Redefining The Athlete – Dentist Relationship!

Abstract

What do you think is important to an athlete? Body or Teeth? For his or her good athletic performance, both are essentially important. In this review, the relationship between sports and dentistry will be discussed, in addition to the importance of educating parents, teachers, and children in prevention of injuries related to the sports.

Introduction

An optimal oral health condition contributes massively in achieving optimal performance during competitions. Therefore, the role of dentistry is vital in sports.

It is the duty of a dentist to detect problems of the athlete, such as mouth breathing, poor positioning of the arches, and properly administer medications free of substances, that may provide the positive doping present in many painkillers. Protection of the teeth and gums during the sport should also be looked into.

Sports Dentistry – an upcoming sub-specialty

Sports Dentistry is a less recognized branch of dentistry that involves the prevention, maintenance and treatment of oral and facial injuries. It also involves the collection, dissemination of information on dental trauma and research stimulation. Sports Dentistry till date as a specialty is not included as a compulsory subject in the curriculum offered at most universities globally.

Certain sports are among those, in which the risk of injury due to any sort of impact is considered to be high,such as

• boxing,
• judo,
• karate,
• jiu-jitsu,
• wrestling,
• sumo,
• soccer,
• basketball,
• volleyball,
• handball,
• mountain biking,
• motocross,
• hockey and
• skating

In these sports, both amateur and professional athletes are affected by oral health problems.

Sport-related Traumatic Injuries

Dental trauma in sports is like a linking channel between sports and dentistry. An injury that affects an athlete's oral health can be just as serious as sprained ankles, torn ligaments or broken bones.

Approximately 80% of all dental injuries affect one, if not more, of the front teeth. Two of the best means of protection against oral injuries are through the use of

• helmets and
• mouth guards.

In high-risk sports activities like snowboard riders, who are subjected to falls or collisions should use protective helmets fabricated from polycarbonate to reduce the risk of oral, facial and skull lesions. They promote better distribution of the stresses and forces attenuating impact energy. The location of the nasal bone is anatomically potentially more vulnerable to injuries.

Since 1950 American Dental Association recommends use of mouth guards to prevent dento alveolar trauma during sports activity. The National Federation of High School Athletics (NFHSA) has established rules for all sports that require mouth guards in schools, which include high school football, hockey and lacrosse.

Lack of awareness among athletes to use the protectors during training and competition is justified due to discomfort in breathing and pronunciation difficulties. Face shields does not guarantee that the entire oral and facial lesions will be prevented but can help in minimizing the damage depending on the magnitude and source of force.

Mouth Guards and Sports

Mouth guards are coverings worn over teeth, used to protect them from injury due to teeth grinding and during sports. Mouth guard don’t not affect systemic functions of the athlete. It dissipates the stress transmitted in the area of impact and reduces the

• incidence of lacerations of soft tissue,
• trauma to the anterior teeth after a frontal blow,
• damage to the posterior teeth in both arches and
• mandibular fractures.

Mouth guards are generally classified into three categories: pre-fabricated, thermoplastic and custom.

Stock mouth protectors

• Ready to wear type and can be bought at most sporting goods stores
• Inexpensive, Bulky, Breathing and talking difficulty
• Little can be done to adjust fit
• Very minimal protection
• Not recommended by Dentists to use

Boil and bite mouth protectors

• Can be bought at many sporting goods stores
• May offer a better fit than stock mouth protectors.
• Made of thermoplastic material.
• Placed in hot water to soften, then placed in the mouth and shaped around the teeth using finger and tongue pressure.

Custom-fitted mouth protectors

• Individually designed in a dental office or a professional laboratory based on the dentist's instructions.
• Most comfortable type of mouth guard providing excellent protection.
• Expensive due to the use of special material and extra time and work involved.

Athletes usually prefer prefabricated or thermoplastic mouth guards because they find it less expensive. However, these categories have deficiencies such as excessive weight and bad fit. Mouth guard must be made by a dentist, using plaster model of the athlete. Regardless of the material, a mouth guard fabricated for the athlete should not hamper with the phonetics and breathing. Mouth guards should be replaced after a season of use.

Other Athlete – Specific Problems

Dentists play an important role in enhancing the psychological situation of athletes and improving muscle performance. In 2004, at Athens Olympics, dental care was among a highly searched service and various dental procedures were performed.

Carbonated sports drinks have a detrimental effect on the teeth due to low pH and the presence of citric acid in its composition. It acts like an erosive for tooth tissue if consumed frequently. They are mainly consumed with the purpose of rehydration and electrolyte replacement during highly aerobic sports. The low pH of carbonated sports drinks also affect the color of composite resin restorations.

Swimming athletes are often found affected with biocorrosion of enamel due to the chlorination of pools to reduce bacterial contamination and algae. Divers suffer barodontalgia due to changes in barometric pressure. Changes in atmospheric pressure cause dental barotraumas, manifesting as tooth fracture reduction and retention. Studies provide cases of athletes who died from bacterial endocarditic from foci of oral infections. Changing the volume of gas within cavities of the rigid body, associated with fluctuations in atmospheric pressure can cause adverse effects, most commonly oral diseases.

It is important that the dentist makes a detailed assessment of oral health status of the athlete to detect changes and pathologies such as dental malocclusion. Alterations in the occlusion can significantly interfere with the efficacy of chewing, and subsequent digestion of food, thus impairing nutrient absorption.

Sports Dentistry – How to Learn

The Academy of Sports Dentistry, which is recognized by the American Dental Association, is the most reputable professional dental association that provides continuing sports dentistry education and training to dentists. The Academy also provides dentists with guidance about what is appropriate regarding mouth guards and injury protection, as well as information from reputable sources about what is proven, researched and recommended. In United States, there is no fellowship or residency program for sports dentistry as there is for sports medicine.

Dentistry must have their place of importance in the life of the athlete. Specialized education programs emphasizing upon the importance of first aid measures for dental trauma is essential to promote the knowledge, awareness and motivation among athletes and coaches. Future research is also needed for better guidelines.

REFERENCES

Labella CR, Smith BW, Sigurdsson A. : Effect of mouthguards on dental injuries and concussions in college basketball. Med Sci Sports Exerc. 2002;34:41–44,.