MouthProtectionInfoForClinic

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Sports

Published on January 14, 2009

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Put More “Bite” Into Health Promotion : Put More “Bite” Into Health Promotion Mouthguard Initiative MOUTHA-2-01 Objectives of the “Bite” Mouthguard Initiative : Objectives 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 MOUTHA-2-02 Sports dentistry deals with impact-type injuries : Sports dentistry deals with impact-type injuries MOUTHA-2-03 Types of Impact Injuries in Sports : Types of Impact Injuries in Sports participant apparatus (e.g. bat) projectile (e.g., ball or puck) (Pinkham & Kohn, Dent Clinics N Amer 35:609-26, 1991) MOUTHA-2-03 Ability of Projectiles inSports to Cause Injury : Ability 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 35:609-26, 1991) MOUTHA-2-05 Mouthguards are especially recommended for collision, contact and fast-moving sports. : Mouthguards are especially recommended for collision, contact and fast-moving sports. MOUTHA-2-06 Sports with Mandatory Mouthguard Rules for Practice and Competition : Sports with Mandatory Mouthguard Rules for Practice and Competition Amateur boxing football ice hockey men’s lacrosse women’s field hockey Professional boxing (Ranalli and Lancaster, J Public Health Dent 53: 96-100, 1993) MOUTHA-2-07 Evolution of Mouth Protection in Sports : Evolution of Mouth Protection in Sports Year Event 1913 boxing 1st sport to introduce mouth protection 1960 Nat’l Fed State H.S. Assns mandates face guards for high school football 1962 Nat’l 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 Nat’l Academy for Sports Dentistry established 1990 NCAA mandates mouthguards be a visible color (Johnsen & Winters, Dent Clinics N Amer 35:657-66, 1991; Lancaster and Ranalli, Pediatric Dent 15:398-402, 1993) MOUTHA-2-08 ADA Endorsement of Mouthguards : ADA 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 35:657-66, 1991) MOUTHA-2-09 Academy for Sports Dentistry endorses mouthguard use for the following sports: : Academy 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 35:657-66, 1991) MOUTHA-2-06 Protective Benefits of Mouthguards : Protective 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 35:657-66, 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 49:22-24, 1982) MOUTHA-2-11 Cost/Benefit of Mouthguards : Cost/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 109:84-7, 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 35:733-56, 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 77:632-36, 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 128:1273-74, 1997) MOUTHA-2-12 Incidence of Tooth Avulsions or Fractures in the Military is Unknown : Incidence of Tooth Avulsions or Fractures in the Military is Unknown MOUTHA-2-13 Proportion of Tooth Avulsions or Fractures Due to Sports-Related Injuries in the Military is Also Unknown : Proportion of Tooth Avulsions or Fractures Due to Sports-Related Injuries in the Military is Also Unknown MOUTHA-2-14 Civilian Incidence/Prevalence Data on Sports-Related Oral Trauma : Civilian Incidence/Prevalence Data on Sports-Related Oral Trauma MOUTHA-2-15 Multi-sport : Multi-sport Over 5 million teeth are knocked out at sporting events each year (ADA Council on Dental Materials, JADA 109:84-7, 1984) Nat’l 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 21:27-37, 1993) MOUTHA-2-16 Multi-sport Continued : Multi-sport Continued 13% of all dental injuries are sport-related (Hayrinen-Immonen et al., Endod Dent Traumatol 6:208, 1990) Of all sports-related accidents, 11-18% are maxillo-facial injuries (San, Proc Finn Dent Soc 84:Supplement IV, 1988) MOUTHA-2-17 Multi-sport : Multi-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 11:209-13, 1989) MOUTHA-2-18 Civilian Studies : Civilian Studies Year Population % of Injuries to Oral Region 1951 H.S. football 50% players in 3 states (Cathert, Dent Digest 57:346-48, 1951) 1954 H.S. football 54% nationwide (1954-55 Handbk, Nat’l Fed State H.S. Assns) 1960 H.S. football players 20% in Wisconsin (Morrey, JADA 64:392-3, 1962) MOUTHA-2-19 Football : Football 3.9% of a high school football players suffered from oral trauma while wearing mouth guards. (Garon, Merkle, and Wright, JADA 112:663-65, 1986) MOUTHA-2-20 Basketball : Basketball 7.5% of female college basketball players sustain orofacial injuries. (Morrow, Bonci, Seals, & Barnwell, I Natl Athletic Trainers Assoc 26:334-5, 1991) 10% of male college basketball players sustain orofacioal injuries. (Morrow et al., J Nat’l Athletic Trainers Assoc. 26:338-42, 1991) MOUTHA-2-21 Baseball : Baseball Of all baseball injuries, 41% occur to the head, face, mouth or eyes. (U.S. Consumer Product Safety Commission, 1981) MOUTHA-2-22 Rugby : Rugby Poll of 1987 U.S. World Cup Team 95% believe mouthguards protect 50% wear mouthguards (Chapman, Am J Sports Med 17:690-91, 1989) MOUTHA-2-23 Limitations of Sports Trauma and Mouthguard Studies : Limitations 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 Conclusion From Sports Trauma and Mouthguard Studies : Conclusion 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 Mouthguard Use in the Military is Unknown : Mouthguard Use in the Military is Unknown MOUTHA-2-28 Slide 27: Military Data on Occupationally-related Oral Trauma MOUTHA-2-33 Slide 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 163:1-2, 1998) MOUTHA-2-34 Slide 29: On- and Off-the-job Injury Prevention is one of the top priorities of LTG Peake, the Army Surgeon General. MOUTHA-2-32 Slide 30: Reducing injuries 10% in the Army would save an estimated $35m. (COL Bruce Jones, MD, USACHPPM) MOUTHA-2-36 Slide 31: Mouthguards may also be used to prevent occupationally-related injuries for paratroopers and for tankers. MOUTHA-2-31 Types of Mouthguards : Types of Mouthguards Stock Boil-and-bite Custom-made MOUTHA-2-37 (Padilla & Balikov, CDAJ 21:27-37, 1993) Stock : Stock 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 Boil & Bite : Boil & 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 Custom-made : Custom-made fabricated by dentists from stone casts of patient’s maxillary arch; best adaptation, maximum retention, comfort & stability; least interference with breathing or speech MOUTHA-2-40 Stock and boil-and-bite mouthguards can be purchased at sporting goods stores. : Stock and boil-and-bite mouthguards can be purchased at sporting goods stores. MOUTHA-2-41 Why Athletes Don’t Use Mouthguards : Why Athletes Don’t 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 MOUTHA-2-46 Behaviors of athletes are most influenced by their coaches. : Behaviors of athletes are most influenced by their coaches. MOUTHA-2-47 Sources of Information About Mouthguards Reported by Coaches : Sources of Information About Mouthguards Reported by Coaches Sales representatives 72% Educational Materials 33% Dentists 11% (DeYoung, Godwin, & Robinson J Dent Res 72:277, 1993) MOUTHA-2-48 Course of Action for Mouthguards : Course of Action for Mouthguards educate motivate fabricate MOUTHA-2-49 Educating Patients About Mouthguards : Educating Patients About Mouthguards MOUTHA-2-50 Points to Emphasize Orally : Points 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 To reinforce your oral message, give patients take-home flyers on mouthguards. : To reinforce your oral message, give patients take-home flyers on mouthguards. MOUTHA-2-52 Why educate people who can’t benefit from a service? : Why educate people who can’t benefit from a service? raise awareness diffuse knowledge may influence others as a parent, relative, or peer MOUTHA-2-53 Mouthguards Should Be Checked Regularly for: : Mouthguards Should Be Checked Regularly for: Distortions Bite-throughs Tears If present, replace. MOUTHA-2-54

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