Sports Dentistry involves the protection of teeth and oral structures, and the treatment of sports-related injuries. Dentistry-on-Bellevue being located just two blocks from West Vancouver’s playing fields, Dr. Shainbom is keenly aware of the risk to children and adults of injuring their teeth through hard, fast play. His focus on Sports Dentistry is to increase the awareness of sports-related injuries and the prevention of such injuries within the general sporting population.
Anyone who has ever played a sport knows that, during the game, your entire aim is on playing well, not on what might happen if your face or teeth are injured through a hit or a fall. All sports bring the inherent risk of maxillofacial injury. Whether you or your son or daughter play contact sports such as ice hockey, football, rugby, boxing or martial arts, or other sports previously thought of as “non-contact” including basketball, field hockey, soccer, rollerblading, racquetball, baseball, water polo, diving, gymnastics, surfing, skateboarding and mountain biking . . . all are associated with frequent and considerable trauma to the face, teeth, and gums. These injuries can range from minor to severe, some involving lasting effects that will follow the person throughout their life.
How can an athlete protect themselves from the severe outcomes of a direct hit to the lower face while playing at their highest level of energy and efficiency? Knowledge and adequate preparation are essential in limiting sports injuries. Accurate information and training in how to respond when an athlete endures a facial injury (please read our page, “For the Love of the Game” for the correct means of responding to jammed, broken or lost teeth) is a paramount responsibility of not only the athlete. Parents, coaches and umpires must rehearse these scenarios and have the appropriate materials available on-site.
Although most atheletes practice good sportsmanship, accidents are inevitable regardless of the skills or best intentions of the players. An athelete cannot completely protect themselves from all injury, but trauma to the teeth can be reduced in many instances by wearing a professionally-formed mouthguard which Dr. Shainbom fashions directly from exact impressions taken of the patient’s teeth. The mouthguard is made by either the vacuum or pressure-formed technology described below, and is the only type of mouthguard that should be worn.
How Mouthguards Protect You:
When you are hit in the mouth or jaw, a mouthguard acts as a cushion that redistributes the force of the blow, so the impact is absorbed more evenly. A mouthguard provides a barrier between your teeth and the soft tissue in and around your mouth. Mouthguards also help prevent chipped or broken teeth and protect against cuts to lips, gums, and other soft tissue in the mouth area.
Some studies claim that mouthguards may also help prevent other types of injuries, such as concussion, cerebral haemorrhage (bleeding from a ruptured blood vessel in the brain), and neck injuries. At present, the scientific evidence supporting these claims is inconclusive. However, the Canadian Academy of Sport Medicine (CASM) issued a Position Statement in 2004 suggesting that mouthguards should be worn during participation in soccer “for the definite dental protection they provide and the possible role in concussion prevention.” http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/life-vie/mouth-dents-eng.php).
Four attributes identify a mouthguard that provides the best teeth protection:
1) Accurate Mouthguard Fit – provides full protection of all upper teeth.
2) Retention – a close tight fit helps the mouthguard remain in the mouth.
3) Adaptation/Comfort/Breathability – enables the athelete to exert his/her highest level of oxygen efficiency and energy, and since the player finds it adaptable, it’s a mosuthguard the athelete will actually wear throughout play.
4) Resilience of the Mouthguard/Sportsguard – how long the mouthguard will last, if worn regularly.
Mouthguard design and fabrication are extremely important. There are different types of mouthguards and each offers a different level of protection.
Stock and Boil-and-Bite Mouthguards:
Stock Mouthguard: The stock mouthguard, available at most sporting good stores, comes in limited sizes (usually small, medium, and large). They are the least expensive and this is a very good example of the old adage, “you get what you pay for”. The prices range approximately from, $3 to $25. These protectors are ready to be used without any further preparation; simply remove from the package and immediately place in the mouth. They are loose and bulky and therefore, lack any retention. They must be held in place by constantly biting down. This interferes with speech and breathing, making the stock mouthguard the least acceptable and least protective option.
Boil and Bite Mouthguard: Also store bought and the most commonly used mouthguard, this type is heated in hot water and moulded to the teeth. It offers a bit more stability, but is still very bulky and uncomfortable, and does not offer the coverage and level of protection required to prevent injury.
Custom-Made Mouthguards: Designed and fitted here by our dentist, these are the most satisfactory of all types of mouth protectors. They fulfill all four criteria for accurate fit, retention, comfort, and resilience because of the stability of material, which provides for longer life even with daily wear. They interfere the least with speaking and studies have shown that the custom-made mouthguard has virtually no effect on breathing.
There are two categories of custom mouthguards, the Vacuum-Formed Mouthguard and the Pressure Laminated Mouthguard.
The vacuum formed mouthguard is made from a thermoplastic material (EVA) that offers a much higher level of protection and comfort than store-bought mouthguards. The material is a single layer, 3mm thick and formed over a model poured from a patient’s impression.
A laminated mouthguard comprises two or three layers of EVA material, layered together under high heat and pressure which provides exceptional fit and impact resistance. This mouthguard can be further designed to suit the player’s individual needs by adjusting the placement and thickness of the EVA layers, based on the sport played and the player’s anatomy. It is the most recommended protection for high contact sports and for the athlete looking for the best possible protection.
And Now for the Fine Print:
No mouthguard/sportsguard will protect all of the player’s teeth from facial injury. The strength and placement of impact, if it is harsh enough and is a direct hit, can dislodge teeth even when the player is wearing the best mouthguard. However, the level of protection afforded by custom-made mouthguards has been well-researched, and although concussion protection remains inconclusive, there is no question that in most cases, a custom-made mouthguard/sportsguard will save the player from more severe dental injury and from thousands of dollars in dental expense in rebuilding a smile, as well as years of possible after-effects, if teeth are lost from not wearing a mouthguard at all. Keep in mind, a store-bought sportsguard has been shown to have no greater protection than wearing no mouthguard. Considering the pain, expense and possible complications that could occur from not wearing a custom-fabricated mouthguard fashioned by a dentist, it is a wise investment for any player, well worth the minimal cost.
For additional information, Dr. Shainbom asks you to please read the publication from the IOC Medical Commission – Sports Dentistry or contact the Academy of Sports Dentistry at http://www.academyforsportsdentistry.org.