Custom Sports Guards

Summer is a great time for sports.  Who doesn’t love to be outdoors, getting some fresh air, and knocking your front teeth out?  WHAT!!!  That wasn’t supposed to happen!

Unfortunately, over 5,000,000 (!) teeth are lost each year due to sports-related injuries.  Now, you know I recommend a custom-made mouth guard, but people don’t always do what they are supposed to (you know who you are!), and so we need a way to deal with dental emergencies. 

Let’s deal with the most serious first.  A tooth is completely knocked out of the mouth.  It is imperative to get the tooth back in the socket within 5 to 10 minutes if the tooth is to be successfully re-implanted.  First, rinse the tooth of any debris with some water.   If it’s an upper tooth,  hold the top of the athlete’s head and push the tooth back into the socket.  It doesn’t have to be exactly straight, just get it in there.  Try and stabilize it by having the athlete bite down on a towel or a wad of wet paper towels, or just by having him or her holding it in place.  For a lower tooth, hold the patient under the jaw and re-implant the tooth, then stabilize as above.

Now, the athlete may be traumatized, he or she may be young and very upset, or there could be additional damage to the tooth socket which prevents the placement of the tooth.  In that case, you must keep the tooth moist and get the athlete to a dentist or oral surgeon immediately.  Place the tooth in some milk, if available, or have the athlete keep the tooth under his or her tongue.  If  water is the only medium available, place it in water.  In any case, apply direct pressure to the socket for at least 5 minutes to control bleeding.  Use anything available that is fairly clean – paper towels, regular towels, even a clean T-shirt will do.

If the tooth is broken, save the pieces.  The root may still be in the patients mouth.  If the nerve is not exposed, and the patient is not in pain, the athlete may choose to complete the game.  If the nerve is exposed, or if there is pain, get the athlete to the dentist ASAP. 

Now, there are 3 positions that the tooth may be pushed into after a collision:

1) Lateral Displacement – The tooth is either pushed back or pulled forward.  No treatment is necessary on the playing field.  Transport the athlete to a dentist or oral surgeon ASAP.

2) Extruded Tooth – An upper tooth is hanging down, or a lower tooth has been pushed up.  Push the tooth back into the socket using firm finger pressure and stabilize with a towel or a wad of wet paper towels.  Transport the athlete to a dentist or oral surgeon ASAP.

3) Intruded tooth - Tooth pushed into socket.  No treatment necessary on the playing field.  Transport the athlete to a dentist or oral surgeon ASAP.

Well, that was exciting!  Hopefully, we will all avoid any dental injuries, but at least now we have a little understanding of what to do if any occur.  Remember, accidents happen, and not just on the playing field.  So, have a happy, fun, and most importantly, safe summer!

Dr. Rob From

With all the hoopla these days about concussions in professional football, I thought I’d just take a moment to discuss concussions in all contact sports, and how a well-made, custom-fitted mouth guard can drastically reduce the incidence and severity of concussions.  There, I’ve said concussions four times in one little paragraph!

In any case, people don’t usually associate mouth guards with concussion protection; they usually assume that mouth guards are made to protect the teeth and gums.  However, even with sports where there are helmets and facial cages, it is the blow to the chin that can be the most devastating.

When an athlete is hit from below, specifically under the chin, two things happen simultaneously: First, the upper and lower jaws are smashed together, causing potential tooth damage.  Second, the force of the blow is transmitted to the entire skull, literally causing your brain to bounce around. 

Now, nature has provided certain shock-absorbing measures around the brain to protect it, but I needn’t tell you what the force of a 250 pound linebacker coming at you full force is like.  And when contact is made, the protection barriers of the brain are sometimes overwhelmed –  your brain hits the inside of the skull, and gets a bruise – this is what a concussion is.  Remember, your brain weights about 3 pounds, and without the skull to give it reinforcement, would crush under it’s own weight.  It really is very delicate.

Now, I’m not saying that one concussion will damage you permanently.  However, it has been shown that the effects of multiple concussions are cumulative.   How many professional athletes have had to end their careers early because they have suffered too many concussions?

So, let’s put this all in perspective.  In contact sports, you need all types of cushioning to be protected – a well-made mouth guard is just one of the tools required for full, safe protection.  So, if you are investing in the best equipment for your sport, why not make a custom-fitted mouth guard part of the package?  Remeber, the effects of multiple concussions can last a lifetime, so go out there and play safe!

Ah,  summer!  Long, lazy days, summer camp, and lots of outdoor sports.  Now is the best time to invest in the best protection you can get – a custom-fitted mouth guard!

As the number of people playing contact sports increases, so do the chances of oral injuries and concussions.  Studies have shown that mouth guards made with PolyShok, a unique plastic polymer, are much more effective in preventing these injuries.  For less than the cost of a pair of sports shoes, you can provide your children and yourselves with the kind of protection that the American Dental Association has determined to be the best for contact sports – a custom-fitted mouth guard.

Unlike boil and bite moutguards, which can deform and are bulky, making breathing and speaking difficult, custom-fitted sports guards conform exactly to the shape of your mouth.  They are comfortable, not bulky, and allow for speaking and breathing with ease.  There really is no better protection you can get.

So, while you’re considering the best equipment for your sport of choice,  don’t forget that little piece of PolyShok that will make such a big difference in your oral protection – a custom-fitted mouthguard!

The American Dental Association has estimated that over 200,000 sports-related oral injuries are prevented each year by the use of mouth guards. Mouth guards, much like air bags, cushion the force of a blow to the jaw and dissipate the energy, greatly decreasing the incidence and severity of concussions because the lower jaw (the mandible), is not forced back into the base of the skull (the TMJ), and harmful forces are not transmitted to the brain.  In addition, the teeth and soft tissues of the mouth are protected because the upper and lower jaws are not brought forcefully together, and the front teeth are cushioned.  Costs related to replacing teeth lost due to trauma can run into the thousands, and can lead to a lifetime of dental problems. 

 Types of Mouthguards

To be effective, a mouth guard  must be comfortable, have excellent self-retention, retain no odor or taste, have little or no interference with speaking or breathing, wear well and resist deformation, not be bulky but have adequate thickness to be protective.  Currently, there are 4 types of mouthguards available.

Stock Mouth Guards:  These are the so-called “one-size-fits-all” type of sports guard that can be bought at sporting good and department stores.  They are also carried at some pharmacy chains.  They are inexpensive, used right out of the box, and offer the least amount of protection.  They tend to wear out quickly, have poor retention, are bulky, and make speaking and breathing difficult.  I do not recommend these guards for any type of sports activity.

 Boil and Bite Guards:  Approximately 90% of the sports guards used today by high schools and colleges are of this type.  Marketed and advertised heavily to young athletes, they are made from a thermoplastic material that is softened in boiling water, then adapted by finger and tongue pressure in the mouth by the athlete.  The problem with these mouth guards is that during the heating process and subsequent adaptation, thin spots develop in the material, offering greatly reduced protection.  Since they are thermoplastic, the heat of the mouth can deform the material.  Often, they do not cover all the posterior teeth, and are frequently cut and adjusted by the athlete to make a more comfortable fit, further reducing their effectiveness. They are bulky and interfere with breathing and speaking.  While offering a perceived benefit for a low cost, I do not recommend these for sports activities.

Custom Sports Guards:  Custom made mouth guards are superior in every way to the stock and boil and bite guards.  After an impression is taken, most commonly of the upper teeth, there are two possible custom mouth guards that can be fabricated:

     i)  Vacuum Mouth Guard:   Using a vacu-form machine, a piece of material (commonly EVA – ethylene vinyl acetate) is heated above a stone model of the upper teeth.  The material is lowered on the model, and a vacuum pulls the material over the teeth.  However,  these sports guards have their limitations.  All material thins out when heated by as much as 50%, sometimes more.  So, a 3mm sheet of EVA (the recommended thickness for most sports), can end up being 1.5mm, and offer greatly reduced protection. Additional layers cannot be added, because the material will not fuse unless heat and pressure are used.  Because no pressure is used, the internal fit is compromised.

     ii)  Pressure Laminated Mouth Guard:   By far the best sports guard available.  These custom-fitted mouth guards are fabricated by a special machine, which fuses layers of material using heat and as much as 10 atmospheres of pressure.   Therefore, the internal fit of these guards is extremely precise.  These sports guards have virtually no elastic memory (they will retain their shape), will not deform with the heat of the mouth,  and additional layers can be fused together to form a thicker guard, or to add material where extra protection is needed.  These guards also have the additional advantage of being able to be customized.  So, when a sports guard fits well, is personalized, and allows breathing and speaking, it is much more likely to be used.