Dental injuries and the attitudes of rugby players to mouthguards.
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Adolescent↗
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Orofacial injuries and the use of mouthguards by the 1984 Great Britain Rugby League touring team.
Mouthguards are considered by most authorities to be an essential part of equipment for players in any body-contact sports, especially the combative type e.g. Rugby Union, Rugby League, American Football (gridiron), boxing, etc. (Turner, 1977). The qualities provided by the mouthguard are dental protection, especially of the upper anterior teeth, soft tissue protection around the mouth, a reduction in the risk of fracture of the mandible, and a reduction in the concussion force from a blow to the mandible (Clegg, 1969; Upson, 1982; Davies et al, 1977). Of the 28 players interviewed, only 7 (25%) wore mouthguards, the commonest reason for not using a mouthguard being difficulty with breathing, a finding in common with other similar surveys (Davies et al, 1977). In view of the fact that 17 (60.7%) had sustained oral injuries - dental and jaw injuries, intra-oral and circumoral lacerations, in the past, it was a surprising response to find that only 2 (7.2%) stated that mouthguards should be compulsory when playing Rugby League football.
Adolescent↗
Mouthguards, an evaluation of two types for Rugby players.
At the beginning of the 1983/84 Rugby season a dental examination was carried out on 120 players, 55 of whom were fitted with the mouth-fitted type of mouthguard and 65 the laboratory-made type of mouthguard. At the end of the season only 98 players were available for the completion of the study. A further dental examination showed that there was no damage to the teeth when either type of mouthguard was worn. Variations in the attitudes of the players to each type of mouthguard were also recorded.
Athletic Injuries↗
Orofacial injuries and mouthguards: a study of the 1984 Wallabies.
As mouthguards provide protection of the teeth, jaws, adjacent soft tissues and also protect the brain against concussion following impacts to the mandible, the use of mouthguards in contact sports is strongly recommended. It is therefore essential to gauge regularly the use of mouthguards in the various contact sports at all levels of competition. Of the 30 members of the 1984 Australian Rugby Union Touring Team (the Wallabies), 80% wore mouthguards and of these, 75% believed that wearing mouthguards should be made compulsory for Rugby players. A comparison of these and other findings is made with previous studies in Rugby, and also with a similar study of the 1984 Great Britain Rugby League Touring Team.
Athletic Injuries↗
The reliability of team-based primary data collectors for the collection of exposure and protective equipment use data in community sport.
OBJECTIVE: Reliable data allows for the generalisation of study findings to the wider population. The aim of this study was to assess the reliability of using community team based primary data collectors for the collection of exposure and protective equipment use data. METHODS: Nine clubs (23 teams) from a metropolitan Australian Football league in Victoria each provided one primary data collector to monitor exposure and protective equipment use over a regular playing season. Four random audits of this data collection for each team were conducted throughout the regular playing season. The audits were compared with data collected by the club data collectors and the level of agreement assessed. RESULTS: Although exposure data agreement was higher during competition and protective equipment use agreement higher during training, there was no significant difference in data collected by the primary data collectors and the random audits. CONCLUSIONS: The use of trained data collectors associated with Australian Football teams provides reliable information about player exposure and protective equipment use in community intervention studies.
Athletic Injuries↗
Community football players' attitudes towards protective equipment--a pre-season measure.
BACKGROUND: The Australian football injury prevention project (AFIPP) was a randomised controlled trial examining the effects of protective equipment on injury rates in Australian Football. OBJECTIVE: To present the results of the AFIPP baseline survey of community football players' attitudes towards protective equipment. METHODS: Teams of players were recruited from the largest community football league in Victoria, Australia, during the 2001 playing season; 301 players were enrolled in the study and all were surveyed before the season began about their attitudes towards protective headgear and mouthguards. RESULTS: Almost three quarters of the players (73.6%) reported wearing mouthguards during the previous playing season (year 2000) compared with only 2.1% wearing headgear. The most common reasons for not wearing headgear and mouthguards (in non-users) were: "I don't like wearing it" (headgear: 44.8%; mouthguards: 30.6%), and "It is too uncomfortable" (headgear: 40.7%; mouthguards: 45.8%). CONCLUSIONS: The higher mouthguard usage reflects the favourable attitudes towards mouthguards by Australian football players generally. Similarly, the low headgear usage reflects the low acceptance of this form of protection in this sport. Further research should be directed towards establishing the reasons why players seem to believe that headgear plays a role in injury prevention yet few wear it.
Adult↗
Perception of Nigerian athletes of the use of mouth guards to prevent the stresses of sports injury.
OBJECTIVE: The perception of Nigerian athletes of the use of mouth guards to prevent the stresses of sports injuries was examined using psychological, sociological, and physical stress variables. METHODS: The descriptive survey research design was used in this study. Participants (n = 333) were selected using the purposive random sampling technique and data were collected using the 4 point Likert type instrument. The coefficient alpha was used to determine the reliability of the instrument with r = 0.79 for psychological, r = 0.66 for physical, and r = 0.74 for sociological stress. RESULTS: The result reveals that female athletes perceived the use of mouth guards as being more important to prevent the stresses of sports injuries than male athletes, while athletes who had used mouth guards for longer periods also perceived them as being more important to prevent the stresses of sports injuries compared to those who had used them less. The result also revealed a significant difference (p<0.05) among the various sport groups as independent variables on the psychological and physical stress variables. Scheffe post hoc analysis was used to identify the group where significant difference was found. CONCLUSIONS: The study concluded that since the impact of injury is perceived to affect the cognitive function of athletes, athletes should be educated on the use of mouth guards in order to reduce the incidence of oral and dental injuries to the barest minimum.
Adolescent↗
Scale of protection and the various types of sports mouthguard.
OBJECTIVES: To present a grading system of the protection offered by various types of mouthguard, together with an indication of associated risks, in order to make athletes aware of the consequences of improper or no mouth protection. METHODS: A review of the literature on mouthguards, mouthguard materials, and novel laminates for mouthguards was carried out as it was apparent that information on mouthguards was lacking. Studies on stock (or unfitted) mouthguards, mouth formed (boil and bite) mouthguards, and custom mouthguards are reviewed. RESULTS: A scale of protection offered by various mouthguards and novel laminates has been produced, where 0 indicates no mouthguard and 10 indicates a custom made mouthguard offering excellent protection. CONCLUSIONS: From work carried out on laminates and the manufacturing processes of mouthguards, it became apparent that information was lacking to enable athletes make informed decisions about the best oral protection for their chosen sport.
Athletic Injuries↗
An evaluation of mouthguard requirements and dental injuries in New Zealand rugby union.
OBJECTIVES: To document the effects of compulsory mouthguard wearing on rugby related dental injury claims made to ACC, the administrator of New Zealand's accident compensation scheme. METHODS: An ecological study was conducted. Estimates of mouthguard wearing rates were available from prospective studies conducted in 1993, 2002, and 2003. Rugby related dental injury claims were available for the period 1995-2003. Player numbers were available from 1998. Mouthguard wearing was made compulsory during match play for rugby players at under 19 level and below at the beginning of the 1997 season, and for all grades of domestic rugby at the beginning of the 1998 season. Greater powers of enforcement were provided to referees at the beginning of the 2003 season. RESULTS: The self reported rate of mouthguard use was 67% of player-weeks in 1993 and 93% in 2003. A total of 2644 claims was reported in 1995. There was a 43% (90% confidence interval 39% to 46%) reduction in dental claims from 1995 to 2003. On the reasonable assumption that the number of players and player-matches remained constant throughout the study period, the relative rate of injury claims for non-wearers versus wearers was 4.6 (90% confidence interval 3.8 to 5.6). The cumulative savings in claim costs compared with the cost per year if claim numbers had remained constant from 1995 is 1.87 million NZD. CONCLUSION: Although ecological studies have acknowledged weaknesses, the findings provide evidence that mouthguard use is a simple and effective injury prevention strategy for rugby players. The use of mouthguards for all players in both matches and contact practice situations is strongly recommended.
Adolescent↗
Preventing head and neck injury.
A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport.
Athletic Injuries↗
Influences of palatal side design and finishing on the wearability and retention of mouthguards.
OBJECTIVES: To examine the influences of design and finishing on mouthguard wearability and retention. MATERIALS AND METHODS: 17 students at the Dental Technician Institute at Osaka University School of Dentistry, Osaka, Japan, participated in this study after providing informed consent. For each student, a single-layer custom-made mouthguard was fabricated from a 3.8-mm-thick ethylene-vinyl acetate sheet using a standardised procedure to obtain a precise fit. Each mouthguard was modified by changing the margin location and shape through five consecutive steps. At each step, questionnaires with a visual analogue scale regarding wearability (comfort, breathing, speaking, swallowing, lip closure, temporomandibular joint fatigue and swallowing) and retention were completed by subjects after wearing the mouthguard for 5 min. Statistical analyses were carried out among the steps using Wilcoxon's signed-rank test with a significance level of p<0.05. RESULTS: Significant improvements were found for comfort, breathing, speaking and swallowing by trimming the palatal margin to the cervical area, smooth finishing and occlusal adjustment of the mouthguard (p<0.01). No significant differences were found for retention throughout the procedure. CONCLUSIONS: Within the limitations of this experimental study, design and finishing at the palatal side appear to have significant influences on mouthguard wearability, but not retention.
Adult↗
A modified maxillary mouthguard.
Custom made maxillary mouthguards made from thermoplastic materials using dental impressions give valuable protection to the teeth and jaws of participants in contact sports. A bimaxillary mouthguard has been described which offers enhanced protection, but with considerable increase in cost. This paper describes a modification to current maxillary mouthguard design that is comfortable to wear, inexpensive to make and which may provide protection comparable to that of a bimaxillary type, while retaining other desirable features of the more complex appliance.
Humans↗
Injuries sustained in rugby by wearers and non-wearers of mouthguards.
Previous studies have shown a higher prevalence of head and neck injuries in non-wearers when compared with wearers of mouthguards. The purpose of the present study was to compare the pattern of injuries to those of past studies and also to investigate whether the injuries sustained differed significantly between wearers and non-wearers. A sample of 321 university students participating on 555 player occasions was studied in a cross-sectional survey. No statistically significant differences (p greater than 0.05) were found between wearers and non-wearers of mouthguards with respect to head and neck injuries in general and to oral injuries in particular. We conclude that injuries sustained at rugby in this study were not associated with the use or non-use of mouthguards.
Adolescent↗
The pattern of use of mouthguards in rugby league (a study of the 1986 Australian Rugby League touring team).
Generally speaking, in contact sports the higher the grade of competition the greater the risk of a player sustaining any type of injury. Therefore it is important to conduct studies periodically of international sporting teams from different countries to detect any changes in regional injury patterns, besides assessing attitudes to the use of available protective equipment. A study of the prevalence of orofacial injuries and use of mouthguards by members of the 1984 Great Britain Rugby League Touring Team has previously been reported (Chapman, 1985a). In order to obtain a suitable basis for comparison of those results, a similar study of the members of the 1986 Australian Rugby League Touring Team to Great Britain was conducted. The most important finding was the much higher usage rate of mouthguards by the Australian footballers when compared with the British figure. Results of the study also support the function of mouthguards in reducing the incidence of orofacial injuries in contact sports.
Adolescent↗
Orofacial injuries and international rugby players' attitudes to mouthguards.
This is the first such study of British rugby and the third yet published, the other two involving the 1984 Australian Wallabies and the 1987 United States Eagles. The report shows that while all 30 players believed mouthguards provided local protection, nine did not wear a mouthguard. Only one of the 21 who wore a mouthguard was willing to play without it, while eight mouthguard wearers felt mouthguards should be compulsory for adult rugby players. Twelve players had previously sustained an orofacial injury playing rugby which required treatment, only one of whom was wearing a mouthguard at the time. The full results are presented and compared with those of the previous two reports.
Adult↗
Injuries sustained by users and non-users of gum shields in local rugby union.
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Adolescent↗
Oro-facial and dental injuries in club rugby union players.
Oro-facial and dental injuries are of particular importance as dental tissues have a low potential for recovery when damaged and such injuries can give rise to functional, aesthetic and psychological disfigurement. Also their repair can be costly, distressing and time consuming. This study sought to clarify the nature and severity of oro-facial injuries amongst rugby players in a first division club in Scotland. A secondary aim of the study was to examine the influence of position and standard of play on injury rates. The results show that oro-facial injuries are common amongst rugby players, and that players in the first fifteen were at the greatest risk. Although injuries may still occur when mouthguards are used, their severity will be reduced by use of such protective devices.
Adolescent↗
Temporomandibular dysfunction syndrome associated with scuba diving mouthpieces.
As previous reports have highlighted that temporomandibular joint dysfunction syndrome can occur during scuba diving due to the use of a diving mouthpiece, 74 divers of varied experience (62 male, 12 female) were asked to evaluate the efficiency of the mouthpiece for the ease of grip, insertion into the mouth, clearing of water, air sharing, comfort and overall efficiency. They also recorded the level of muscle and joint discomfort experienced during diving and non-diving activities. The results indicate that temporomandibular joint problems unrelated to diving are compounded by the use of a diving mouthpiece. The diver's assessment of muscle tension and comfort while using the mouthpiece was found to be a good predictor of whether temporomandibular dysfunction would occur and the assessment scores have been used in a formula to aid selection of a mouthpiece.
Diving↗