SPORTS DENTISTRYFamily DentistryDavid L. Burns D.D.S.4616 West Jefferson Blvd.Fort Wayne, IN 46804260-432-8596e-mail: drdlburns@comcast.netweb: www.davidlburnsdds.com

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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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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 grossdisease 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 fromthe 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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There are advantages which can be stated. These are either 1) direct or 2) indirect.

1) DirectPrevent trauma to teeth, jaws and supporting tissues.

2) IndirectElimination of concussions and neck injuries.With these important factors in mind the following list of requirements formouth 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 thin3. Have sufficient retention to prevent accidental dislodgement during

athletic contact or signal calling4. 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

thinness7. 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 guard8

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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