Dentistry is the treatment and prevention of oral/facial athletic
injuries and related oral diseases and manifestations.
The 1990 report of the "Better Health Program" entitled,
"Sports injuries in Australia, Causes, Costs and Prevention"
estimated that sports injuries cost Australia (population 18
Million) about $1.4 billion per year and that between 30-50%
of these injuries are preventable. Multiply these numbers for
the United States (population 260 million). Participation in
exercise and sport whether positive or negative, will always
remain a major consideration in the health of a national population.
In sports, the challenge is to maximize the benefits of participation
and to limit injuries. Sports dentistry has a major role to play
in this area. Prevention and adequate preparation are the key
elements in minimizing injuries that occur in sport. For sports
dentistry the prevention of oral/ facial trauma during sporting
activities can be helped by many facets. Included are teaching
proper skills such as tackling technique, purchase and maintenance
of appropriate equipment, safe playing areas and certainly the
wearing and utilization of properly fitted protective equipment.
In some sports, injury prevention, through properly fitted
mouthguards are considered essential. These are the contact sports
of football, boxing, martial arts and hockey. Other sports, traditionally
classified as non contact sports, basketball, baseball, bicycle
riding, roller blading, soccer, wrestling, racquetball, surfing
and skateboarding also require properly fitted mouthguards, as
dental injuries unfortunately, are a negative aspect of participation
in these sports.
The National Youth Sports Foundation for the Prevention of
Athletic Injuries, reports several interesting statistics. Dental
injuries are the most common type of oral facial injuries sustained
during participation in sports. Victims of tooth avulsions who
do not have the teeth properly preserved or replanted will face
lifetime dental costs estimated from $10-15,000 per tooth, the
inconvenience of hours spent in the dental chair and possibly
other dental problems. (See "What to do when a tooth is
knocked out" Section)
Treatment of oral/facial injuries, simple or complex, is to
include not only treatment of injuries at the dental office,
but also treatment at the site of injury, such as a basketball
court or football or rugby field, where the dentist may not have
the convenience of all the diagnostic tools available at their
office. Knowledge and ability to do "on site" differential
diagnosis is essential, withoutthe use of radiographs and dental
operatories, to determine the future treatment and prognosis
of the injury.
Preseason screenings and examinations are essential in preventing
injuries. Examinations are to include health histories, at risk
dentitions, diagnosis of caries, maxilla/mandibular relationships,
orthodontics, loose teeth, dental habits, crown and bridge work,
missing teeth, artificial teeth, and the possible need for extractions
for orthodontic concerns or wisdom teeth. These extractions should
be done months prior to playing competitive sports as to not
interfere with their competition or weaken their jaws during
competition. Determination of the need for a specific type and
design of mouthguard is made at this time.
Mouthguard design and fabrication is extremely important.
There are four types of mouthguards according to the dental literature.
Stock, Boil and Bite, Vacuum Custom made, and Pressure Laminated
Custom made. (See Mouthguard Section).
First of all, it is essential
to educate the public that stock and boil and bite mouthguards
bought at sporting good stores do not provide the optimum treatment
expected by the athlete. These ill fitting mouthguards cannot
deal with idiosyncrasies athletes and children may have. If everyone
had the same dentition; were of the same gender; played the same
sport under the same conditions; had the same experience and
played the same position at the same level of competition, and
were the same age and same size mouth, with the same number and
shape of teeth, prescribing a standard mouthguard would be simple.
This is the precise reason why mouthguards bought at sporting
good stores, without the recommendation of a qualified dentist,
should not be worn.
Idiosyncrasies are to be noted during mouthguard design and
fabrication. These may include jaw relationships where mouthguards
may have to be designed on the mandibular arch such as a Class
III prognathic bite. Otherwise, where possible, mouthguards should
be built on the maxillary (upper) arch.
Erupting teeth (ages 6-12) should be noted so the mouthguard
can be designed to allow for eruption during the season. Boil
and bite mouthguards do not allow for this eruption space.
For patients with braces, special designs for the mouthguards
are essential to allow for orthodontic movement without compromising
on injury prevention and fit. This can only be achieved through
consultations with your dentist.(See mouthguard section for further
information on types and designs for mouthguards.)
Sports Dentistry also includes the need for recognition and
referral guidelines to the proper medical personnel for non dental
related injuries which may occur during a dental/facial injury.
These injuries may include cerebral concussion, head and neck
injuries, and drug use. We are NOT suggesting that dentists treat
these injuries, but as health professionals dentists should be
able to recognize these entities and refer these patients to
the proper medical personnel. For example, if a patient comes
into the office for a broken or knocked out tooth, dentists must
rule out the possibility of a head injury or concussion before
treating the patient for the dental injury. If certain symptoms
are present, such as persistent head aches or nausea, immediate
referral to medical personnel is essential. (See concussion section).
Smokeless tobacco should also be included and addressed under
Sports Dentistry. Smokeless tobacco is often associated with
certain sports, and the public should be educated on the dangerous
properties and consequences of using smokeless tobacco. (See
Smokeless tobacco section.)
Is not uncommon for dentists to recognize the symptoms of
anorexia and bulimia through dental examination. Eating disorders
are not as infrequent as one may think in female athletics. Woman's
gymnastics, volleyball, and basketball are just a few sports
where eating disorders have been documented in the medical/dental
literature. Erosion patterns in the teeth, caused by gastric
acids, often help dentists in the differential diagnosis of eating
disorders. These patients need to be referred to the proper medical
and psychological health professional.
As you can see sports dentistry deals with much more than
just mouthguards. Visit the other sites on Sports Dentistry On
Line for other specific information on these topics.