Sport Health – Sports Medicine Australia 2001; Vol 19 (1): 34-35
Australians probably wear more mouthguards than any other nation
How do you know they are safe as you need?
As a result of continuous work by the Sporting and Dental Communities for at least 15 years, the Australian recreational sportsperson is more aware of the high potential risks and consequences of orodental injury. Consequently, whilst there is world wide evidence of a rise in the number of tooth injuries from sport, Australian injuries fortunately may not be escalating at the same rate. But, there are hidden dangers that few know about, so none of us should be complacent!
Unfortunately, the continuing emphasis and growth in the demand for mouthguards has led to a rapid increase in the range of mouthguard designs that are actively being sold and marketed. This has led in turn to unsupported claims about the effectiveness of some mouthguards.
The fundamental question is: How protective are mouthguards and are they as safe as their makers claim?
For instance, one Australian manufacturer has claimed that a new mouthguard material achieved a ‘32% reduction when impacted by forces less than 10kN’. (Aust Dent J 1997; 42(3): 189-91).
That increase in absorption sounds fantastic but, the maker had only tested a piece of material and not a mouthguard. When the material was made into an entire mouthguard the results were dramatically different. As impact increased, absorption decreased by a startling 72%.
In contrast, the absorbency of the best mouthguards only decreases by about 5% when subject to the same range of impact forces. (Endod Dent Tramatol1999; 15: 157-163).
Yet again, the devil, as we often discover to our cost, is in the detail. It is difficult if not impossible, not only for you, but also for dentists and dental technicians, to critically evaluate supposedly authoritative statements made by ‘experts’. It is for precisely these reasons, that there should be an Australian Standard for mouthguards and we should all be very much aware of what we are recommending.
In its 1995 report Football Injuries to the Head and Neck, the National Health and Medical Research Council identified the urgent need to prevent orodental injuries. Based on research that I conducted with others in Germany in 1994, the Council recommended the creation of an Australian Standard. Since then, although an Australian Standards Technical Committee has been formed, it is not feasible to estimate with any certainty, when a Standard will be available for review. The Committee meets infrequently and there has been little obvious progress.
Another concern is that whilst mouthguards are widely recommended as an essential piece of protective equipment, their use is not compulsory in most contact and collision sports. Mouthguards use is more widespread at the higher levels of competitive play. But, with the main bulk of sports people at the community level, usage rages fall dramatically – sometime to less than 25% of players.
Why is this? It is understandable that the elite competitors may have access to superior equipment and better advice than others in their sport but, can this be justified? No!
Furthermore, despite the widespread support given to mouthguard use as an injury prevention measure, there have been no controlled trials of mouthguards in the field.
The combination of the lack of a Standard and the absence of a controlled field study has placed limits of the soundness and consistency of the advice that educators, trainers, coaches, sports organisations and dentists are able to provide to the sporting community.
In this data vacuum, it is possible for unsubstantiated or doubtful claims or advice to be made.
The lack of a controlled field trial is to be rectified. A new three-year field based study (the Australian Football Injury Prevention Project or AFIPP) will investigate the effectiveness of mouthguards and barriers to mouthguard use in Australian Rules Football.
The AFIPP may partially solve the dilemma and the results could have wide-ranging implications, not only for the entire sporting community, but for the dental profession too.
In the meantime, what can you do?
- Find Out More
- Take advantage of the Internet download Are you Absolutely Sure You or Your Child have Enough Protection from Sporting Injury? available from my website – www.goodinnovations.com – (Note: this information has been updated and is available in ‘Mouthguards and Sport Safety’ from www.mouthguardsafety.com)
- Seriously consider purchasing What You Need to Know to Minimise or Eliminate Dental Injuries in Your Sport. Dr Robert Zaichuck of Canada says, ‘This is the best patient education I have ever seen on the topic’. (Note: this Manual has been updated and is now titled ‘Mouthguards and Sport Safety’)
- By reading this article you have already increased your awareness.
- Take the Same Approach as the AFIPP Research Team
- The first scientific field trial into sports injury prevention to be conducted in Australia will exclusively use Custom Laminated Mouthguards (Playsafe).
- For the Study, the AFIPP required mouthguards that could be produced to a consistently high standard, had proven performance and had been extensively and independently researched and tested.
- You and others will find that once you have worn a mouthguard with the Playsafe (Custom Laminated) level of protection and comfort you will not go back to inferior types.
About the Author
Julian Hodges is an international thermoforming and mouthguard consultant. He introduced Custom Pressure Laminated Mouthguards to Australia in 1984 and since then has lectured on the concept and trained dental specialists in mouthguard fabrication. Julian represents the Australian Dental Industry Association on the Standards Australia Technical Committee for Sports Mouthguards.
