For a mouthguard to function properly, it must fit well. It is possible to produce a well-fitting mouthguard using the "dry model" technique, which is relatively inexpensive and easy to learn. Custom-fitted intraoral mouthguards help prevent or reduce the severity of concussions as well as minimize oral cavity injuries. (+info)
(2/59) A preliminary study of patient comfort associated with customised mouthguards.
OBJECTIVE: To compare patient perception of custom made mouthguards of ideal and less than ideal designs in terms of their comfort and "wearability". METHOD: A mouthguard of ideal design (A) and one incorporating common design faults of underextension and unadjusted occlusion (B) were provided for 22 active sportsmen and women. They were not informed of the details of the design or the status of the protector. Half the participants were asked to wear mouthguard A first and the other half wore B first, each worn for one hour on two consecutive nights. Questionnaires were used to evaluate and rate the comfort and wearability of each mouthguard. RESULTS: Eighteen people completed the study. The ideal appliance was rated as significantly more retentive and comfortable overall and specifically was more comfortable to lips, gums, and tongue. It was also recognised as being less bulky, less likely to keep the teeth apart, or to cause pain in the jaw muscles. CONCLUSIONS: Comfort is likely to be increased if mouthguards are extended labially to within 2 mm of the vestibular reflection, adjusted to allow even occlusal contact, rounded at the buccal peripheries, and tapered at the palatal edges. (+info)
(3/59) Acceptability of baseball face guards and reduction of oculofacial injury in receptive youth league players.
GOALS: To assess the relative injury reduction effect and acceptability of face guards on batter's helmets. METHODS: A non-randomized prospective cohort study among 238 youth league baseball teams in Central and Southern Indiana during the 1997 season. Coaches, parents, and players were asked to respond to pre-season and post-season questionnaires. Approximately one half of the teams were supplied with face guard helmets (intervention); all others used this protection at their discretion (comparison). RESULTS: Parents, players, and coaches on the intervention teams reported a reduction in the incidence of oculofacial injuries compared with comparison team respondents (p=0.04). There was no reported adverse effect of face guard use on player performance. CONCLUSIONS: Helmet face guards should be required for batters to prevent facial injuries in baseball. (+info)
(4/59) Dental evaluation of scuba diving mouthpieces using a subject assessment index and radiological analysis of jaw position.
OBJECTIVE: To compare two experimental scuba mouthpieces with a commercially available design. METHODS: A laboratory study using six men to assess effort, muscle pain, muscle fatigue, facial discomfort, tooth discomfort, and loss of lip sensation using a visual analogue scale. Cephalometric radiographs and analysis of jaw position with each mouth piece were also used. RESULTS: Fully customised mouthpieces caused the least discomfort, muscle pain, fatigue, and effort. They also resulted in the least mandibular displacement from the resting position. Radiographic analysis of jaw position showed that the fully customised design resulted in the least displacement from normal jaw position. CONCLUSIONS: A fully customised design gives the greatest comfort, least effort, and least mandibular displacement. This design is recommended, particularly for divers who experience temporomandibular dysfunction associated with diving. (+info)
(5/59) Transient forces generated by projectiles on variable quality mouthguards monitored by instrumented impact testing.
OBJECTIVES: (a) To determine the force-time trace that occurs when a spring mounted simulated upper jaw is impacted; (b) to examine if mouthguards of variable quality have significant influence on such force-time traces; (c) to attempt to relate physical events to the profile of the force-time traces recorded. METHODS: A simulated jaw, consisting of ceramic teeth inserted into a hard rubber arch reinforced with a composite jawbone, was fitted with various mouthguards as part of a previous round robin study. A clinical assessment distinguished good, bad, and poor mouthguards, and these were each fitted to the jaw, which was then submitted to instrumental impact tests under conditions expected to produce tooth fractures. The force-time trace was recorded for such impact events. RESULTS: The spring mounting method caused two distinct peaks in the force-time trace. The initial one was related to inertia effects and showed an increase in magnitude with impactor velocity as expected. The second peak showed features that were related to the differences in the mouthguards selected. CONCLUSIONS: The use of a force washer within a conical ended impactor enabled force-time traces to be recorded during the impact of a spring mounted simulated jaw fitted with mouthguards of variable quality. The spring mounting system causes an initial inertial peak followed by a second peak once the spring mount has fully compressed. Good fitting guards, which keep most teeth intact, result in high stiffness targets that in turn generate high reaction forces in the impactor. If the spring mounting is omitted, the two peaks are combined to give even higher reaction forces. The force-time trace offers some potential for assessing both overall mouthguard performance and individual events during the impact sequence. Mouthguards with good retention to the jaw remained attached during the impact event and helped to preserve the structural integrity of the target. This in turn developed high forces in the second part of the force-time trace. Guards that detached during impact and allowed tooth fractures showed lower forces in the second part of the test. The force profile measured offered some quantitative support to, and agreement with, the observed clinical quality of the mouthguards. (+info)
(6/59) Promoting oral health: interventions for preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. A report on recommendations of the task force on community preventive services.
The Task Force on Community Preventive Services (the Task Force) has conducted systematic reviews of the evidence of effectiveness of selected population-based interventions to prevent and control dental caries (tooth decay), oral (mouth) and pharyngeal (throat) cancers, and sports-related craniofacial injuries. The Task Force strongly recommends community water fluoridation and school-based or school-linked pit and fissure sealant delivery programs for prevention and control of dental caries. Using the rules of evidence it has established, the Task Force found insufficient evidence of effectiveness or ineffectiveness of the remaining interventions reviewed. Therefore, the Task Force makes no recommendation for or against use of statewide or communitywide sealant promotion programs, population-based interventions for early detection of precancers and cancers, or population-based interventions to encourage use of helmets, facemasks, and mouthguards to reduce oral-facial trauma in contact sports. The Task Force's finding of insufficient evidence indicates the need for more research on intervention effectiveness. Until the results of such research become available, readers are encouraged to judge the usefulness of these interventions by other criteria. This report presents additional information regarding the recommendations, briefly describes how the reviews were conducted, and provides information designed to help apply the strongly recommended interventions locally. (+info)
(7/59) The impact of face shield use on concussions in ice hockey: a multivariate analysis.
OBJECTIVE: To identify specific risk factors for concussion severity among ice hockey players wearing full face shields compared with half face shields (visors). METHODS: A prospective cohort study was conducted during one varsity hockey season (1997-1998) with 642 male ice hockey players (median age 22 years) from 22 teams participating in the Canadian Inter-University Athletics Union. Half of the teams wore full face shields, and half wore half shields (visors) for every practice and game throughout the season. Team therapists and doctors recorded on structured forms daily injury, participation, and information on face shield use for each athlete. The main outcome measure was any traumatic brain injury requiring assessment or treatment by a team therapist or doctor, categorised by time lost from subsequent participation and compared by type of face shield worn. RESULTS: Players who wore half face shields missed significantly more practices and games per concussion (2.4 times) than players who wore full face shields (4.07 sessions (95% confidence interval (CI) 3.48 to 4.74) v 1.71 sessions (95% CI 1.32 to 2.18) respectively). Significantly more playing time was lost by players wearing half shields during practices and games, and did not depend on whether the athletes were forwards or defence, rookies or veterans, or whether the concussions were new or recurrent. In addition, players who wore half face shields and no mouthguards at the time of concussion missed significantly more playing time (5.57 sessions per concussion; 95% CI 4.40 to 6.95) than players who wore half shields and mouthguards (2.76 sessions per concussion; 95% CI 2.14 to 3.55). Players who wore full face shields and mouthguards at the time of concussion lost no playing time compared with 1.80 sessions lost per concussion (95% CI 1.38 to 2.34) for players wearing full face shields and no mouthguards. CONCLUSIONS: The use of a full face shield compared with half face shield by intercollegiate ice hockey players significantly reduced the playing time lost because of concussion, suggesting that concussion severity may be reduced by the use of a full face shield. (+info)
(8/59) Beneficial effects of air inclusions on the performance of ethylene vinyl acetate (EVA) mouthguard material.
OBJECTIVE: To investigate the impact characteristics of an ethylene vinyl acetate (EVA) mouthguard material with regulated air inclusions, which included various air cell volumes and wall thickness between air cells. In particular, the aim was to identify the magnitude and direction of forces within the impacts. METHOD: EVA mouthguard material, 4 mm thick and with and without air inclusions, was impacted with a constant force impact pendulum with an energy of 4.4 J and a velocity of 3 m/s. Transmitted forces through the EVA material were measured using an accelerometer, which also allowed the determination of force direction and magnitude within the impacts. RESULTS: Statistically significant reductions in the transmitted forces were observed with all the air inclusion materials when compared with EVA without air inclusions. Maximum transmitted force through one air inclusion material was reduced by 32%. Force rebound was eliminated in one material, and reduced second force impulses were observed in all the air inclusion materials. CONCLUSION: The regulated air inclusions improved the impact characteristics of the EVA mouthguard material, the material most commonly used in mouthguards world wide. (+info)