Preventing Traumatic Injuries to Teeth
Over the weekend I took my two boys to the local YMCA Halloween party. Wow! They had a variety of activities for the kids including pony rides and three inflatable jump houses! My 4 year old wasted no time, he immediately ran to the jump house to join the other kids.
As a father I encourage this activity, but the dentist inside me always cringes while watching eight to ten children jumping uncontrollably in such small quarters. I’m just waiting for the random collision of child verses child which knocks out one of the children’s teeth or lacerates the lip. These accidents are rare but need to be considered during physical activity. Fortunately, all the children left with big smiles including my two boys to collect some candy and take a pony ride.
Dental injuries can happen at anytime, but I tend to see an increased number of injured children and young adults in the summer and fall. Injuries can range from a small chip on a front tooth to complete avulsion of one or more teeth.
I find these injuries to be very hard to digest with adults, but especially difficult in children and adolescents. Serious injuries such as complete avulsions will commit a young adult to many long dental visits often with a guarded prognosis depending on the severity of the injury.
Anyone who participates in a physical sport that carries a significant risk of injury to the head or neck should wear a mouth protector also known as a mouthguard. This includes a wide range of sports such as football, hockey, basketball, baseball, gymnastics and volleyball.
Mouthguards, which typically cover the upper teeth, can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft tissues of the mouth. Dental injuries are the most common type of orofacial injury sustained during participation in sports. Victims of total tooth avulsion who do not have teeth properly preserved or re-implanted may face a lifetime of dental cost of $10,000-$15,000 per tooth, hours in the dentist’s chair, and the possible development of other problems such as periodontal disease.
It is estimated by the American Dental Association that mouthguards prevent approximately 200,000 injuries to the mouth each year in high school and college football alone.
A properly fitted mouthguard must be protective, soft, odorless, tear resistant, cleansable, and cause minimal interference during speech and breathing. Most important, the appliance should have great retention and adequate thickness to aid in protection during any blows to the head or neck.
There are three types of mouthguards on the market, two of which can be purchased at the local sporting goods store. These include stock, boil and bite, and custom mouthguards.
The stock mouthguard comes in three sizes small, medium, and large. These are the least effective because they often don’t fit well and the athlete has to clench to hold them in position. This minimizes the ability to breathe and speak freely. More importantly, they are prone to concussion if they sustain a blow to the chin.
The boil and bite mouthguard is currently the most popular mouth protector on the market. These are made from a thermoplastic material and can be purchased at the local sporting goods store. The athlete immerses the material in boiling water and then forms it in the mouth using their fingers, tongue, and biting pressure. Available in multiple sizes, these still often lack proper extension and are often trimmed by the athlete to reduce posterior bulk and gagging effects.
Custom mouthguards are fabricated by your dentist and are the most effective of the various mouth protectors. They fulfill all the criteria for retention, thickness, comfort, and stability of material. They interfere the least with speech and studies indicate they virtually have no effect on breathing.
As a dentist, I would recommend the custom fit mouthguard as my first choice for protection. The appliance will be the most effective and the athlete will be more compliant if they are able to participate in the sporting activity without the bother of an ill fitting mouthguard.
Regardless of type, a mouthguard will help prevent a variety of injuries to the teeth and surrounding soft tissue and help maintain a positive experience during these physical activities.