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Mouthguards: difference in longitudinal dimensional stability between single- and double-laminated fabrication techniques.

Though the use of mouthguards (MGs) has increased with the increase in sporting activities, little is known about the influence of their fabrication methods on longitudinal dimensional stability. The objective of this study was to compare the difference in the longitudinal dimensional stability between single and laminated MGs. Single-layer MGs were made from a 4.0 mm thick ethylene vinyl acetate (EVA) sheet and laminated MGs were made from two 2.0 mm thick sheets of EVA. MGs were kept in a 37 degrees C water bath for 60 h, equivalent to the time period of 3-months inter-oral use. MG deformation was analyzed by measuring designated points on the MG border using a profile projector (J-12, Nikon Inc., Tokyo, Japan) before and after the water immersion. A finite-element model was also created to examine the time course of stress accumulation during the sheet forming process using Finite Element software. Longitudinal deformation was smaller in the laminated MGs than in the single-layer MGs in the anterior area (P < 0.05). Finite element method (FEM) analysis also showed the largest stress accumulation in the anterior incisal area where deformations were mainly observed. Laminated double layer MGs have advantages over single-layer MGs in terms of longitudinal stability due to lower stress accumulation during the fabrication process.

Equipment Design↗

Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion.

Although it is widely accepted that mouthguards decrease the incidence of dental injuries, there is a controversy among sports medicine professionals as to the effectiveness of mouthguards in decreasing the incidence or severity of sports-related cerebral concussion (SRCC). While some experimental data suggest that this may be the case, there exist a number of reports suggesting that mouthguards do not serve this purpose. These conclusions have been drawn, however, without actually measuring the extent of neurocognitive dysfunction in athletes following sports-related concussion. The purpose of this study was to determine whether mouthguard use reduces the neurocognitive and symptomatic impairments that follow an injurious episode of SRCC. Preseason baseline data were collected as part of an ongoing clinical program that uses a computerized neurocognitive test to assess various faculties of brain function and symptoms reported at the time of testing. Follow-up testing from 180 student-athletes who had sustained an SRCC was analyzed for the purpose of this study. These athletes were separated into one of two groups: those who reported using mouthguards and those who did not. Neurocognitive testing was accomplished using the Immediate Post-Concussion and Assessment Test (ImPACT). Results suggest that neurocognitive deficits at the time of the athletes' first follow-up assessment did not differ between mouthguard users and non-users, suggesting that mouthguard use does little to reduce the severity of neurocognitive dysfunction and onset of symptoms following sports-related head trauma. However, an interesting finding in this study was that athletes experienced significantly lower neurocognitive test scores and reported higher symptom scores following SRCC regardless of mouthguard use. This emphasizes a thorough clinical evaluation of athletes that have sustained an SRCC. Although it was found in this study that mouthguard use does not decrease the severity of concussion, it is important to note that the use of mouthguards is paramount in reducing maxillofacial and dental trauma and their use should continue to be mandated by athletic associations and supported by all dental and sports medicine professionals.

Adolescent↗

Custom-fitted protective mouthguards.

Custom-fitted protective mouthguards for children and adults during sports activities can prevent or minimize traumatic dental injuries. This article reviews a method for fabrication of custom mouthguards and discusses their use.

Adolescent↗

Attitudes of college football officials regarding NCAA mouthguard regulations and player compliance.

The National Collegiate Athletic Association (NCAA) mandates the use of brightly colored, intraoral mouthguards by football players to reduce the frequency and severity of craniofacial and intraoral morbidity and mortality, and to enhance the ability of officials to observe player compliance. The purpose of this 12-question mail survey was to determine the attitudes of on-field game officials regarding current NCAA mouthguard regulations and patterns of utilization by college football players. The sample consisted of all 50 Big East Football Conference officials; a response rate of 100 percent was achieved. Only 42 percent of the officials reported observing all players in compliance, and quarterbacks were identified by others as the least compliant group (52%). The majority (88%) indicated that the 1990 rule for brightly colored mouthguards had been beneficial to them in determining player compliance, and 52 percent reported that this rule had resulted in more frequent use by these athletes. Nearly all officials (96%) indicated that they would issue a warning for noncompliance to the player or coach, rather than charging a timeout for a violation as prescribed by NCAA regulations. The majority (70%) believe current enforcement is appropriate, but expressed the opinion that coaches should be held more accountable for player compliance.

Adult↗

Attitudes of college football coaches regarding NCAA mouthguard regulations and player compliance.

OBJECTIVES: The purpose of this study was to assess the attitudes of Division 1-A college head football coaches regarding the NCAA mouthguard regulations, current patterns of use by players, and responsibility for enforcement; and to compare the coaches' responses with those of officials studied previously. METHODS: A 15-item questionnaire was mailed to all 106 Division 1-A football coaches to assess their attitudes. Percent frequency distributions of coaches' responses to each item were computed and compared to the officials' responses. RESULTS: Responses were received from 98 coaches (92.45%). While 87 percent of coaches reported having a team dentist, the majority reported that the team trainer was responsible for selecting the type of mouthguard used. Most coaches (53%) reported that all players wore mouthguards, but that quarterbacks were least compliant. Most coaches reported that mouthguard rules were beneficial in determining player compliance and resulted in more frequent use. Seventy-four percent would warn the player of a violation themselves, yet only 26 percent felt the coach had the greatest influence on players wearing mouthguards. Seventy-six percent felt the current enforcement of the rules is appropriate. Coaches opinions varied from those of officials. CONCLUSIONS: Coaches view themselves, the players, or the trainer as most responsible for players wearing mouthguards, not referees. This finding coincides with the officials' opinion that the coaches should be accountable.

Adult↗

Incidence of orofacial injuries in high school sports.

OBJECTIVES: This study determined the incidence of orofacial injuries in athletes attending seven neighboring Minnesota high schools who participated in varsity soccer, wrestling, and basketball during the 1996-97 academic year. METHODS: Incidence was determined through athletes' written surveys and athletic trainer records. RESULTS: Survey response rates ranged from 86.3 percent to 94.0 percent among schools for all sports. The incidence rate of at least one orofacial injury per athlete in a season was 27.6 percent (SD = 20.2) in soccer, 72.3 percent (SD = 9.3) in wrestling, and 55.4 percent (SD = 23.9) in basketball. Ten percent of athletes sustained dental injuries. Fixed orthodontic appliances posed a higher risk for sustaining an injury in all sports. The games-to-practices ratios for injuries were 6.8 (soccer), 1.2 (wrestling), and 1.8 (basketball). Half of the athletes believed mouthguards prevent injuries; however, only 6 percent of the athletes reported mouthguard use. Athletic trainers reported eight orofacial injuries. CONCLUSIONS: The substantial rate of orofacial injuries among high school athletes participating in soccer, wrestling, and basketball needs to be minimized. Dentists should ask their adolescent patients routinely about sports participation. Policies should be developed to require school officials to report orofacial injuries, to inform athletes of their risk for orofacial injuries, and to consider mandated mouthguard use for these athletes.

Adolescent↗

Attitudes of Central Collegiate Hockey Association ice hockey players toward athletic mouthguard usage.

OBJECTIVE: The purpose of this study was to examine Central Collegiate Hockey Association ice hockey players' attitudes regarding the use of athletic mouthguards and to determine the effects of mouthguard type, player position, education, and usage time with respect to attitudes. METHODS: A questionnaire measuring players' attitudes toward mouthguards was sent to certified athletic trainers (ATC) responsible for providing healthcare coverage at 10 institutions of the Central Collegiate Hockey Association (CCHA). The ATC's distributed the surveys to all the players on their respective collegiate teams. Out of a total of 265 players listed on the roosters of the CCHA, one hundred and sixty five (62%) players returned the surveys, with 158 surveys used in the analyses (60%). RESULTS: Approximately 13.3% of players (n=21) reported wearing mouthguards 50% of the time or greater during games and 3.8% (n=6) reported wearing mouthguards 50% of the time or greater during practices. Twenty-six percent (n=41) of the players never received educational information regarding using mouthguards. Thirty-nine percent (n=59) of the players reported altering mouthguards to obtain a better fit while 91% of the players were not influenced by the cost of the mouthguard. A 2 x 2 x 2 ANOVA revealed a significant interaction among player position and mouthguard type with respect to player attitudes (F(1,131) = 4.96, P < 0.05), with defensive players having more negative attitudes toward mouthguard usage compared to offensive players. CONCLUSION: No one specific factor affecting attitudes was identified, however, players reported limited educational opportunities to learn about the effectiveness of mouthguards. Therefore, coaches, dentists, and healthcare providers should engage in more preventive educational programs to increase player attitudes and compliance.

Analysis of Variance↗

A tongue shield appliance: design, fabrication, and case report.

An intraoral tongue shield appliance for unconscious patients is described. This appliance has advantages over other such appliances in that it does not require impressions for its fabrication, can be made quickly, and placed and retained in a patient with a limited oral opening. Its use is demonstrated in a pharmacologically paralyzed and sedated patient with tongue trauma.

Anesthesia, General↗