Title: Put More
1Put More Bite Into Health Promotion
MOUTHA-2-01
2Objectives of the Bite Mouthguard Initiative
- Inform practitioners about the incidence of
oro-facial trauma and the role mouthguards play
in their prevention - Have practitioners educate patients and coaches
about mouthguards - Convince practitioners to fabricate more
mouthguards - Inform practitioners about the types of
mouthguards and barriers to their use
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3Sports dentistry deals with impact-type injuries
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4Types of Impact Injuries in Sports
- participant
- apparatus (e.g. bat)
- projectile (e.g., ball or puck)
- (Pinkham Kohn, Dent Clinics N Amer 35609-26,
1991)
MOUTHA-2-03
5Ability of Projectiles inSports to Cause Injury
- airborne pucks can travel as fast as 90 mph
- baseballs tennis balls can travel as fast
as 100 mph - (Pinkham Kohn, Dent Clinics N Amer
35609-26, 1991)
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6Mouthguards are especially recommended for
collision, contact and fast-moving sports.
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7Sports with Mandatory Mouthguard Rules for
Practice and Competition
- Amateur
- boxing
- football
- ice hockey
- mens lacrosse
- womens field hockey
- Professional
- boxing
(Ranalli and Lancaster, J Public Health Dent 53
96-100, 1993)
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8Evolution of Mouth Protection in Sports
- Year Event
- 1913 boxing 1st sport to introduce mouth
protection - 1960 Natl Fed State H.S. Assns mandates face
guards for high school football - 1962 Natl Alliance Football Rules Cmt mandates
mouthguards for high school football - 1974 Football Rules Cmt of NCAA mandates
mouthguards for college football - 1976 College hockey mandates mouthguard use
- 1983 Natl Academy for Sports Dentistry
established - 1990 NCAA mandates mouthguards be a visible
color - (Johnsen Winters, Dent Clinics N Amer
35657-66, 1991 - Lancaster and Ranalli, Pediatric Dent 15398-402,
1993)
MOUTHA-2-08
9ADA Endorsement of Mouthguards
- 1960 - first resolution endorsing use of
mouthguards passed - 1985 - resolution supporting the use of
mouthguards for all sports where risk of injury
is significant passed. - (Johnsen Winters, Dent Clinics N Amer
35657-66, 1991)
MOUTHA-2-09
10Academy for Sports Dentistry endorses mouthguard
use for the following sports
- acrobatics
- baseball
- basketball
- boxing
- cycling
- discus
- equestrian sports
- field hockey
- football
- gymnastics
- handball
- ice hockey
- judo
- karate
- lacrosse
- motorcross
- martial arts
- parachuting
- rugby
- racquetball
- skiing
- soccer
- squash
- surfing
- skate boarding
- shot putt
- skydiving
- trampoline
- tennis
- volleyball
- wrestling
- weight lifting
- water polo
(Johnsen Winters, Dent Clinics N Amer
35657-66, 1991)
MOUTHA-2-06
11Protective Benefits of Mouthguards
- reduce tooth fractures dislocations
- protect against intraoral soft tissue lacerations
bruises - protect against jaw fractures by absorbing energy
from traumatic blows to the chin - prevent upward backward displacement of
mandibular condyle - (Johnsen Winters, Dent Clinics N Amer
35657-66, 1991) - may protect against brain concussions by
cushioning shock from a blow to the jaw
preventing transmission of the shock through the
TMJ to the skull - (Blum Kranz, J Dent Children 4922-24, 1982)
MOUTHA-2-11
12Cost/Benefit of Mouthguards
- Total rehabilitative costs for a single
knocked-out tooth are more than 20 times that of
a custom-made mouthguard. - 200,000 (est.) football injuries per year are
prevented by mouthguards. (ADA Council on Dental
Materials, JADA 10984-7, 1984) - Since the introduction of mandatory mouthguards
and padded helmets in football, the incidence of
dental injuries has been reduced from 10 chance
each year to a 0.35-0.45 chance. (Camp, Dent
Clinics N Amer 35733-56, 1991) - Incidence of facial dental injuries per 100
players declined from 2.2 to 0.3 following
adoption of face-mask mouthguard regulations.
(Heintz, JADA 77632-36, 1968) - Dental treatment for teeth avulsed by youngsters
trying to slam-dunk basketballs ranged from
35-2,200, with a mean cost of 929. (Kumamoto
et al JADA 1281273-74, 1997)
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13Incidence of Tooth Avulsions or Fractures in the
Military is Unknown
MOUTHA-2-13
14Proportion of Tooth Avulsions or Fractures Due to
Sports-Related Injuries in the Military is Also
Unknown
MOUTHA-2-14
15Civilian Incidence/Prevalence Data on
Sports-Related Oral Trauma
MOUTHA-2-15
16Multi-sport
- Over 5 million teeth are knocked out at sporting
events each year - (ADA Council on Dental Materials, JADA 10984-7,
1984) - Natl Youth Sports Found. for the Prev. of
Athletic Injuries estimates that athletes have a
10 chance of sustaining an injury to the face or
mouth during playing season. - (Padilla Balikou, J Calif Dent Assoc 2127-37,
1993)
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17Multi-sport Continued
- 13 of all dental injuries are sport-related
- (Hayrinen-Immonen et al., Endod Dent Traumatol
6208, 1990) - Of all sports-related accidents, 11-18 are
maxillo-facial injuries - (San, Proc Finn Dent Soc 84Supplement IV, 1988)
MOUTHA-2-17
18Multi-sport
- 9 of adolescent athletes suffered oral trauma
75 of these injuries involved individuals not
wearing mouthguards 40 occurred to baseball and
basketball players. - (McNutt et al., Pediatric Dent 11209-13,
1989)
MOUTHA-2-18
19Civilian Studies
- Year Population of Injuries to Oral Region
- 1951 H.S. football 50
- players in 3 states
- (Cathert, Dent Digest 57346-48, 1951)
- 1954 H.S. football 54
- nationwide
- (1954-55 Handbk, Natl Fed State H.S. Assns)
- 1960 H.S. football players 20
- in Wisconsin
- (Morrey, JADA 64392-3, 1962)
MOUTHA-2-19
20Football
- 3.9 of a high school football players suffered
from oral trauma while wearing mouth guards. - (Garon, Merkle, and Wright, JADA 112663-65, 1986)
MOUTHA-2-20
21Basketball
- 7.5 of female college basketball players
sustain orofacial injuries. - (Morrow, Bonci, Seals, Barnwell, I Natl
Athletic Trainers Assoc 26334-5, 1991) - 10 of male college basketball players sustain
orofacioal injuries. - (Morrow et al., J Natl Athletic Trainers Assoc.
26338-42, 1991)
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22Baseball
- Of all baseball injuries, 41 occur to the head,
face, mouth or eyes. - (U.S. Consumer Product Safety Commission, 1981)
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23Rugby
- Poll of 1987 U.S. World Cup Team
- 95 believe mouthguards protect
- 50 wear mouthguards
- (Chapman, Am J Sports Med 17690-91, 1989)
MOUTHA-2-23
24Limitations of Sports Trauma and Mouthguard
Studies
- many had very small samples
- most were limited to adolescents in a
restricted locale for a limited time - definition of outcomes varied widely
25Conclusion From Sports Trauma and Mouthguard
Studies
- estimates of protective effect of mouthguards
vary widely between and within sports - a substantial number of studies have been done
- most studies conclude mouthguards contribute to
reducing oro-facial injuries
MOUTHA-2-27
26Mouthguard Use in the Military is Unknown
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27Military Data on Occupationally-related Oral
Trauma
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28- Ankle injuries and HEAD TRAUMA tie as the
leading cause of MAJOR injuries in IDF
paratroopers. - Overall injury rate 0.89 or 9/1000 plane jumps.
- Earlier studies show injury rates of 0.3-1.4
or 3.1-14/1000 plane jumps. (Bar-Dyan,
Bar-Dyan, Shemer, Milit Med 1631-2, 1998)
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29 On- and Off-the-job Injury Prevention is
one of the top priorities of LTG Peake, the
Army Surgeon General.
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30 Reducing injuries 10 in the Army would save
an estimated 35m. (COL Bruce Jones, MD,
USACHPPM)
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31 Mouthguards may also be used to prevent
occupationally-related injuries for paratroopers
and for tankers.
MOUTHA-2-31
32Types of Mouthguards
- Stock
- Boil-and-bite
- Custom-made
(Padilla Balikov, CDAJ 2127-37, 1993)
MOUTHA-2-37
33Stock
ready to wear without further preparation
least expensive bulky lack retention must be
held in place by constant occlusal pressure may
interfere with speech or breathing
MOUTHA-2-38
34Boil Bite
immersed in hot water formed in mouth using
finger, tongue biting pressure available in
limited sizes may lack proper extension into
buccal vestibules or posteriorly
MOUTHA-2-39
35Custom-made
fabricated by dentists from stone casts of
patients maxillary arch best adaptation,
maximum retention, comfort stability least
interference with breathing or speech
MOUTHA-2-40
36Stock and boil-and-bite mouthguards can be
purchased at sporting goods stores.
MOUTHA-2-41
37Why Athletes Dont Use Mouthguards
- lack of awareness
- may not know mouthguards are recommended for
the sports they engage in - use not encouraged by coach
- not mandatory for the sports they engage in
- object to mouthguard use
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38Behaviors of athletes are most influenced by
their coaches.
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39Sources of Information About Mouthguards Reported
by Coaches
- Sales representatives 72
- Educational Materials 33
- Dentists 11
- (DeYoung, Godwin, Robinson J Dent Res 72277,
1993)
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40Course of Action for Mouthguards
- educate
- motivate
- fabricate
MOUTHA-2-49
41Educating Patients About Mouthguards
MOUTHA-2-50
42Points to Emphasize Orally
- If you play sports or participate in training
activities such as pugil stick, bayonet, or
confidence course, you may need a mouthguard. - Mouthguards will help protect your teeth against
fractures and loss from sports injuries.
MOUTHA-2-51
43To reinforce your oral message, give patients
take-home flyers on mouthguards.
MOUTHA-2-52
44Why educate people who cant benefit from a
service?
- raise awareness
- diffuse knowledge
- may influence others as a parent, relative, or
peer
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45Mouthguards Should Be Checked Regularly for
- Distortions
- Bite-throughs
- Tears
- If present, replace.
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