Study: mouthguards work in protecting athletes from expensive injuries to teeth

January 21, 2002

CHAPEL HILL - Common sense has led many dentists, sports physicians and athletic trainers to recommend custom-fitted plastic or rubber mouthguards for athletes to protect their teeth during rough play. Little or no convincing scientific evidence, however, supported the recommendation in sports other than football.

Publication this month of a new investigation by University of North Carolina at Chapel Hill researchers changes that. By studying players on 50 Division I men's college basketball teams, the researchers have found strong evidence that mouthguards protect against dental injuries in men's basketball, too.

The plastic or rubber devices, which act as cushions for teeth to absorb shock waves, apparently had no significant protective effect against concussions or lip or tongue lacerations in those athletes.

A report on the findings appears in the January issue of Medicine & Science in Sports & Exercise, the journal of the American College of Sports Medicine. Authors are Drs. Cynthia R. LaBella, a sports medicine fellow at UNC at the time of the study; Bryan W. Smith, clinical assistant professor of orthopaedics and pediatrics at the school of medicine and head team physician; and Asgeir Sigurdsson, associate professor of endodontics at the school of dentistry.

"Dental injuries can be permanent and disfiguring," LaBella said. "They also are universally expensive to treat."

No definitive prospective studies existed on how common tooth injuries are among college basketball players, she said. Also, good evidence that mouthguards reduce risks of dental injuries in those players was notably lacking, and that's why she and her colleagues carried out their research.

LaBella contacted 100 college athletic trainers at Division I schools across the country. Fifty agreed to report data on dental injuries and concussions using an Internet Web site every week during the 20-week 1999-2000 basketball season. The response rate was 86 percent.

About 13 percent of the athletes wore mouthguards. Because the total number of players using over-the-counter mouthguards rather than custom-fitted ones was small, figures for the former were omitted from the analysis.

"Custom-fitted mouthguards do not significantly affect rates of concussions or lip and tongue lacerations," LaBella said. "In this study of 50 teams, there were 45 dentist referrals in one season. All of those referrals were for injuries in athletes without mouthguards."

Not wearing such custom-fitted mouth protection boosted the risk of dental injuries more than five times, the authors found.

A conservative estimate of the minimum initial cost per dentist referral for treatment of a serious dental injury is $1,000, they said. That does not include the cost of crown replacements about every 10 years.

"There is no question that this total is substantially more expensive than the cost of providing an entire team with custom-fitted mouthguards, for which the direct cost in materials is less than $20 per player," the authors wrote. "Properly trained athletic trainers can perform the majority of the labor required for construction."

Rules requiring mouthguards in high school football were established in 1962 and in college football in 1974. Athletic trainers from 38 states in all four major regions of the country participated in the UNC project.

"This study provides a strong rationale for health-care providers to recommend mouthguard use in college basketball players," Smith said.
Note: LaBella, who recently joined the Center for Athletic Medicine in Chicago, can be reached at (312) 337-0516 (w) or, Smith at (919) 966-3655 (w) or, and Sigurdsson at (919) 966-2707 (w) or Contact: David Williamson, (919) 962-8596

UNC News Services

University of North Carolina at Chapel Hill

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