By Dr. Teri Barichello
Soccer players don’t question wearing shin guards, football players their helmets, volleyball players their knee pads. Clearly shins, heads and knees are worth protecting. Why then don’t we place the same value on our teeth? Why isn’t the use of mouthguards just as routine as other protective measures?
Millions of children and adults participate in sports and recreation activities, and depending on the activity, they are at an increased risk of sustaining dental injury. When teeth sustain a traumatic blow or injury, the damage can often lead to permanent alteration in appearance or irreversible changes to its function. A single accident can create the need for lifelong follow-up care and maintenance.
April is National Mouthguard Month. The intention is to draw attention to the increasing and serious issue of oral trauma and injury as a result of sports and recreation activities. One in six sports related injuries is to the craniofacial area. Football, boxing, basketball, lacrosse and hockey are obvious examples of high contact, high risk activities but injuries aren’t confined to these sports. Often participating in non-contact sports results in dental trauma. Some of the most traumatic injuries have been reported as a result of baseball, bicycling, gymnastics or skateboarding. Studies show that while young boys show a slight higher prevalence of dental injury than girls, that gender difference evens out as they enter young adulthood.
The great news is that we can all easily protect our smiles by wearing a properly fitted mouthguard.
There are three types of athletic mouthguards, two of them are available over the counter and one is custom fabricated by a dentist. The over the counter versions offer convenience and are lower cost but have limitations in their comfort and level of protection. The first over the counter type is a pre-sized, stock version. They are generally available is sizes S-L and there is no customization for fit. They often don’t fit comfortably and wearers usually need to hold their teeth together to keep them in. For this reason, this type is considered to be less protective. The second over the counter type is commonly called a “boil and bite”. The guard is warmed in boiling water then self adapted to the users mouth. This type has better retention than the stock version but is often bulky which can make it hard to speak or breathe. For optimal protection, there needs to be certain thickness of material in key areas. This is a concern with the boil and bite due to the self adaptation process which often leads to dangerously thin areas. In addition, lab impact tests have shown that the boil and bite mouthguard has less adequate cushioning and shock absorption than that available with a custom fit. A custom made mouth guard is by far the most protective and comfortable type of guard. This version requires a visit to your dentist who will take impressions and either fabricate it onsite or send it to a laboratory for a precise, customized fit. Custom versions tend to be more expensive, but offer superior protection, are far more comfortable and are more easily adaptable to orthodontic appliances. The expense incurred to have a proper mouthguard made could save a person thousands of dollars if there is damage from an accidental injury.
Mouthguards for All!
The use of a mouthguard is not age dependent. It is recommended for all people, young and old, who participate in activities with the risk of injury to the face or teeth. When parents consider enrolling a child in an activity, they are recommended to have a conversation with their dentist to discuss the level of risk and whether a guard is appropriate. Good habits start young, so there will be increased acceptance and compliance by young adults if wearing a mouthguard has been part of their routine all along.
Dr. Barichello is a 1998 graduate of the OHSU School of Dentistry. She was a private practicing general dentist in Oregon City for 13 years before taking her current position as Vice President and Chief Dental Officer at The ODS Companies. She is a Past President of the Oregon Dental Association and trains in the high contact martial art, Poekoelan, for which she is an avid proponent of the use of mouthguards.