Oro-dental trauma burden and mouthguard usage among contact sports players: A call for sports dentistry initiatives in Sri Lanka.

BACKGROUND/AIM: Contact sports-related oro-dental trauma contributes to a significant proportion of sports injuries among school children. Oro-dental trauma imposes a detrimental impact on the oral health-related quality of life. However, the burden of oro-dental trauma among contact sports players and their practices of mouthguards remains a research gap in Sri Lanka. The current study bridges that while providing evidence for contextual changes such as initiating sports dentistry. MATERIALS AND METHODS: The study was conducted among 1340 adolescent contact sports players in Colombo district, Sri Lanka; 63.1% males and 36.9% females (age 13-18), who were enrolled in football, rugby, hockey, boxing, basketball, and martial arts in the school setting. A checklist was administered to obtain demographic information, sports practices, and the use of mouthguards. An oral examination was conducted for those who experienced oro-dental trauma during the last 12 months. RESULTS: Self-reported oro-dental trauma pooled prevalence of the contact sports players was 35.9% (95% CI = 33.3-38.5), with males' preponderance. Dental trauma was present in 23.8% (n = 319), while 15.8% were uncomplicated and 8% were complicated. Soft tissue injuries were present in 12.1% (n = 162). Oro dental trauma (ODT) was highly prevalent among boxing, rugby, and hockey players. Only 20.8% (n = 279) of players used mouthguards. However, 91.0% (n = 254) of them were using ready-made mouthguards. Mouthguard use and the type of mouthguard showed statistically significant associations across the type of oro-dental trauma among contact sports players. CONCLUSIONS: Contact sports-related oro-dental trauma prevalence is as high as 35.9% among Colombo district school children in Sri Lanka. However, their level of mouthguard usage is shallow at 20.8%. Further research is necessary to investigate the reasons behind this, and national guidelines should be developed to prevent and manage sports-related accidental injuries.

Development of a Wearable Mouth Guard Device for Monitoring Teeth Clenching during Exercise.

Teeth clenching during exercise is important for sports performance and health. Recently, several mouth guard (MG)-type wearable devices for exercise were studied because they do not disrupt the exercise. In this study, we developed a wearable MG device with force sensors on both sides of the maxillary first molars to monitor teeth clenching. The force sensor output increased linearly up to 70 N. In four simple occlusion tests, the trends exhibited by the outputs of the MG sensor were consistent with those of an electromyogram (EMG), and the MG device featured sufficient temporal resolution to measure the timing of teeth clenching. When the jaw moved, the MG sensor outputs depended on the sensor position. The MG sensor output from the teeth-grinding test agreed with the video-motion analysis results. It was comparatively difficult to use the EMG because it contained a significant noise level. Finally, the usefulness of the MG sensor was confirmed through an exercise tolerance test. This study indicated that the developed wearable MG device is useful for monitoring clenching timing and duration, and the degree of clenching during exercise, which can contribute to explaining the relationship between teeth clenching and sports performance.

[The results of orthodontic treatment using aligners from the perspective of quality of life of patients with dentoalveolar anomalies]. / Rezul'taty ortodonticheskogo lecheniya elainerami s pozitsii kachestva zhizni patsientov s zubochelyustnymi anomaliyami.

THE AIM OF THE STUDY WAS TO ANALYZE: The impact of morphological and functional dental components on the quality of life of adult patients undergoing orthodontic treatment using clear aligners. MATERIALS AND METHODS: Morphological and functional results of orthodontic treatment with aligners as well as the dynamics of oral health related quality of life was assessed in 55 patients aged from 20 to 25 years. RESULTS: The study of the efficacy of orthodontic treatment with aligners showed significant improvement of morphological and functional features of dental arches as well as oral health related quality of life in the course of treatment. CONCLUSION: Orthodontic treatment with aligners is efficient for achieving morphological and functional improvement and enhances social adaptation of patients by increasing oral health related quality of life.

Prevalence of dentofacial injuries in contact sports players: A systematic review and meta-analysis.

BACKGROUNDS/AIMS: Contact sports present intense physical contact, and usually, players have a high risk for dentofacial injuries. It is unclear how often these injuries occur and which contact sports present the highest rates. The aim of this study was to assess the prevalence of dentofacial injuries among contact sports participants. METHODS: A literature search was performed in seven electronic databases (Embase, LILACS, LIVIVO, PubMed, Scopus, SportDiscus, and Web of Science). The gray literature (Google Scholar, OpenGrey, and ProQuest), as well as the reference lists of included studies, was assessed. Experts were consulted to indicate additional studies. The eligible studies were observational studies that contained details of the contact sports participants who were aged over 18 years old, either professional or not, who sustained at least one dentofacial injury in the past, the number of sustained injuries, and studies which provided quantitative data on the characteristics of the dentofacial injuries, such as type and site. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS: Among 1152 identified studies, 17 articles remained for final analysis. One study was classified as high risk of bias, 14 studies as moderate, and two as low risk. The overall prevalence of dentofacial injuries was 27.57% (95% CI: 17.87-38.47). The prevalence in each sport was rugby 37.36% (95% CI: 17.45-59.82), basketball 27.26% (95% CI: 9.45-50.08), handball 24.59% (95% CI: 14.88-35.83), and field hockey 19.07% (95% CI: 6.82-35.62). The most common injury was dental injury 19.61% (95% CI: 8.13-34.56). CONCLUSION: The overall prevalence of dentofacial injuries among collective contact sports participants was approximately 30%. The most common injury presented was dental injury.

Effect of wearing mouthguards on the physical performance of soccer and futsal players: a randomized cross-over study.

AIM: The aim of this study was to assess the influence of custom-fit mouthguards on the aerobic performance of soccer and futsal players under 17 (U-17). MATERIAL AND METHODS: Forty players from 3 Brazilian clubs participated in the study. The athletes' aerobic performance was assessed through the 20-meter shuttle-run test. All athletes performed two tests with and without mouthguard. Two outcome variables were analyzed: (i) the total distance covered in the test (meters) and (ii) the maximum oxygen uptake (VO2 max). A questionnaire assessing the level of acceptance of mouthguards considering different parameters was administered to the athletes before the delivery of the mouthguards and after 2 weeks of use. The questionnaire used a visual analogue scale (VAS). Paired t-test was used to compare the results obtained from the shuttle-run tests and the questionnaires. RESULTS: Mouthguards did not influence the aerobic performance of the players, considering both the total distance covered in the tests and the VO2 max. Stability was the parameter with the highest acceptance. Levels of acceptance regarding breathing (P = 0.022) and communication (P = 0.002) increased after mouthguards usage. Communication had the lowest level of acceptance considering all parameters assessed. Only 10% of the players reported receiving recommendations to use mouthguards while playing football or futsal. None of the participants reported having used mouthguards before. CONCLUSIONS: The use of custom-fit mouthguards does not affect the aerobic performance of soccer and futsal U-17 players. Future studies should focus on the development of appliances with maximum protection and minimum influence on communication.

Traumatic Dental Injuries Resulting from Sports Activities; Immediate Treatment and Five Years Follow-Up: An Observational Study.

BACKGROUND: Traumatic dental injuries (TDIs) represent 18-30% of all oral pathologies and a considerable number of these are sports related. It is very important to treat sports-related injuries and prevent complications. However, very few studies investigate the most expedient therapeutic strategies for the treatment of dental trauma correlated to sports. OBJECTIVE: The aim of this work was to focus on the average recovery time for different lesions, to assess adequate times for each athlete, to identify any association with complications and to investigate whether or not the use of mouth-guards interfered with a full recovery to normal health. METHODS: This study involved a group of 30 athletes (15 male and 15 female) who had dental injuries of varying severity.For the purposes of data collection, two classifications were taken into account: a classification for hard tissue trauma and another for periodontal lesions. The athletes were subdivided in "type of lesion' groups".They were then treated depending on their individual lesions and followed up for 5 years. A statistical analysis was carried out to study the association between recovery time, lesion types and occurrence of complications. RESULTS: The time for recovery was different for each type of lesion and ranged from 3-5 days (only uncomplicated fractures) to 14 days (all hard-periodontal tissue traumas). The total number of recorded pulp complications amounted to 6 cases. Among 30 athletes, 20 had begun and maintained, during the five-year follow-up period, the habit of using mouth-guards when practicing their sport activities. CONCLUSIONS: Recovery time and the severity of lesions are statistically associated: the more serious the injury, the more time an athlete needs to recover and return to competitive sports events. Furthermore, recovery time and precautionary measures (mouth-guards) did not influence the onset of complications. The subjects' habit of wearing a mouth guard continued even after the end of the therapy and follow-up periods.

Evaluación de las Lesiones Orofaciales y Traumatismos Dentales en Deportes de Combate y no Combate

Los deportes de combate conllevan un alto riesgo de padecer traumatismos dentoalveolares. Este estudio se evaluó la incidencia de traumatismos y lesiones orofaciales relacionadas con los deportes de combate, junto con la evaluación de las actitudes y hábitos de los deportistas respecto al uso de protectores bucales. Este estudio se realizó mediante sistema de encuestas digitales distribuidas en diferentes clubes deportivos donde se practican deportes de combate y no combate. Los deportistas de combate tienen más probabilidad sufrir alguna lesión orofacial que los no deportistas de combate. El sexo masculino y la experiencia son factores predisponentes en la aparición de traumatismos y lesiones orofaciales, siendo las laceraciones de tejidos blandos las más frecuentes. Los deportistas de combate llevan más protectores bucales que los deportistas en general, siendo el protector tipo II el más usado. Los deportistas que no llevan protectores no consideran que sea necesario. En caso de sufrir una avulsión dental, la mayoría de los participantes consideran que es posible reimplantar un diente avulsionado.

Combat sports carry a high risk of suffering dentoalveolar trauma. This study evaluated the incidence of dentoalveolar lesions related to combat sports, together with the evaluation of athletes' attitudes and habits regarding the use of mouth guards. This study was carried out using a digital survey system distributed in different sports clubs where combat and non-combat sports are practiced. Combat athletes are more likely to suffer a dentoalveolar lesion than non-combat athletes. Male sex and experience are predisposing factors in the appearance of dentoalveolar lesions, with soft tissue lacerations being the most frequent. Combat athletes wear more mouth guards than athletes in general, with the type II protector being the most used. Athletes who do not wear protectors do not consider it necessary. In case of suffering a dental avulsion, most of the participants consider that it is possible to reimplant an avulsed tooth.

Dental and Orofacial Injuries.

Oral and facial injuries are very common in sport, and can be very expensive to treat. Many of these injuries are preventable with proper pre-competition assessment and suitable well-designed protection. Prompt sideline identification and management of orofacial injuries and appropriate follow-up are crucial to successful outcomes. There have been significant recent advances in both trauma management and mouth guard design and fabrication techniques. Athletes have a unique set of challenges-including collisions, finances, travel and training, dehydration, sport beverages, and high carbohydrate diets-that may compromise their oral health.

Propuesta del curso optativo Protectores Bucales en el Deporte / Proposal of the optional course Mouth Guards in Sports

Introducción: La protección de las estructuras dentomaxilofaciales durante las actividades deportivas y el ejercicio físico se hace cada vez más necesaria, por lo que el Técnico Superior en Prótesis Estomatológica debe saber confeccionar protectores bucales y dominar el conocimiento en estos temas. Objetivo: Diseñar un curso optativo en primer año del Técnico Superior en Prótesis Estomatológica que contribuya a la formación de un profesional capaz de elaborar protectores bucales personalizados. Métodos: Se realizó un estudio cualitativo con carácter descriptivo. Se emplearon métodos del nivel teórico: (histórico-lógico, inductivo-deductivo, analítico-sintético, sistémico-estructural y la modelación) y empírico: (revisión documental, criterios de especialistas). Resultados: Se diseñó un curso optativo de 20 horas de duración, con carácter presencial y estructurado en tres temas. El curso optativo Protectores Bucales en el Deporte contribuye a potenciar actividades curriculares que tributen al desarrollo de una cultura para la protección bucodental. Conclusiones: El diseño del curso optativo se corresponde con las necesidades de aprendizaje de los Técnicos Superiores en Prótesis Estomatológica para confeccionar protectores bucales.

Introduction: The protection of the dentomaxillofacial structures during sports activities and physical exercise is increasingly necessary, so the Superior Technician in Stomatological Prosthesis must know how to make mouth guards, and develop knowledge on these topics. Objective: To design an optional course in the first year of the speciality Superior Technician in Stomatological Prosthesis that contributes to the training of a more qualified professional to make mouth guards. Methods: A qualitative descriptive study was carried out. Theoretical methods: (historical-logical, inductive-deductive, analytical-synthetic, systemic-structural and modeling), and empirical methods: (documentary review, specialist criteria) were used. Results: An optional face-to-face and structured in three topics course of 20 hours was designed. The optional course Mouth Guards in Sports contributes to promoting curricular activities which support the development of a culture on oral protection. Conclusions: The design of the optional course corresponds to the learning needs of the Superior Technician in Stomatological Prosthesis to make mouth guards.

Assessment of the Risk Factors for Oro-Dental Injuries to Occur during General Anesthesia and Measures taken by Anesthesiologist to Prevent them.

BACKGROUND AND AIM: Anesthesiologist gain access to the airway passage orally with the help of laryngoscope. Dental trauma can occur during different steps in anesthesia. The aim of the study is to evaluate the risk factor for dental trauma perioperatively and to look for the preventive measures mostly employed by the anesthesiologist to prevent dental insult. MATERIALS AND METHODS: The present study involved 40 anesthetists working in private hospitals using simple random sampling. They were asked to answer a questionnaire designed to look for the risk factors that makes tooth most prone for injury and find out the measures that anesthesiologists follow to prevent such injuries to occur. Codes were placed for the obtained data and Medcalc statistical package was used for analysis. RESULTS: Injuries mostly occur during intubation with a laryngoscope in patients where there is limited visibility to the hypopharynx. Maxillary left central incisor was mostly affected. Some anesthetists used plastic blades or curved blades to prevent such injury. CONCLUSION: Patient with poor dentition and history of difficult intubation should be sent for pre-operative dental evaluation to prevent dental injuries.

Impact absorption and force dissipation of protective mouth guards with or without titanium reinforcement.

BACKGROUND: Mouth guards are used to reduce the risk of experiencing dental injuries. Various individual and commercial designs are available. METHODS: The authors prepared 20 artificial maxillae from a polyether-resin to simulate teeth, jaw bone and gingiva. They customized two designs of mouth guards by using stone models from impressions of the artificial maxillae; one (n = 10) was constructed of four layers of ethylene vinyl acetate (EVA) (total thickness = 4.0 millimeters) (group EVA), and the other (n = 10) was constructed of EVA with an intermediate layer of 1.0-mm-thick sheet titanium from the left maxillary canine to the right maxillary canine (total thickness = 4.0 mm) (group EVA-Ti). They used a drop-weight impact testing machine (DTM 1000-S, Omnipotent Instruments, Seremban, Negeri Sembilan Darui Khusus, West Malaysia) for a frontal impact with 1.7 kilograms of mass dropped at 0.34 meter per second. The force of the drop was verified by means of a laser Doppler vibrometer (laser model OFV-323 and controller model OFV-3020, Polytec, Irvine, Calif.) to calculate the absorbed energy. They used a high-speed camera (FastCam APX-RS, Photron, San Diego) to obtain images of energy dissipation over the length of the mouth guard. RESULTS: The mean effective total impact energy that reached the maxillae-mouth guard models was 5.66 (standard deviation [SD], 0.035) joules. The mean absorbed energy in group EVA was 4.39 (0.023) J (77.8 percent of total impact energy). The mean (SD) absorbed energy in group EVA-Ti was 4.28 (0.013) J (75.9 percent of total impact energy). The mean (SD) total dissipated energy was 1.26 (0.21) J in group EVA and 1.36 (0.11) J in group EVA-Ti. The mean (SD) transmitted energy for the mouth guards was 1.08 (0.19) J in group EVA and 0.99 (0.05) J in group EVA-Ti. There was no statistically significant difference between the groups in terms of any energy transmission or absorption. CONCLUSION: The results of this study suggest that an additional intermediate titanium layer in the anterior area of a mouth guard may not have a beneficial effect on impact absorption and dissipation. PRACTICAL IMPLICATIONS: The use of mouth guards is a general requirement for physical sports activities, and it should be strongly encouraged for people playing contact sports in particular. However, the authors' results indicate that the total thickness of a mouth guard is more important than is the use of an additional intermediate layer (in this case, titanium).

Conhecimento de professores e estudantes de educação física da Unisul acerca dos protetores bucais na prática de atividades esportivas / Knowledge of teachers and students of physical education at Unisul about mouth guards in sports practice

A literatura não deixa dúvidas da importância do uso dos protetores bucais (PBs) na prática de esportes de impacto para a prevenção de traumas orofaciais. Objetivo: avaliar o nível de conhecimento dos professores e alunos do Curso de Educação Física da Universidade do Sul de Santa Catarina, Unidade Pedra Branca, campus Grande Florianópolis, com relação ao uso dos PBs na prevenção de traumas. Materiais e método: este é um estudo exploratório descritivo, no qual foi aplicado um questionário com questões que avaliaram o conhecimento dos entrevistados. Os dados obtidos foram tabulados em uma planilha do Microsoft Excel e submetidos à análise estatística descritiva no software SPSS 20.0. Resultados: foi demonstrado que 93,9% dos entrevistados conheciam os PBs. Com relação ao seu uso, apenas 30,5% dos entrevistados já utilizaram ou utilizam os PBs, sendo que apenas 2,3% utilizam PBs personalizados. Conclusão: pode-se concluir que ainda há pouca informação acerca dos PBs pelos profissionais e alunos do curso de Educação Física, especialmente com relação aos PBs personalizados, que são os mais indicados.(AU)

The literature is clear regarding the importance of the use of mouth guards in the practice of impact sports to prevent orofacial trauma. Objective: to evaluate the level of knowledge of teachers and students of Physical Education at the Santa Catarina Southern University (UNISUL), Pedra Branca unit, campus of the great Florianópolis area, SC, Brazil, regarding the use of mouth guards to prevent trauma. Materials and method: descriptive exploratory study that applied a questionnaire to assess the knowledge of respondents about mouth guards. The data obtained were tabulated in an Excel spreadsheet and submitted to descriptive statistical analysis in the SPSS 20.0 software. Results: the study showed that 93.9% of respondents were familiar with mouth guards. Regarding their use, only 30.5% of respondents had used or uses the device and only 2.3% uses custom-made mouth guards. Conclusion: it may be concluded there is still little information on mouth guards from teachers and students of Physical Education, especially regarding custom-made mouth guards, which are mostly indicated.(AU)

Avaliação do conhecimento em odontologia e educação física acerca dos protetores bucais / Assessment of odontology and physical education undergraduation students knowledge on mouth guard

Este estudo teve o propósito de avaliar o nível de conhecimento de 150 alunos de graduação dos cursos de Odontologia e Educação Física acerca dos protetores bucais no município de Belém, Brasil. Além disso, objetivou-se promover maior informação a esses futuros profissionais, por meio de palestras e distribuição de folders, nas quais o foco principal eram os protetores bucais, suas indicações, seus tipos, sua higienização e armazenamento. Os participantes da pesquisa pertenciam ao último ano de seus referidos cursos de graduação. A análise dos resultados permitiu evidenciar que 68 por cento dos alunos entrevistados ainda não possuem informação adequada acerca dos protetores bucais, mas que, apesar disso, em sua maioria são conscientes quanto aos riscos a que vários atletas são submetidos em esportes que exigem impacto físico. Os autores acreditam que é extremamente importante que haja maior divulgação da importância da utilização de protetores bucais na prática esportiva, visando a prevenção e a promoção de saúde da população em geral.

This study had the aim to assess the level of knowledge of 150 Odontology and Physical Education undergraduation students concerning mouth guards in the city of Belém, Brazil. Besides that, we tried to provide further information to these future professionals through speeches and distribution of folders in which the main focus was the mouth guards, their indications, types as well as hygienization and storage. The participants in the research were in the last year of their specific undergraduation courses. The analysis of the results showed that 68 percent of the interviewed students still do not have suitable information on the mouth guards, but despite of that, in their majority they are aware of the risks many athletes face in sports which have physical impact. The authors believe the spread of the information on the use of mouth guards in sportive practice is relevant and aims to prevent trauma and promote health of general population.

Oral injury and the use of mouth guards. Soccer, rugby, basketball player in Japanese high school / 体力科学

The use of mouth guards in contact sports effectively prevents oral injuries and preserves oral structures. Many contact sports in which a high impact collision could easily cause oral injury do not require athletes to use mouth guards. We discuss the circumstance of oral injury and awareness concerning the use of mouth guards in Japanese high school soccer and rugby and basketball teams.<BR>During an interview, each athlete was asked a series of questions concerning their history of oral injury while participating in sports and actual circumstances of using a mouth guard.<BR>The incidence of oral injuries was 32.3% in soccer, and 56.5% in rugby, 46.6% in basketball while 0.8% of athletes possessed some type of mouth guard in soccer, 24.1% in rugby and 1.3% in basketball. Although 81.8% of soccer athletes and 81.2% of basketball athletes thought mouth guards were unnecessary, only 26.2% of rugby athletes shared this opinion. Many athletes playing soccer and basketball had insufficient knowledge about mouth guards, and were not interested in preventing oral injury. Due to the diversity of sports that can produce oral injury, it is recommended that mouth guards be worn by all individuals participating in rugby, soccer and basketball.