Avoid Dental Injuries - Basketball, Scooters and Tramps - Get Your Mouth-Guard On!

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In my years as a pediatric dentist, I dread one call above all others. Usually it comes just as it's getting dark out, and I have just kicked my shoes off for the day. "Dr. Greg, my son (about 2:1) broke his tooth!"

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Various studies report that injuries to the head account for about 7-10% of all emergency room visits. The National Sports Safety Foundation reports over 15 million broken teeth or cut lips and over 5 million lost (avulsed) teeth each year. And, you guessed it, around a quarter of them are directly related to competitive sports injuries! So, which sports you might ask? Football and hockey have virtually no childhood dental injuries; basketball and baseball account for the biggest offenders. The answer is obvious, sports mouth-guards are mandatory for football and hockey, but less that 6% of basketball and baseball players wear them since they are not required.

The American Dental Association estimates a missing permanent tooth lost to injury will cost between ,000 - ,000 over a person's lifetime to replace, repair, maintain and replace again. That's per tooth! Now I am not saying terrible dental injuries from golfing or falling down the steps don't occur, but if basketball and baseball accounts for over half of all dental injuries, my vote is for mandatory! I have heard all the excuses why not to wear one: can't talk, can't breathe, won't stay in; just tell that to the football players who quit complaining a long time ago or the elbow heading toward your smile!

Mouth-guards come in three types: stock, "boil and fit" or custom made. Depending on the level of sport competitiveness and age of the kid, each has its place. Stock mouth-guards are purchased at sporting stores, can often be trimmed with a sharp pair of scissors (don't let your mother catch you using her sewing pair), and are the only real option open to kids who wear braces. Problems with the stock guards are they don't fit well, you have to bite on them to stay in, and they don't work to prevent injuries if they are safely inside the gym bag.

Boil and fit mouth-guards are the most common and inexpensive. Sporting stores such as Sports Authority carry a range of arch sizes. For everyone but the kids with braces, you heat these guards in hot water, bite into them, and form a custom fit. You can trim the edges and you have an upper arch mouth-guard that stays in and is comfortable. If you lose a baby tooth, heat it up again and reform it! These are great for kids under about 13 yrs, but need some parental supervision to prepare.

Custom mouth-guards are readily made by most dental offices. Dental insurance, including Medicaid, will likely cover the expense of about . A custom mouthguard provides a comfortable upper arch cover for teeth and gums that not only protects teeth but lessens impact damage to the jaws and jaw joints. And, they come in colors! They should be considered essential gear for contact sports, as well as skateboarding and gymnastics.

Oh yea, Trampolines and scooters. My personal experience has shown too many kids on a trampoline causes LOTS of dental injuries. Limiting kids on the tramp, matching weights of children jumping together, and mouthguards would go a long way to stopping injuries. Scooters are the same - no more than two at a time please! I welcome your questions and comments. Greg Evans, DDS

Properly Fitted Custom-Made Mouth-guards. Howard Chi, DMD, MA. Compendium. Jan 2007:28(1) pp36-41

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