the attempt was unsuccessful. During the1966 season, however, it is estimated that over ninety percentof the squad will wear mouth guards and the attempt can beconsidered highly successful. 5
  6. 6. Duties of the Team Dentist1.Examine the dentition of each individual player. A. Be sure teeth are sound and supporting structures are free of pathology B. Examine occlusion, paying particular attention to: a. missing posterior teeth b. locked occlusion c. excessive retrognathic and prognathic relationships d. amount of freeway space e. harmony of occlusion and muscle function f. past history of injuries, paying particular attention to concussions andneck injuries2.Take adequate impressions of each individual player and see that accuratemodels are poured3.Fit the finished mouth guards4.Make adjustments and make sure the players are wearing them at all times5.Educate the players and the coaches to the advantages of wearing “Intra-occlusal shock absorbers”. 6
  7. 7. Space does not permit comment on all the above duties.Attention should, however, be focused on two pertinent ones.1. Too many athletes are participating in contests when grossdisease is present in their mouths. Routine physical examinationsfail to uncover serious dental problems. Oral diagnosis, and earlytreatment, offer the athlete the opportunity to operate at peakefficiency by eliminating the possibility of toothaches, dentalabscesses and rampant contagious gum infections.2.The head coach and the coaching staff are the key to anysuccessful mouth guard program. Many coaches have an aversionto the wearing of mouth guards. They feel that they detract fromthe ruggedness of the individual. The dental profession mustcontinue to point out the advantages of wearing “intra-oral shockabsorbers”. This is not only their duty but an obligation. Blows tothe head during contact sports result in pressure waves that passthrough the skull with accompanying impulses to the brain anddeformation of the bone. A study at the University of KentuckyMedical Center (2), indicated that there is a reduction in theamplitude and duration of the pressure wave and a reduction inbone deformation when a mouth guard was used. 7
  8. 8. There are advantages which can be stated. These are either 1) direct or 2)indirect. 1) Direct Prevent trauma to teeth, jaws and supporting tissues. 2) Indirect Elimination of concussions and neck injuries. With these important factors in mind the following list of requirements for mouth guards is presented. The mouth guard should: 1. Be custom made to an accurate model of the players mouth. 2. Be comfortable in wearing so that the players will accept it; edges should be skin thin 3. Have sufficient retention to prevent accidental dislodgement during athletic contact or signal calling 4. Have a high degree of resiliency to assure “Shock Absorber Effect”. 5. Be tough enough to prevent cuspal penetration; except in an unusual mouth the mouth guard should last at least for two seasons. 6. Provide for 2mm to 8mm occlusal thickness and still maintain marginal thinness 7. Be thermally resistant to enable sterilization by boiling or autoclaving and also be compatible with the oral tissues at cool temperatures. 8. Be chemically odorless and tasteless. 9. Be capable of identification- each player should have his own name or number inscribed on his mouth guard 8
  9. 9. REFERENCES1. Bureau of Dental Health and Bureau of Economics Research Statistics.“Evaluation of mouth protectors used by high school football players”Journal of the American Dental Association. Volume 68: March 19642. Hickey, J.C., et al: The Relation of Mouth Protectors to CranialPressure and Deformation”. University of Kentucky Medical Center. I ADRProgram and Abstracts of Papers, July 19653. Stenger, J.M., et al: “Mouth guards: Protection against shock to head,neck and teeth”. The Journal of the American Dental Association.Volume 69: 273-281; September 1964 9

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