Emergency Treatment

Due to the high incidence of sports-related dental injuries, it is vital that primary healthcare providers such as school nurses, athletic trainers, team physicians, and emergency personnel are trained in the assessment and management of dental injuries. Dental team members can assist these providers by offering to speak to their schools, since they will be providing immediate treatment at sporting events. The ADA has urged its members to work together with schools, colleges, athletic trainers, and coaches to develop mouthguard programs and guidelines to prevent sports injuries.

The main method for preventing orofacial injuries in sports is wearing mouthguards and headgear, consisting of a helmet and face protector. Yet, a study by the National Institute of Dental and Craniofacial Research (NIDCR) reported that children do not consistently wear mouthguards and headgear during organized sports. Even in football, a sport that requires the use of mouthguards, as earlier noted, only about 75% of students are in compliance.¹⁵

Parental perceptions of children’s risks to injury, expenses associated with protective gear, and peer pressure may influence use of mouthguards. Interestingly one study found that lower socioeconomic parents were reported to be more aware of orofacial injuries than affluent parents.¹⁶ The observed patterns of mouthguard wearing by males and females can represent cultural differences, peer pressure, and/or nature of sports played, including the following:

1. Perceptions that female athletes are less aggressive and thus, a reduced risk of injury may exist,

2. Perceptions regarding the absence of long-term commitment to a sport may result in a differential willingness to devote resources to female athletes,

3. Aesthetic appeal may influence protective orofacial gear usage,

4. Female athletes may play in non-league-based sports with fewer or less stringent rules or may play less combative sports than male players.¹⁵

The literature indicates the use of mouthguards by athletes is most influenced by their coaches.¹⁷ However, several studies indicate mouthguard compliance by athletes is usually not mandated by their coaches or referees.³⁵ One study found that coaches reported they did not have sufficient knowledge of mouthguards. Coaches also reported that most information about mouthguards comes from sales representatives (72%), educational materials (33%), and dentists (11%).¹⁸

In 1995, the ADA House of Delegates revised their policy recognizing “the preventive value of orofacial protectors” and endorsed their use “in sports activities with a significant risk of injury at all levels of competition.”¹⁹