Properly diagnosed, designed,
and custom fabricated mouthguards are essential in the prevention
of athletic oral/facial injuries.
In a 1995 study, it was found there was a high incidence
of injuries in sports other than football, in both male and
female sporting activities. In football where mouthguards
are worn, .07% of the injuries were orofacial. In basketball
where mouthguards are not routinely worn, 34% of the injuries
were orofacial. The various injuries ranged from simple contusions
and lacerations, avulsions (teeth knocked out), concussions
and broken jaws.
Most often, the most common type of head injury is dental in
nature. Loosing a tooth can be an expensive proposition - costs
range from $10,000 to $15,000 per tooth in lifetime dental
costs.
The American Dental Association estimates that mouthguards
do prevent over 200,000 injuries each year in high school and
collegiate football alone.
The term "mouthguard" is a rather generic term today,
there are many different products that go by the same name.
The "over the counter" ones that everyone is familiar
with to very custom mouthguards delivered by a dentist. Almost
all mouthguards worn today are from the variety that can be
purchased "over the counter", only 10% are custom
made by a dentist for the athlete.
If a mouthguard is to be made correctly, it must fulfill several
different objectives.
Mouthguard criteria list;
Types
of mouthguards presently available -
Stock Mouthguard
These are found at the local sports store. The cost is minimal
but so is the protection they offer. There is no special
preparation to wearing one of these guards - purchase the
size closest to what is required - then put into the mouth.
If we refer to the "Criteria List" above, this
type of mouthguard "attempts" (but falls short
of) tooth protection and concussion prevention. It does
not fulfill at all the other items listed.
The fact that they are "stock" means most users
cut and otherwise alter them as an attempt at reducing
bulk and increasing comfort. These types of adjustments
often
render the guards even less protective.
As sports dentists and health professionals interested in
injury prevention, we do not recommend this type of mouthguard
to our patients and athletic teams.
|
| Stock mouthguard after several weeks of use |
Mouth formed or Boil and Bite Mouthguard
These are the most common guard now used by athletes. The perceived
advantage is that they will be more "custom". In
fact, this supposed advantage is in most cases actually a
large disadvantage. The procedure is to boil the thermoplastic
guard, insert it into the mouth and then by using biting
pressure - mould it into position. The problem occurs mostly
from the fact that biting into the guard decreases the thickness
dramatically - thus decreasing the tooth and concussion protection.
Several studies have shown that mouthguards of this type
decrease in thickness on average from 70%-95% - thus negating
almost all protection for the athlete.
Most people (as with the "stock" variety) do trim
and otherwise adjust these type of mouthguards as an attempt
to make them more comfortable and easier to tolerate. These
alterations further diminish the protection. One other major
problem with these are that they inadequately cover the posterior
teeth (back molars). This area of coverage is VERY important
in concussion prevention.
Due to the fact that most mouthguards used are of the "boil
and bite" type, most of the public assumes that mouthguards
in order to perform must be bulky, nonretentive, interfere
with speech and breathing. This is not the case.
Custom-made Mouthguards
These type of guards take into consideration all the points
from the "mouthguard criteria list" above.
Additional factors including the age of the athlete, allowances
for erupting permanent teeth, type of sport being played, etc
can all be taken into account when planning a custom guard.
None of these are possible in the stock or boil-and-bite type
guards.
This type of mouthguard is far superior to the stock and boil-and-bite
type mouthguards.
Your dentist makes this type of guard. Most often an impression
(mould) of the upper teeth is made and poured into stone. A
sheet of mouthguard material is then heated and vacuumed over
the stone model. The excess material is trimmed and the guard
is polished for delivery.
The vacuum machines used for this type of guard are very adequate
for these single layer guards but now research is showing that
multiple layered (pressure laminated) guards are preferred
over these single-layer ones.
Pressure Laminated Mouthguard
These custom mouthguards are made with the same mould taken
for the single-layered except a special machine presses multiple
layers of guard material over the models so as to build even
more protection into the guard.
The increased thickness is the most important aspect to these
type guards. As the thickness increases, the materials will
absorb greater forces and distribute them much more efficently.
Also, this increased thickness does a great deal to decrease
the incidence of concussion related injuries.
Another important point to make is that although these are
markedly more thick than the single-layered guards, they are
NOT uncomfortable to wear nor do they feel bulky.
Some dentists have the special machines to fabricate these
in their offices. Most commonly the models are sent to a dental
laboratory that will fabricate a pressure laminated mouthguard.
We highly recommend the custom made (multiple-layered) mouthguard
type for the very best in oral/facial protection as well as
concussion prevention.
The Bi-Arch Mouthguard
The Bi-Arch custom sportsguard will provide the maximum protection
for the athlete. Compared to a store bought sportsguard,
the Intact Pro will fit better, provide more comfort, protect
the natural dentition and restorative work and will improve
the athlete’s performance and will not impede breathing.
