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

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
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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.
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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.
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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.
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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.
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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
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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
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