Monday, October 28, 2013

Mouthguards - Protecting Your Child During High Impact Sports

According to the American Academy of Pediatric Dentistry (AAPD), approximately 30 million children in the US participate in some sort of organized sports program, which is very good news for the youth of our country.  However, as pediatric dentists, we see the only downside to having our young patients out there playing team sports – the dental trauma from sporting accidents. The AAPD reports that about 32% of serious dental trauma occurs during sporting activities, with baseball and basketball leading the pack as having the highest rates of sports-related dental injuries.  Mandating and updating gear such as helmets and facemasks in sports like lacrosse and football have greatly reduced the number of dental trauma injuries to our children, but we lag behind greatly in the areas of protecting kids in other sports that do not mandate protective facial gear.

As parents and professionals, what do we do?  The consequences of orofacial trauma can often go on for months or years, in terms of pain, expense, loss of time at school (and parents’ work) and can psychologically affect children and teenagers who may have to cope with broken or lost teeth.   There are some recommendations we can make to our patients which will hopefully lower the risk of a serious injury to your child’s mouth and teeth – but they do involve wearing a protective mouthguard consistently.

There are three types of mouthguards available:

-     -      “Stock” mouthguards can be purchased over-the-counter at any sporting goods store.  They are designed for use without any modification and must be held in place by clenching the teeth together.  Positives: They are a good option for those patients whose mouths are rapidly changing because of orthodontic brackets and appliances. Negatives: These mouthguards can be cumbersome and can interfere with breathing or speaking. They may also provide less protection than custom mouthguards, as their retention can be poor.

-       -    Mouth-formed “boil-and-bite” mouthguards are adapted to the mouth by immersing the appliance into hot water and then applying biting pressure to the mouthguard for fit.  Positives: These mouthguards are most commonly used by athletes because they are more comfortable than the “stock” mouthguards, can be purchased at most sporting good stores, and can be fitted in the convenience of your own home. Negatives:  They can vary greatly in size, protection, retention, comfort and cost.

-        -   Custom-fabricated mouthguards are the most highly recommended type of mouthguards – these are produced from a dental model of the patient’s mouth and delivered with the supervision of a dentist. Positives: Superior because they are designed for maximum protection, cushioning and retention by ensuring all the teeth are covered, as it is fabricated with a highly detailed dental impression.  Negatives: In children and teenagers, their mouths change so rapidly that often a custom-fabricated mouthguard may not last more than one sports season (3-6 months), and it can also be the most expensive option. This process involves 2 appointments – the 1st is to take a dental impression and the 2nd appointment is to deliver the final mouthguard. When a custom mouthguard is not available or feasable, the Academy for Sports Dentistry (ASD) prefers the mouth-formed or “boil-and-bite” mouthguard.

It’s always best to talk to your dentist during your child’s exam as to the best course of action to take when protecting them from high-impact sports. We have trained our children to make the automatic move to click their seat belt when they get into the car, or put on a bike helmet, so it is time to take the first step in training them to become adults who consider a mouthguard a crucial part of their sporting equipment.  Together we can all do our best to make sure the beautiful smiles we work so hard to keep are there for their lifetime!

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