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Why should you wear a mouthguard?


More people participate in sports now than ever.  For some, the need for safety equipment is a number one priority, despite the fact that mouthguards are not mandatory equipment in most sports.   The worth of a mouthguard as a piece of safety equipment is indisputable.  Mouthgurads do more than protect your teeth.  Mouthguards can cushion blows to the face and neck by distributing forces evenly throughout the skull and can decrease a player’s overall susceptibility of suffering head and other regional injuries.  A mouthguard stabilizes a player’s jaw in a position that makes them less likely to suffer a head injury such as a concussion.   Finally, mouthguards provide additional protection for your tongue and cheeks from being cut by your teeth during an impact.


A mouthguard should be part of every athlete's gear, no matter the sport. Even adults or weekend athletes need to protect their smile and preserve their health.


- Wear a mouthguard at all times when playing sports. If possible, wear a mouthguard custom-fitted by your dentist, especially if you wear bridges or braces.


- Do not wear removable appliances like retainers when playing sports.


There are two major types of mouthguards:


Custom-made: Designed by a dentist and made on a cast of your teeth, these are the most the most effective method for preventing and reducing mouth injuries. Only your dentist can only make these types of mouth guards, but they're not very expensive and they're certainly worth the investment in safety.  These also cause the least interference with speaking or breathing and provide the best protection and fit over braces and fixed bridges.


Ready-made: Purchased at most sporting goods stores. They do not fit as well as those that are custom–made, however they do provide good protection from injury.


If you are a coach of a junior sports team, talk to a local dentist about organizing a mouthguard clinic - many communities find clinics to be a particularly successful way to get everyone involved and informed.


Mouthguard Care


Your mouthguard only works  properly if it is kept in good shape. Always remember to keep your mouthguard clean by washing it in water before and after wearing it and store it in a special case or a ziplock bag when not in use.


Remember – to take your mouthguard to your regular dental visit so that it can be inspected by your dentist for wear and defects that may warrant replacement.  You should always replace your mouthguard if it becomes damaged or if there is any change in your mouth or teeth.  Do not chew on your mouthguard.


Do Hockey Mouth Guards prevent Concussions?


Research has demonstrated a correlation between mouthguards use and the prevention of concussions.

Although the primary function of a mouth guard is to prevent dental injuries, recent research may lead to another role, being that of preventing concussions. A conclusive study done at Notre Dame University showed a drastic reduction in concussions once it became mandatory to wear a mouth guard for all football practices and games.


The following is a brief description of a concussion:


What is a concussion?

In simplified terms a concussion occurs when the brain is jarred or knocked against, the cranium (skull bone), resulting in swelling of the brain. The brain does not have a nice protective rubber encasement to protect it from the skull bone.


There are three grades of concussion:


In a Grade One concussion, the player suffers no loss of consciousness, is briefly confused but lasts less than 15 minutes. Treatment in this case should involve removal of the player from the ice and not be allowed to return until the effect has totally dissipated at least 15 minutes.This would mean that once any bleary-eyed ness or confusion has passed they should still remain on the bench for that additional 15 minutes. (A hard thing to do if it happens to be your best player in a tight game).


In a Grade Two concussion there is also no loss of consciousness but the confused state lasts more than 15 minutes. This player of course cannot return to the game. Consultation with a physician would be recommended. In this case the player should not be allowed any physical activity until they are at least symptoms free for one week.


In a Grade Three concussion the player loses consciousness totally. Even if the player loses consciousness for only a few seconds this is still classified as a Grade Three concussion. The player should go to the nearest hospital by ambulance. The player must now rest for at least one month after all symptoms disappear. At the end of one month it is strongly recommended that an EEG (electroencephalogram), A CAT scan or an MRI be performed to check for any abnormalities in the brain.


The reason for such a long recovery period is to prevent what is termed the "Second impact syndrome."

Research shows that with each concussion the swelling factor goes up four times. The second concussion results in four times the original swelling while a third blow to the brain results in four time four or sixteen times the four swells, - of the second and the fourth concussion is now sixteen times four or 64 times the original swelling. Get out your calculator. Pat LaFontaine had six concussions in his NHL career, which ended prematurely due to his injuries.


Further research has discovered that the risk of seizures after a traumatic brain injury increases with the severity of the injury.


In the New England Journal of Medicine 338:20-24 1998 a study group of 4,541 people who had suffered traumatic brain injuries between 1935-1984, with loss of consciousness, all showed a high risk of future seizures.


Preformed, warm water mouth guards have lower chance of being worn by younger hockey players on a consistent basis, mainly due to the improper fit . . .


Consult your dentist for a property fitted mouth guard there may, be more at stake that you children's dentition.


Sports Dentistry Facts


* It has been shown that properly fabricated custom made mouthguards by your dentist can reduce the rate of concussion as well as dental and mandibular injuries.


* Stenger and others have demonstrated in 1962 the reduction of concussions and head and neck injuries as well as reduction in dental facial injuries when the Notre Dame football team wore professionally fabricated custom made mouthguards.


* Repeated concussions appear to impart cumulative damage, resulting in increased severity and duration with each incident. Therefore it is imperative to diagnose and deliver proper custom made mouthguards to athletes after an episode of concussion.


* In football, the chance of having a second concussion is four times greater than the chance of sustaining a first concussion.


* Catastrophic brain swelling may occur following a second minor head injury in individuals who are still symptomatic from a prior concussion.


Facts from the National Youth Sports Foundation for Safety


* Dental injuries are the most common type of orofacial injury sustained during participation in sports; the majority of these dental injuries are preventable.


* An athlete is 60 times more likely to sustain damage to the teeth when not wearing a protective mouthguard.


* The cost of a fractured tooth is many times greater than the cost of a dentist diagnosed and designed professionally made mouthguard.


* Every athlete involved in contact sport has about a 10% chance per season of an orofacial injury, or a 33-56% chance during an athletic career.


* The cost to replant a tooth and the follow-up dental treatment is about $5000.


* Victims of knocked out teeth who do not have a tooth properly preserved or replanted may face lifetime dental costs of $15,000-$20,000/tooth, hours in the dental chair, and the possible development of other dental problems such as periodontal disease.


* It is estimated that faceguards and mouthguards prevent approximately 200,000 injuries each year in high school and college football.


* The stock mouthguard which is bought at sports stores without any individual fitting, provide only a low level of protection, if any. If the wearer is rendered unconscious, there is a risk the mouthguard may lodge in the throat potentially causing an airway obstruction.


Facts from the American Dental Association and the California Dental Association 


* A properly fitted mouthguard reduces the chances of sustaining a concussion from a blow to the jaw.


* Mouthguards should be worn at all times during competition; in practice as well as in games.


* Contact your local dental society and association for information on dentists and mouthguard programs in your area.


* The American Dental Association recommends wearing custom mouthguards for the following sports: acrobats, basketball, boxing, field Hockey, football, gymnastics, handball, ice hockey, lacrosse, martial arts, racquetball, roller hockey, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, surfing, volleyball, water polo, weightlifting, wrestling.

To become the international advocacy group for the prevention of sports related oral and maxillofacial injuries in children, through the use of education and preventative outreach tools, to ensure the long-term enjoyment of a healthy and happy smile.
To provide a means for the provision of prosthetic devices to those children who have suffered the misfortune of premature tooth loss as a result of injury.
To act as a leader within the dental profession for the promotion of preventive oral healthcare education, within all socio-economic classes, to decrease the incidence of severe oral diseases.
25 November 2002
Dr.Waji Khan