A Little Knowledge Can Be Harmful With Respect to Mouthguards

Recently, a number of young athletes were asked by their team dentist, and an instructor of a dental school Sports Dentistry course, to exchange their PlaySafe Heavy Pro mouthguard in favor of wearing a special mouthguard to help bring awareness to breast cancer.

It was a touching suggestion by the dentist. The athletes were eager to help. Little did they know, that in doing so, by placing their trust in the dentist, their lives would be drastically effected.

For those of you that are not familiar with Glidewell Lab's PlaySafe Heavy Pro mouthguard, it is a custom fitted athletic mouthguard that is fabricated over a dental cast of an athlete's teeth using multiple layers of EVA (Ethyl Vinyl Acetate), heat and pressure. The final product being one of the most protective types of athletic mouthguards available. PlaySafe Heavy Pro mouthguards offer a protective cushion of 4-5 millimeters of thickness. PlaySafe Heavy Pro mouthguards offer the best possible protection to the athlete's teeth and soft tissue, and may reduce the incidence and severity of concussions.

The mouthguard that the dentist wanted the athletes to wear instead offered little protection, in one case, a mere 1.2 mm. Research and literature shows that to be adequately protective, mouthguards must offer at least 3mm of protective EVA.

If one looks closely to the top photo of the Breast Cancer Awareness mouthguard, one can see the outline of the teeth on the exterior of the mouthguard surface. One can see immediately that there is not enough thickness to be protective. Visually, it is similar to a teeth whitening tray.

These young athletes were now, unknowingly, putting their bodies in jeopardy and the dentist either had no idea or didn't care.

During one game an athlete wearing a pink Breast Cancer Awareness mouthguard received a concussion. The following week, the same athlete received a second concussion which ended his playing time for the rest of the season. During the same game, a second athlete wearing a pink mouthguard sustained a blow that resulted in slamming the mandibular teeth into the maxillary teeth and the fracture of 4 molars on the left side.

I treated the four fractured molars. At that time I took a panoramic x-ray. By viewing the film, the mechanism of injury was obvious, as well as preventable. The panoramic film was made using an Instrumentarium OP100D. The anterior bite stick has a known thickness of 2.0 mm. Using the built in calibration and measuring tool, it was determined that with the anterior teeth separated by 2.0 mm, the occlusal separation on the left side after the injuries were 1.7mm between teeth #14 & 19, 1.0mm between Teeth #15& 18 and 0.8mm between teeth #16 & 17. Clearly, the pink mouthguard DID NOT provide enough separation to be protective.

I contacted the team trainer and strongly urged that the pink mouthguards be immediately removed from action.

To be fair, mouthguards are a strong deterrent to injury, but cannot guarantee that they will totally prevent injury. Just like the football helmet cannot guarantee prevention of head injury. That being said, we need to do everything we can to provide the very best helmets according to research of product materials and fabrication technique. Same with athletic mouthguards. We need to provide state of the art mouthguards according to research and literature review.

The athlete's dentist maintains that the injuries are just a coincidence and that the pink Breast Cancer Awareness mouthguards are adequately protective and played no factor in the athlete's injuries.

The sad fact is the athlete's dentist could have had it both ways. He could have fabricated mouthguards that were both protective as a PlaySafe Heavy Pro mouthguard and promote Breast Cancer Awareness. The dentist chose not to.

Sports Dentistry courses are quickly becoming popular among dental professionals and dental students. Dental professionals and dental schools need to be aware that, in many cases, the instructors of these courses have no formal training in the subject. The best resource for obtaining sports dentistry education is through the Academy for Sports Dentistry, the foremost authority on the subject; or from an instructor that has earned an Academy of Sports Dentistry Fellow award (F.A.S.D.). To become a Fellow, one must be a member of ASD for a minimum of 5 years and have earned at least 400 continuing education units in Sports Dentistry. Dental professionals, as well as athletic organizations, need to be aware that mere membership in the Academy for Sports Dentistry may not reflect the true knowledge of the course instructor or the team dentist candidate. As seen, a dentist with a little knowledge can be harmful with respect to mouthguards.

If you would like more information regarding PlaySafe Mouthguards contact Glidewell Dental Lab at 1-800-854-7256. If you would like more information regarding the Academy For Sports Dentistry, please visit their website: www.academyforsportsdentistry.org