Which youth sports have the most mouth injuries?
If you answered football or hockey, you would be wrong. Because the use of mouth guards in youth and high school football, lacrosse, and ice hockey has been mandatory since the early 1970s, these sports have experienced a dramatic decline in the number of dental and jaw injuries. Instead, published reports show that the majority of mouth injuries occur in popular youth sports such as baseball, basketball, soccer, field hockey, softball, and gymnastics, which lag far behind in injury protection. Recent studies also report that oral and facial injuries to female athletes exceed those in males. According to a study published in the Journal of Pediatric Dentistry, roughly three times as many mouth injuries occur on the basketball court as on the football field. Most of these injuries could have been prevented with the simple use of a mouth guard.
Are mouth injuries serious?
You bet they are. Injuries to the mouth and jaw, such as broken, cracked, and lost teeth and jaw and joint fractures, are painful and hard to treat:
- Severe jaw and joint injuries may require surgery and general anesthesia, which requires hospitalization and wiring the jaw shut for 30 days to let the injury heal.
- A lost tooth must be re-implanted, or false teeth made and fitted. Although easier to treat than a broken or fractured jaw, lost teeth are just as painful.
- Players wearing braces can sustain serious mouth lacerations if the braces are hit with a ball or by another player. These types of injuries may call for extensive repair and can lengthen orthodontic treatment time.
Three Different Types of Mouth Guards
A mouth guard is a piece of soft plastic shaped to fit inside the mouth, protecting the lips, cheeks, tongue, teeth, and jaw when they are hit by large object, such as a ball or someone’s elbow or head.
There are 3 main types of mouth guards:
- Stock: The least expensive style, stock-type mouth guards cost about $2.00 and come in three sizes: small, medium, and large. You get what you pay for in terms of fit. Some users complain that they are too wide in the back, making it harder to talk.
- Boil & Bite: A semi-custom fit can be made using a “boil and bite” model mouth guard. Hot water is used to soften the plastic, and your child then bites into the guard, molding it to his or her teeth. This type of mouth guard sells for between $5 and $15 and offers very good protection.
- Custom: A dentist or orthodontist makes the best-fitting mouth guards in a dental office. Not surprisingly, this kind of mouth guard is the most expensive of the three, costing between $35 and $65. Custom mouth guards are the best option if your child plays a number of sports each year or plays sports with continuous activity, like basketball or soccer. Custom mouth guards are advised for children with braces so that the mouth guard will not interfere with treatment (for more on mouthguards for children with braces, click here). Once a child reaches age 13 or 14, a custom-fitted mouth guard should generally continue to fit for as long as needed.
No 1 type of mouth guard is recognized as providing more protection. “The key point is to play it safe,” says Dr. Hugh R. Phillis, a trustee of the American Association of Orthodontists and an orthodontist in Nashua, New Hampshire. “Any mouth guard is better than none,” he says.
What kind of injuries do mouth guards prevent?
Mouth guards, regardless of type, help prevent injury to the mouth, teeth, lips, cheeks, and tongue. Mouth guards worn by players with braces may even prevent injury to another player caused by contact with the braces. They also cushion blows that might cause jaw fractures.
Whether mouth guards also protect against concussion is unclear. According to the National Association of Athletic Trainers’ 2004 Position Statement on the Management of Sport-Related Concussion, the “wearing of a mouth guard is thought by some to provide additional protection for the athlete against concussion by either reducing the risk of injury or reducing the severity of the injury itself.” The NATA notes, however, the absence of biomechanical studies to support the theory that mouth guards result in less force being delivered to the brain at the point of head contact.
Even though a mouth protector is worn, it is still possible for a tooth to be knocked out; however, the wearing of a protector will significantly reduce the risk of tooth injuries.
Replacing a Mouth Guard
A new study published in the September/October issue of Sports Health: A Multidisciplinary Approach found that mouth guards may increase the number and intensity of mouth cuts and abrasions, exposing an athlete to an increased chance of infection due to the bacteria, yeast, and fungi that mouth guards routinely collect.
Researchers stress that even with the increase in oral lesions, mouth guards are still an important piece of safety equipment for contact sports. “By no means should the value of a mouth guard be discounted,” Glass emphasizes. “The protection they do offer teeth during contact sports is important. However, the length of time that a mouth guard is used and how often it is cleaned needs to be revised.”
As a result, oral health professionals now recommend four safety steps:
- Replace the mouth guard regularly or when it becomes sharp or jagged. A mouth guard should be replaced as soon as it becomes distorted or develops sharp jagged edges, or after 14 days of regular use.
- Replace the mouth guard if you develop oral irritation or an ulcer. Because the molds from mouth guards may cause exercise-induced asthma and allergies, mouth guards should be replaced whenever an athlete develops any type of oral lesion (mouth sore) or respiratory distress.
- Sanitize the mouth guard daily. Because mouth guards have a natural ability to become a breeding ground for bacteria, fungi, and mold, they should be sanitized on a daily basis using a commercially available antimicrobial denture-cleansing solution.
- Attend ongoing oral exams. Athletes’ mouths should be examined on an ongoing basis while they are using mouth guards.
“This study stresses the importance of informing athletes of the danger of not properly taking care of a mouth guard. A mouth guard will do your mouth good only if you keep it in good shape,” adds Glass.
In what sports should mouth guards be worn?
The American Academy of Pediatric Dentistry recommends a sports mouth guard for all youth competition, regardless of age. The American Dental Association recommends mouth guards for the following sports:
- Martial Arts
- Water Polo
- Discus Throwing
- Ice Hockey
- Shot Putting
- Field Hockey
Some athletic associations are getting the message that mouth guards are an important piece of sports equipment. In the fall of 1999, for instance, the Massachusetts Interscholastic Athletic Association, the governing body in the state for high school athletics, made mouth guards mandatory for junior varsity and varsity soccer players for the first time. Mouth guards may soon become mandatory in other sports as well.
Updated and revised August 25, 2009