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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
The old saying, “ An ounce of prevention is worth a pound of


cure” provides the theme for the treatment phase of this


presentation.


   Our studies at the University of Notre Dame, plus countless


high school studies made throughout the United States, clearly


indicate that injuries to the teeth and jaws can be virtually


eliminated if adequate preventive measures are taken. The


solution lies in the development of the Team Dentist concept.

                                                                2
The Logical individual to assume full responsibility for prevention of

injuries to the teeth and jaws would be a dentist. In order for the team

dentist to function advantageously he should have official status. The

team dentist should assume a position alongside the team physicians

and the trainer for the benefit of the entire squad.

   The primary duty of the team dentist is to provide each player on

the squad with an adequate mouth guard. He must make the final

decision as to which type of mouth guard is to be used. A mouth guard

program that is not under the specific direction of an individual dentist

is doomed to failure. Usually a team of dentists cooperate in the

overall effort, but every team needs direction and a team of dentists is

no exception.                                                        3
There are three basic types of mouth guards.



1.Stock type- ready made and simply places on

the dental arch of the player.



2.Mouth formed-molded directly over the arch

in the mouth of the player.



3.Custom-made over an impression of the dental

arch of the player.
                                                 4
In 1993 the American Dental Association conducted a study designed
to see which type of mouth guard was most acceptable to the players
themselves(1). Players from several high schools in the Chicago,
Illinois area were given the opportunity to wear all three types of
mouth guards for an extended period of time. They were then asked to
choose one of the three to wear for the remainder of the season. The
overwhelming majority selected the custom-made type. Our
experiences substantiate these findings (3).
  Prior to 1958, an attempt was made to introduce mouth guards to
the Notre Dame football team, but because the mouth guards provided
were bulky and ill fitting, the attempt was unsuccessful. During the
1966 season, however, it is estimated that over ninety percent
of the squad will wear mouth guards and the attempt can be
considered highly successful.
                                                                       5
Duties of the Team Dentist


1.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 and
neck injuries
2.Take adequate impressions of each individual player and see that accurate
models are poured
3.Fit the finished mouth guards
4.Make adjustments and make sure the players are wearing them at all times
5.Educate the players and the coaches to the advantages of wearing “Intra-
occlusal shock absorbers”.                                                   6
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 gross
disease is present in their mouths. Routine physical examinations
fail to uncover serious dental problems. Oral diagnosis, and early
treatment, offer the athlete the opportunity to operate at peak
efficiency by eliminating the possibility of toothaches, dental
abscesses and rampant contagious gum infections.
2.The head coach and the coaching staff are the key to any
successful mouth guard program. Many coaches have an aversion
to the wearing of mouth guards. They feel that they detract from
the ruggedness of the individual. The dental profession must
continue to point out the advantages of wearing “intra-oral shock
absorbers”. This is not only their duty but an obligation. Blows to
the head during contact sports result in pressure waves that pass
through the skull with accompanying impulses to the brain and
deformation of the bone. A study at the University of Kentucky
Medical Center (2), indicated that there is a reduction in the
amplitude and duration of the pressure wave and a reduction in
bone deformation when a mouth guard was used.

                                                                7
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
REFERENCES



1. 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 1964

2. Hickey, J.C., et al: The Relation of Mouth Protectors to Cranial

Pressure and Deformation”. University of Kentucky Medical Center. I ADR

Program and Abstracts of Papers, July 1965

3. 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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Sports Dentistry

  • 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. The old saying, “ An ounce of prevention is worth a pound of cure” provides the theme for the treatment phase of this presentation. Our studies at the University of Notre Dame, plus countless high school studies made throughout the United States, clearly indicate that injuries to the teeth and jaws can be virtually eliminated if adequate preventive measures are taken. The solution lies in the development of the Team Dentist concept. 2
  • 3. The Logical individual to assume full responsibility for prevention of injuries to the teeth and jaws would be a dentist. In order for the team dentist to function advantageously he should have official status. The team dentist should assume a position alongside the team physicians and the trainer for the benefit of the entire squad. The primary duty of the team dentist is to provide each player on the squad with an adequate mouth guard. He must make the final decision as to which type of mouth guard is to be used. A mouth guard program that is not under the specific direction of an individual dentist is doomed to failure. Usually a team of dentists cooperate in the overall effort, but every team needs direction and a team of dentists is no exception. 3
  • 4. There are three basic types of mouth guards. 1.Stock type- ready made and simply places on the dental arch of the player. 2.Mouth formed-molded directly over the arch in the mouth of the player. 3.Custom-made over an impression of the dental arch of the player. 4
  • 5. In 1993 the American Dental Association conducted a study designed to see which type of mouth guard was most acceptable to the players themselves(1). Players from several high schools in the Chicago, Illinois area were given the opportunity to wear all three types of mouth guards for an extended period of time. They were then asked to choose one of the three to wear for the remainder of the season. The overwhelming majority selected the custom-made type. Our experiences substantiate these findings (3). Prior to 1958, an attempt was made to introduce mouth guards to the Notre Dame football team, but because the mouth guards provided were bulky and ill fitting, the attempt was unsuccessful. During the 1966 season, however, it is estimated that over ninety percent of the squad will wear mouth guards and the attempt can be considered highly successful. 5
  • 6. Duties of the Team Dentist 1.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 and neck injuries 2.Take adequate impressions of each individual player and see that accurate models are poured 3.Fit the finished mouth guards 4.Make adjustments and make sure the players are wearing them at all times 5.Educate the players and the coaches to the advantages of wearing “Intra- occlusal shock absorbers”. 6
  • 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 gross disease is present in their mouths. Routine physical examinations fail to uncover serious dental problems. Oral diagnosis, and early treatment, offer the athlete the opportunity to operate at peak efficiency by eliminating the possibility of toothaches, dental abscesses and rampant contagious gum infections. 2.The head coach and the coaching staff are the key to any successful mouth guard program. Many coaches have an aversion to the wearing of mouth guards. They feel that they detract from the ruggedness of the individual. The dental profession must continue to point out the advantages of wearing “intra-oral shock absorbers”. This is not only their duty but an obligation. Blows to the head during contact sports result in pressure waves that pass through the skull with accompanying impulses to the brain and deformation of the bone. A study at the University of Kentucky Medical Center (2), indicated that there is a reduction in the amplitude and duration of the pressure wave and a reduction in bone deformation when a mouth guard was used. 7
  • 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. REFERENCES 1. 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 1964 2. Hickey, J.C., et al: The Relation of Mouth Protectors to Cranial Pressure and Deformation”. University of Kentucky Medical Center. I ADR Program and Abstracts of Papers, July 1965 3. 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