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 “While there are several good commercially available mouthguard
products, all of them require self-adjustment by the athlete and
certain amount of practice to achieve good fit,” Dr. Trenton E.
Gould from The University of Southern Mississippi in Hattiesburg
told Reuters Health by email.
“Custom fabricated mouthguards, properly fitted by a dentist, can
often help optimize fit and comfort, both of which contribute to
enhanced compliant usage,” he added.
The National Federation of State High School Associations requires
mouthguards in only five sports, and the National Collegiate
Athletic Association mandates them in only four sports – but oral
and dental injuries account for up to 38 percent of all
sport-specific injuries, according to NATA.
In a new position statement, the organization makes 31
recommendations for preventing and managing sport-related dental and
oral injuries. While most of advice applies to athletic trainers and
other healthcare professionals, several of the recommendations are
relevant for coaches, athletes and parents, too.
The most important have to do with the wear and care of mouthguards,
which as Gould said should be properly fitted and worn consistently.
Athletes should examine their mouthguards daily for fit and for any
damage, and the mouthguard should be replaced if it is loose or
damaged. Especially for younger athletes, the mouthguard should be
routinely inspected for fit and retention to accommodate new teeth
and growth.
In addition, said Gould, who is one of the authors of the position
statement, “Clinicians, athletic trainers, coaches, and parents
should have a plan for how to deal with dental trauma.” At minimum,
he added, an appropriate oral health care specialist should be
identified in advance for emergencies.
“Most of the dental injury classifications (including tooth and root
fractures) covered in the position statement do not represent a
dental emergency,” Gould said. “As such, the athlete can be allowed
to return to play immediately as pain permits, often with a
mouthguard in place to prevent further injury. No additional time
loss is warranted, but the athlete should be referred to a
trauma-ready dentist within 24 hours.”
In contrast, significant displacement of teeth and tooth loss
require immediate removal from participation and referral to a
trauma-ready dentist or emergency facility.
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While the athletic trainer should know how to handle tooth loss,
it’s useful for athletes and parents to know what to do with those
teeth. Since the single most important factor for optimal healing is
putting the tooth back where it came from, this should be the first
objective. The tooth might need to be rinsed gently in cold water,
milk, or IV salt solution. After it is replanted, the athlete should
bite down on a sterile gauze pad to keep the tooth in place until
the dentist can take care of it.
If the tooth can’t be replanted immediately, it should be submerged
in a special salt solution – or, if that’s not available, in cold
low-fat milk – for transport. It should not be wrapped in dry gauze
or a dry paper towel.
Especially for these more serious injuries, it’s up to the dentist
to determine when it’s safe for the athlete to return to
participation.
“It is critical to have the right sports medicine team including
athletic trainers in place to address dental injuries should they
occur,” Gould said. “Proper prevention and treatment can ensure the
right sports safety protocols are in place so that the athlete can
return to activity safely and effectively.”
The complete set of recommendations and the evidence supporting them
appear in the Journal of Athletic Training.
SOURCE: http://bit.ly/2huuds0 Journal of Athletic Training, online
December 5, 2016.
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