April 2014

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Posted on August 15, 2014
April Pediatric Dentistry Fort Collins Blog

Wow, March went quick. Funny that I see flowers coming up and the edges of lawns greening up. Our family started it’s travel for boys Lacrosse this weekend and were treated to a gorgeous stadium setting on the DU campus; the kids scrimmaged a Denver team at half time. What a blast!

Our topic this month is a revisiting of sports mouth guards. I have been very busy making custom mouthguards for my son’s teammates, so sports and pediatric dentistry is very relevant!

First the statistics, about 7% of all emergency room visits are due to injuries to the head and neck and most of these are related to the jaws and teeth. A knocked out permanent tooth will cost around $15,000 to replace and maintain over a person’s lifetime. Getting hit in the mouth with a stick or elbow or ball is painful and potentially disfiguring. I treat a lot of these injuries every year, and absolutely NONE have occurred when a mouthguard was being worn.

Most of the hang ups about mouthguards are in two camps. The first is our traditional beliefs. We think certain sports need them and others don’t. Football and hockey require mouthguards as does Lacrosse so injuries are way down (locker room and backyard play not included) compared to basketball, soccer and volley ball. The second complaint is a kid can’t talk or breathe well with a mouthguard in place; this complaint is one with design of the mouthguard or a kid negotiating.

Mouthguards come in three flavors, non-moldable, boil and bites, and custom made. This industry has exploded in recent years along with the explosion of interest in alternative and girls sports. And, like any business, there will be companies that prey upon the fears of parents or our fascination with technology. I can’t believe the costs and marketing that goes into some of these products. We have colors, injection molding for shock absorption, straps, bumps and choices of upper and lowers, wow!

I think all that hype is just hype. I have heard of no credible, scientific source that has shown the bells and whistles to be any safer that the more traditional flexible, single ply mouthguards. I used to advocate for the non moldable varieties for kids in braces and the boil and bite mouthguards for children until they get all permanent teeth. While that is still the best advice to save money, the money you are saving is actually minimal compared to the comfort and functionality of the custom made mouthguard.

Mouth guards require an even layer of soft plastic between the teeth and a flange that covers the entire facial surface of the tooth and ends along the fixed or keratinized gum tissue. Most commercial mouthguards have too thick of a biting surface and do not go far enough above the teeth. These factors determine the protection from a blow to the jaws and direct blow to the teeth. With a blow to the jaws, the less far apart the jaws are, the less the jaw is translated out of its resting “socket” and vulnerable to dislocation injury. Fat, fancy mouthguards are fine for blows DIRECTLY under the chin moving only vertically, but that simply isn’t where most blows occur!

The flange of the guard needs to go above the teeth for two reasons, protect the teeth and give retention to the guard. The reality is if the mouthguard does not fit tight enough for a kid to talk with it in and forget about it in the mouth, they will constantly be readjusting and playing with it. I just saw a picture in the national Lacrosse magazine of this college kid making a play with his mouthguard half out of his mouth, ridiculous! That is also why I don’t like straps on mouthguards, if the mouthguard can hang out of the mouth, it will! So in the final analysis, I am pushing for custom made mouthguards from your dentist. They are the qualified people to make a well fitting mouthguard. I charge $35 bucks. That no longer seems that much in relation to cleats, helmets, pads or other protective gear. For kids with braces, rope wax can be placed on the braces prior to the dental impression, so a custom mouthguard can be made without interfering with braces progression. And for best retention, upper mouthguards are the best, hands down. Call me pushy, but if you are on my son’s team, I made them for free – I feel they were that important even for fourth graders!

A mom / coach just related a story to me last week. One of her volleyball kids took a direct blow to the face with a ball. She was in braces at the time which saved her teeth but made hamburger out of her lips from being cut by the braces. She barely made it through the season for fear of being hit again, and she didn’t go out for volleyball again. The cost of a mouthguard would have saved that kid from a bad experience and maybe changed the way she views sports from now on.

I hope that gives you food for thought. I want to help you raise healthy, happy children, so call me or write for any questions you may have. I am atgreg@biggrinswithdrgreg.com or (970) 407 1020. Have a great season! Go Vipers LAX! Yours, Greg