Learning to Keep Their Guard Up

Wearing a properly fitted mouthguard is imperative for anyone who wants to avoid pain – and steep dental bills – after losing a tooth.

Every August, a scattered stream of extremely large, athletic young men poke their heads inside the University of Southern Calfornia School of Dentistry’s Center for Urgent Care, eliciting stares and whispered comments from the centre’s more standard-sized patients. The behemoths are seeking faculty member Ramon Roges, the centre’s director and, for the past decade, sole mouthguard manufacturer for the USC Trojans, the collegiate football team. “I also am on the sidelines for all their home games in case someone suffers an oral injury during the course of the game. I love football, and I love dentistry, so this has always been a labour of love for me,” Roges said. But mouthguards are not just for the collegiate or professional football player. While losing a tooth might not be the first thing thought about when lacing up high tops or jumping on a bicycle, anyone who has suffered a severe blow to the jaw will not soon forget the experience. Not only is there the immediate pain but depending on the damage done to bone and dentition, it can be an injury that requires numerous dental appointments and several thousand dollars to repair. Over the course of an individual’s life, one lost tooth can cost an estimated US$10,000 to US$15,000. A properly fitted mouthguard is the best protection against such injuries. Customized and manufactured by a dentist, the relatively inexpensive device reduces the risk of dental trauma by nearly 200 percent. Who should be wearing a mouthguard? While the toothless hockey player, stick in hand and grinning ear to ear, is an image we all readily identify, the list of sports where mouthguard protection is recommended includes some not so obvious examples. According to the Academy for Sports Dentistry, not only do the major contact sports, such as boxing, football and martial arts, require properly fitted mouthguards but also less risky activities such as basketball, baseball, bicycle riding, rollerblading, soccer, wrestling, racquetball, surfing and skateboarding. Despite the fact that mouthguards have been proven effective in preventing dental trauma, most athletes refrain from wearing the device – many claim that it inhibits breathing and talking – and few sports organizations require them as mandatory equipment. “That is something that I hear all the time, the mouthguard is uncomfortable or I can’t breathe with it in my mouth. With a professionally made mouthguard, that is just not an issue. Their effect on performance is very minimal,” Roges said. “Believe me, the alternative, possibly losing teeth, is much less desirable.” In the event of an avulsed or knocked-out tooth, a quick and informed reaction is key. The tooth should be immediately retrieved. When picking it up, hold it by the crown or enamel portion, not the root, which can be easily damaged. If dirty, it should be rinsed gently, preferably with cold, whole milk but, if unavailable, water. The tooth should not be stored in water under any circumstances because it will damage the root surface. After cleaning, the tooth should be reinserted into place, for best results, within five minutes. Research shows that replacing the tooth quickly maximizes the chances the tooth will remain viable. However, if stored in whole milk or in a biophosphonate – a medium specially formulated to preserve root tissue – a tooth still can be reinserted up to one hour after being dislodged. In the case of children, primary teeth should not be replaced as this may damage tooth buds of emerging permanent teeth in the gum tissue. “In any case, you need to see your dentist as soon as possible. Of course, if you have a concussion, broken jaw or something of that nature, treat those injuries first. But if you’ve lost or damaged a tooth or damaged oral tissue, get to the dentist right away,” Roges said. One contested benefit of mouthguards is their ability to also minimize concussion. Advocates maintain that the device absorbs the force of upward blows to the jaw, reducing trauma to the brain. While conclusive evidence of this added protection is hard to come by, several studies suggest that the device may reduce the acceleration of the head and, therefore, could have some efficacy in reducing the severity of concussive injuries. “If you are going to be participating in sports, at whatever level, it is always a good idea to wear all safety equipment, and a properly fitted mouthguard should be part of that standard equipment,” Roges said. (Source: Ben Creighton : University of Southern California : October 2007)