Sports Medicine Research: In the Lab & In the Field: Dental Injuries Surveillance Supports Use of Properly Fitted Mouthguards (Sports Med Res)
Wednesday, November 18, 2015

Dental Injuries Surveillance Supports Use of Properly Fitted Mouthguards

Dental injuries sustained by high school athletes in the United States, from 2008/2009 through 2013/2014 academic years.

Collins CL, McKenzie LB, Ferketich AK, Andridge R, Xiang H, and Comstock RD. Dental Traumatology. 2015; [Epub ahead of print].
http://onlinelibrary.wiley.com/doi/10.1111/edt.12228/abstract

Take Home Message: Dental injuries were relatively rare among high school athletes but most of these injuries occurred while an athlete was not wearing a properly fitted mouthguard.

Dental injuries that occur during sports not only impact the player in the short term but may lead to long-term functional, social and psychological impacts. By better understanding the frequency of dental injuries and the circumstances surrounding those injuries, protocols and equipment regulations can be implemented to decrease the risk of injury. Therefore, Collins and colleagues completed a study to estimate the rate of dental injuries among high school athletes in the United States. Furthermore, they also examined the use of mouthguards. The researchers extracted data from the National High School Sports-Related Injury Surveillance Study from the 2008/2009 through 2013/2014 academic school years. Injuries reported to the National High School Sports-Related Injury Surveillance Study were recorded on an internet-based surveillance system. Each reported injury entry included details regarding age, year in school, injury site, injury type, injury severity, and any protective equipment used (including mouthguards). Athlete exposure was considered 1 athlete participating in 1 practice or competition. An injury was defined as an event that required medical attention by a medical professional during a practice, game or competition and resulted in a restriction of the athlete’s participation 1 or more days. Overall, 222 dental injuries were recorded. This occurred during 24,787,2588 athlete exposures resulting in a rate of 0.9 dental injuries per 100,000 exposures. An athlete was three times more likely to have a dental injury during competition than practice.  Athletes participating in field hockey, boys’ basketball, boys’ baseball and wrestling had the highest rates of dental injuries. The injuries most commonly reported were laceration (37%) and chipped/fractured tooth (24%). The most common mechanism was contact with another player (61%). Of the 222 reported dental injuries, 161(73%) athletes were not wearing mouthguards at the time of injury. Forty-seven (22%) injuries occurred while the athlete was wearing a self-fitted (boil-and-bite) mouthguard and 2 injuries occurred when an athlete was wearing a professionally fitted mouthguard. 

Overall, these results support using a well-fitted mouthguard to reduce the risk of dental injuries. This may be particularly important for athletes in field hockey, boys’ basketball, boys’ baseball and wrestling because they had the highest rates of dental injuries. These sports may benefit from a mandate that all athletes participating in these sports wear mouthguards or another piece of equipment to protect the athlete’s mouth and teeth. Also interesting was the fact that only 2 out of 222 (0.9%) injuries occurred to athletes wearing a professionally fitted mouthguard. This suggests that self-fitted mouthguards may not been as effective as a professionally fitted ones. We need to be careful since this was not a clinical trial testing the effectiveness of professionally fitted mouthguards and these findings may be attributable to less athletes in general wearing professionally fitting mouthguards but prior trials have shown the benefits of a well fitted mouthguard. Hence, clinicians should not only encourage their athletes to wear mouthguards during both practice and competition but also strongly encourage athletes to wear mouthguards that are professionally fitted. 

Questions for Discussion: What education, if any do you currently do with your athletes with regards to wearing mouthguards? Would you be in favor of regulations which would make wearing a mouthguard mandatory?

Written by: Kyle Harris
Reviewed by:  Jeffrey Driban

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Collins, C., McKenzie, L., Ferketich, A., Andridge, R., Xiang, H., & Comstock, R. (2015). Dental injuries sustained by high school athletes in the United States, from 2008/2009 through 2013/2014 academic years Dental Traumatology DOI: 10.1111/edt.12228

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