Tim McNutt, DDS, Sory W. Shannon, Jr., DMD, J. Timothy Wright, DDS, MD, Ronald A. Feinstein, MD
Pediatric Dentistry : September, 1989 – Volume 11, Number 3
Resident: Anna Abrahamian
Overview: Mouth guards have been proven to greatly reduce the number and severity of traumatic oral injuries to participants in football and ice hockey, but their acceptance in most other sports has been almost non-existent. The purpose of this study was to determine the extent of mouth protector use and the amount and type of oral trauma associated with and without mouth guard wear. Interviews from 2,470 junior and senior high school football players were collected. Oral trauma, regardless of the sport during which the injury occurred, was evaluated. Prior to examination, each player/subject was also questioned about any history of loss of consciousness while participating in any sport.
Results: Of the 2,470 interviews conducted over the three-year period, there were 222 oral injuries noted (9% of all players suffered some form of oral injury). 64 (3%) reported LOC /concussion while participating in some form of sports activity. The total number of traumatic injuries occurring while not wearing a mouth guard was 167 (75% of the total injuries recorded). Of these 167, 40% of the injuries documented occurred during baseball and basketball AND while the players were not wearing a mouthguard. The total number of concussions or LOCs suffered by subjects/players not wearing a mouth protector was 36 (56% of the 64 LOCs/concussions).
Discussion: Participants not wearing mouth guards were almost 60 times more likely to sustain hard tissue trauma than those who did wear them. Due to the diversity of sports that can produce oral trauma, it is recommended that mouth guards by warm by all individuals participating in contact and non-contact sports. The results also indicate the need for mouthguards that have better soft tissue protection: in the athletes who suffered soft tissue laceration, 44% were wearing a mouth protector at the time of injury. Mouthguards with complete peri-oral coverage are commercially available and these offer increased protection by covering the extraoral lip and cheek.
Summary: Mouth guards function by: 1) spreading the force of impact over all the teeth covered by the mouth protector, 2) prevent traumatic contact between the maxillary and the mandibular teeth, 3) separate the soft tissue and the teeth (preventing soft tissue laceration/bruising), and 4) may help prevent concussions, cerebral hemorrhage, and possibly death, by separating the jaws and preventing the condyles from being displaced up and backwards against the glenoid fossa.
Assessment: Good article written by pediatric dental residents. Highlights how important it is for us to be involved in educating our patients and their families about using adequate oral protection during sports participation.