Mouthguard utilization rates during sport activities in Ankara, Turkey

Abstract –  The objective of this study was to determine the attitudes towards mouthguard use in Ankara, Turkey. In the first part of this study, an eight-item questionnaire was distributed to 22 coaches from 15 secondary schools randomly selected from five municipalities of Ankara, Turkey. The questionnaire sought information on how much coaches know regarding mouthguards and how often children and adolescents of the ages 11–18 use mouthguards. The second part of the study was based on the data obtained from direct interviews answered by 121 university athletes of three different sport modalities (football, ice hockey and martial arts). The purpose of this part of the study was to determine the rate of mouthguard use and the frequency and type of oral trauma in these athletes. The result of the coaches' questionnaires revealed that; none of the 11–18 years old children and adolescents used mouthguards while participating in sports. Of the coaches, 77.2% had seen orofacial trauma in this age group during sport activities and 95.5% of the coaches believed that mouthguards prevented oral injuries. Of the coaches, 72.7% reported that children and adolescents should use mouthguards in sport activities. The second part of the study showed that although all of the athletes owned mouth-formed type of mouthguards, the utilization rate was 74.4%. Of all players, 13.2% had suffered from one or more form of oral injury while not wearing mouthguards. The results show that in Turkey, the use of mouthguards has not become widespread in sports. It can be concluded that regular mouthguard use in sports should be encouraged in Turkey.     

Orofacial/cerebral injuries and the use of mouthguards by professional athletes in Switzerland

Abstract –  The objective of the present study was to measure the occurrence of orofacial and cerebral injuries in different sports and to survey the awareness of athletes and officials concerning the use of mouthguards during sport activities. Two hundred and sixty-seven professional athletes and 63 officials participating in soccer, handball, basketball and ice hockey were interviewed. The frequency of orofacial and cerebral trauma during sport practice was recorded and the reason for using and not using mouthguards was assessed. A great difference in orofacial and cerebral injuries was found when comparing the different kinds of sports and comparing athletes with or without mouthguards. 45% of the players had suffered injuries when not wearing mouthguards. Most injuries were found in ice hockey, (59%), whereas only 24% of the soccer players suffered injuries when not wearing mouthguards. Sixty-eight percentage of the players wearing mouthguards had never suffered any orofacial and cerebral injuries. Two hundred and twenty-four athletes (84%) did not use a mouthguard despite general acceptance by 150 athletes (56%). Although the awareness of mouthguards among officials was very high (59%), only 25% of them would support the funding of mouthguards and 5% would enforce regulations. Athletes as well as coaches should be informed about the high risk of oral injuries when performing contact sports. Doctors and dentists need to recommend a more intensive education of students in sports medicine and sports dentistry, and to increase their willingness to become a team dentist.     

Basketball players' experience of dental injury and awareness about mouthguard in China

Abstract –  The objective of the present study was to describe the occurrence of orofacial, particularly dental injuries in basketball, and to survey the athletes' awareness concerning the use of mouthguards during basketball training and competition. A pilot questionnaire was designed and tested with basketball players. Two hundred and thirty-six male athletes were surveyed. Seventy-seven players were professional players. Exactly 80.6% professionals and 37.7% semi-professional athletes had an experience of oral soft tissue laceration and dental injuries in basketball practice. The difference between the two groups is significant. The incidence of dental and oral injuries was related to the length of training time. About 59% of the athletes ranked the risk of orofacial and dental injury in basketball as medium. Although the awareness of mouthguards among the basketball players was very high (80.1%), only one of them had used the custom-made mouthguard. Most of the athletes gained the knowledge about mouthguards from foreign players (33.5%), media (24.8%) and teammates/classmates (24.3%). The influence of dentists was very weak. Athletes should be informed about the high risk of oral injuries when participating in contact sports. Dentists should play a more significant role in the program of promoting mouthguard use to prevent the occurrence of oral injury in sport participation.     

An evaluation of mouthguard programs in Texas high school football

Recent publications have indicated the interest in and controversy surrounding mouth protectors in sports dentistry. Mouth protection for athletes has been and continues to be dentistry's contribution to sports. Perhaps no other item of protective equipment is more effective in reducing injury to football players than a mouthguard. Although protection is no longer doubtful when a mouthguard is worn, there are still many mouthguards used that are not acceptable to the athletes in terms of comfort, durability, and speech. It is the responsibility of the dental profession to develop and dispense the best mouthguards available. From the present study it may be concluded that a properly constructed custom-made mouthguard will minimize the common complaints coaches and trainers have concerning mouthguards. It is apparent that more education about the types of mouthguards, their merits, and their availability is needed.     

Nigerian dentists' knowledge and attitudes towards mouthguard protection

Abstract –  The objective of this study was to assess the knowledge and attitudes of Nigerian dentists towards mouthguard protection. A pre-tested 15-item, one-page questionnaire was distributed to 185 dentists practising in different parts of the country with government hospitals or private establishments, by 'hand-delivery' system. Filled and returned forms were 170 (response rate of 92%). The period of the survey was between April and August 2003. Dental graduates from the different dental schools in the country responded to this survey. About 49% of the respondents indicated having only classroom lectures on mouthguards during their undergraduate trainings, 11% said they had some laboratory sessions in addition while no form of education on mouthguards was received by 40%. About 82% had never recommended mouthguard protection for athletic patients, and the major reason was no formal training in the subject. Only 58.5% were familiar with the different types of mouthguards, 75.9% would not be able to supervise or fabricate mouthguards and 50.6% would prefer custom-made mouthguard for their athletic patients. About 84% felt the current training on mouthguards in Nigerian dental schools is inadequate. Over 98% agreed that mouthguard usage in contact sports should be encouraged with the involvement of the dentists. The knowledge and attitudes of the respondents towards mouthguard protection did not vary significantly across years of postqualification from dental schools as well as the professional status of the dentists ( P  > 0.05). Although Nigerian dentists support mouthguard protection in contact sports and want to be involved in the provision of mouthguards for athletes, their knowledge of the protective device is inadequate. There is need for attention to be given to this subject in the undergraduate curricula of our dental schools.     

Attitudinal factors influencing mouthguard utilization

From the introduction of a protective mouthpiece in the sport of boxing, the evidence for the importance of this piece of athletic equipment in injury prevention has grown. Yet, despite this knowledge, only five amateur sports and one professional sport have regulations requiring the use of mouthguards. Even in the sports that require their use, compliance is not universal. Attitudes of coaches, officials, parents, and players about wearing mouthguards all influence their usage. Studies of the attitudes of these groups reveal that coaches are perceived as the individuals with the most impact on whether or not players wear mouthguards. There is reluctance among college football officials to enforce mouthguard violations that they believe are inappropriate. Parents see themselves as having responsibility in determining mouthguard use; however, their views about when and for whom mouthguards are necessary reveal a lack of complete understanding of the benefits. Resistance on the part of players stems from the physical characteristics of the mouthguard, interference with breathing and speech, and the effect on the players' image. Education on the effectiveness of properly fitted mouthguards for injury prevention, information on the risk for injury, availability of more comfortable and appealing mouthguards, and development of an approach for expanding regulations are all tools that can lead to the development of more positive attitudes and increased usage.     

Oral injury and mouthguard usage by athletes in Japan

Abstract— The use of mouthguards in contact sports effectively prevents oral injury and preserves oral structures. We investigated oral injuries and awareness concerning mouthguards ainong Japanese high school soccer and rugby players. Athletes were asked a series of questions concerning their history of oral injury while participating in sports, and their pattern of mouthguard use was determined. The data were evaluated statistically using chi-square analysis. The incidence of oral injuries was 32.3% for soccer athletes and 56.5% for rugby athletes, with 0.8% and 24.1% of the respective groups having mouthguards. There were sigmficant differences between the soccer and rugby groups (p<0.001). Although 81.8% of soccer athletes thought mouthguards were unnecessary, only 26.2% of rugby athletes shared this opinion and there was a sigmficant difference between the soccer and rugby groups. Many soccer ath-letes had insufficient knowledge about mouthguards and were not concerned about preventing oral injury, although it was in fact a common problem in their sport. Athletes as well as coaches must be made aware of the high risk of oral injury when playing soccer, rugby, and other contact sports.     

Dental squash injuries – a survey among players and coaches in Switzerland, Germany and France

Abstract –  Squash belongs to sporting activities with medium risk of causing dental trauma. Because of high velocity, close body contact and the use of rackets the injury potential in squash has increased. The aim of this work was to conduct a comparative study between Switzerland, Germany and France on a number of issues: the frequency of dental and facial injuries in squash, athletes' habits of wearing mouthguards, as well as the general level of information about emergency measures after a dental trauma and the resulting consequences. Using a standardized questionnaire a total of 653 individuals, 600 squash players and their 53 coaches, were interviewed. In each of the three countries 200 players belonging to four different divisions (juniors, amateurs, semi-professionals and professionals) were surveyed. Of these 653 interviewees 133 (20.4%) have already observed a dental injury; 27 (4.5%) have experienced a dental trauma themselves. Less than half of all interviewed players and coaches (47.6%) were aware of the possibility of replanting avulsed teeth. Just 5.1% were familiar with the tooth rescue kit. Only one individual wore a mouthguard. The results show that the area of squash requires more information about prevention through sports associations, coaches and dentists.     

Rugby athletes' awareness and compliance in the use of mouthguards in the North West of Italy

Abstract – Background: The prevention of dental injuries during full‐contact sports such as rugby is extremely important. Wearing a mouthguard can significantly reduce the frequency and severity of orofacial injuries, but it is not always used as athletes find it difficult to tolerate. The purpose of the present study was to determine the awareness and the extent of mouthguard use in a sample of young rugby athletes in the North West of Italy. Material and Methods: The athletes of four amateurs rugby teams based in the Province of Turin, Italy completed a questionnaire about playing history, current use and type of mouthguards, disturbs associated with mouthguard use, and general attitudes towards mouthguards. Results: Only 53.85% of the subjects reported wearing their mouthguard all the time both during training and games. The most commonly reported problem associated with using a mouthguard was the discomfort on speech, followed by difficulty in closing lips, adversely affected breathing, adversely affected swallowing and slipping sensation. A statistically significant association between patients <22 years and non‐use of mouthguards was observed. Conclusion: Limited knowledge about oral injury prevention and limited use of mouthguards were observed. The present study suggests that educational courses for rugby players and coaches to promote the use of mouthguards would be extremely important to reduce common complaints about these devices and increase their usage.     

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.     

Oral trauma, mouthguard awareness, and use in two contact sports in Turkey

Abstract –  The purpose of the present study was to evaluate the occurrence of dental hard and soft tissue injuries during participation in contact sports, and the awareness and use of mouthguards in a young adult sample of semi-professional or amateur boxers and tae kwon do participants in Turkey. The samples consisted of 274 young adults [174 male (63.5%) and 100 female (36.5%)] aged between 17 and 27 years of which 185 (67.5%) were tae kwon do practitioners, and 89 (32.5%) were boxers. The participants answered a standard questionnaire. All answers were evaluated and then statistical analyses were performed. Of the total sample, 61 of the subjects (22.3%) suffered dental trauma. Of these sufferers, 32 (17.3%) were boxers and 29 (32.6%) were tae kwon do practitioners. It was found that 19 (6.9%) athletes lost their teeth post-trauma. Of the 54 subjects (19.7%) suffering soft tissue injuries, 44 were female (81.5%), while only 10 were male (18.5%), of which 40 (74.1%) were tae kwon do practitioners and 14 (25.9%) were boxers. Of the total sample of 274 subjects, 228 (83.2%) were well informed about mouthguard usage. Of the total sample, 153 (55.8%) of the subjects used mouthguards, all of which were boil-and-bite type. The results of our study indicate that dentists and sports authorities in Turkey should promote the use of mouthguards in contact sports such as tae kwon do and boxing, which have a serious risk for dental and oral soft tissue trauma and tooth loss.     

A literature review of sports-related orofacial trauma

This literature review evaluates the significance of dental injuries and their relationship to specific sports activities. Many studies have been published on individual sports or groups of sports but most pertain to specific age groups or levels of competition. Research suggests that many sports that do not require mouthguards should encourage male and female participants to use orofacial protectors. Athletes, coaches, athletic directors, athletic trainers, parents, and members of the dental community should be aware of how individuals who participate in sporting activities are at risk for dental trauma. Any sport where the potential for dental trauma can exist (such as basketball, soccer, or wrestling) should consider utilizing mouthguards to protect the competitors. The establishment of mouthguard programs for athletes of all ages, genders, and sports may help to reduce the incidence of dental trauma. A sports-related, orofacial/dental trauma reporting system is considered.     

Dentists' attitudes towards mouthguard protection.

PURPOSE: This study analyzed the attitudes of Virginia general dentists, orthodontists, and pediatric dentists towards mouthguard protection. METHODS: Questionnaires were constructed and mailed to 2500 dentists in Virginia. RESULTS: In this survey, 97% of orthodontists, 84% of pediatric dentists, and 67% of general dentists recommended mouthguard protection for their athletically active patients. The two main reasons for not recommending mouthguards were that the patient could obtain one from a less expensive source than the dental office and the dentist had not received formal training on fabrication or use of mouthguards. More recent graduates were more likely to have been taught mouthguard use and fabrication during their dental training. General dentists (59%) and pediatric dentists (56%) recommended the custom mouthguard while orthodontists recommended the prefabricated stock type (77%) as their primary choice of mouthguard. A majority of general dentists (58%), orthodontists (81%), and pediatric dentists (76%) recommended mouthguard protection for the contact sport of basketball which presently is a non-mandated mouthguard sport. CONCLUSION: Most dentists agree that athletically active patients require mouthguard protection. Many dentists, however, question whether they were the ones responsible for distributing and fabricating the mouthguards.     

Are mouthguards necessary for basketball?

This literature review evaluates the significance of dental injuries and their relationship to a specific sport--basketball. Many studies have been published on individual sports or groups of sports, but most pertain to specific age groups or levels of competition. Research suggests that many sports that do not require mouthguards should encourage male and female participants to use orofacial protectors. Athletes, coaches, athletic directors, athletic trainers, parents, and members of the dental community should be aware of how individuals who participate in sporting activities are at risk for dental trauma. Any sport where the potential for dental trauma can exist, such as basketball, soccer, or wrestling, should consider utilizing mouthguards to protect the competitors. The establishment of mouthguard programs for athletes of all ages and genders who participate in basketball may help to reduce the incidence of dental trauma.     

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.     

The use of mouthguards

A mouthguard is a useful appliance to prevent oral injuries, and their emotional and financial consequences. Most sportsmen are aware of the benefits of a mouthguard. Nevertheless, a relatively small percentage of sportsmen in contact sports are using a mouthguard actually. Whether or not a mouthguard is used, is predominantly determined by its comfort. Therefore, a mouthguard must be optimally comfortable. However, to make sportsmen using an even optimal mouthguard, needs motivation. Stimulating of motivation is the task of parents, coaches, (team) physicians, and (team) dentists. Especially coaches seem to have great influence on sportsmen. Children are very much influenced by their parents. It is the task of general dental practitioners not only to inform sportsmen and their parents, but also their coaches and team physicians about the risks of oral injuries and about the benefits of preparing a mouthguard. General dental practitioners must put themselves disposal to prepare mouthguards for their individual patients as well as for all players of a team who wish to have a mouthguard prepared.     

The prevention of orofacial sports injuries in the adolescent

Custom-made mouthguards are effective in reducing orofacial injuries to junior players. A significant reduction or total elimination of these injuries can be expected when mouthguards are used. An acceptable custom-made mouthguard can be constructed for every adolescent; therefore, they can and should be used in contact sport at junior level. This will help young people to become accustomed to these protective devices at an early age. It is important that first mouthguards are comfortable and that adaptations are done whenever needed to ensure that the recipients will want to continue to use these devices. Sports bodies and coaches should do more to enforce the use of mouthguards at all levels. The high incidence of injuries to the oral region makes their use essential. The time has now come for the use of mouthguards to be made compulsory by contact sports authorities, first, for all senior teams, and subsequently for high school and even primary school pupils. Most parents and many dentists are still unaware of injury hazards and (more importantly) the protection available. A team dentist, where there is a possibility of dental injury, is the ideal situation. One dentist can easily be the team dentist for a number of teams, acting as professional adviser, fitting and adjusting mouthguards and ensuring that trauma (or dental disease) is treated by the player's own dentist.     

Dental and oral trauma and mouthguard use during sport activities in Israel

Abstract – The purpose of the present study was to evaluate the occurrence of oral and dental injuries in young Israeli population engaged in diverse sport activities. The participants' awareness of the use of protective devices, such as mouthguards, during sport activities was also evaluated. A population of 943 young adults, 95% males and 5% females (ages 18–19), was surveyed. A questionnaire was distributed relating to the type of sport activity practised, past oral and dental injuries over their lifetime, specifying the time and type of sports in which the injury occurred and the use and awareness of the protective devices. Of the total population examined, 850 (90%) were active in at least one type of sport, either as professionals or as amateurs. The analysis included the population that regularly participated in at least one sporting activity. The most commonly practised sports were soccer (54% of all active participants) and basketball (50%). The total number of dental and oral injuries experienced during all sport activities was 229, affecting 27% of the participants of whom 73 (9%) suffered dental injuries. Most dental injuries occurred during the basketball and soccer training sessions and matches reaching 42 and 41% of the total number of injuries, respectively, and affected 7.2 and 6.6% of the basketball and soccer players. Traumatic dental injuries in other sports occurred in less than 7% of the participants in these activities. Only 27% of the participants were aware of the protective devices, such as a mouthguards, and only 3% actually used these devices. These results point to the high risk of potential dental and oral injury during sport activities, the little knowledge about the benefits of using mouthguards and their limited utilization. The importance of public health education to increase the awareness of protective measures and devices and their actual use in Israel is the main focus. It should be a combined duty of dentists and sports physicians and of the coaches to encourage the use of protective devices during training and games.