Through my work with the Eastman, I've spent a lot of time analysing the use, benefits and science of mouthwear in relation to sports, so it made sense to introduce a high-end mouthwear service for patients at my practice.
The sporting dentistry course takes place approximately one day a month for a year and we cover trauma to the dentition and face primarily during sport. We also look at things such as how to look after elite athletes in practice, their diet, and, obviously, mouth protection. It's important to have this all-round knowledge if you decide to offer your services as a dentist to, say, a local hockey, rugby, or cricket club. You're suitably equipped to deal with the trauma that'll undoubtedly come your way.
Mouthwear is a significant aspect of the course and one that students are becoming more aware of generally, and they are really keen to find out more. It's worthwhile looking at the science behind it, the technician's point of view and the final manufacture of the laminated mouthwear to be able to fully advise our patients.
Mouthwear is very straightforward to incorporate into the practice; it's not difficult at all. It's a question of people being alerted to what's going on and perhaps receiving a little education on what's needed in terms of impressions and bite registration. Dentists are taking impressions every day, but perhaps there are one or two things they need to be clear on to get a good impression and have all the right information on the model, so the technician can produce a highly accurate result.
In the past I've used commonly available mouthguards and I definitely prefer laminated mouthwear that is properly manufactured in a laboratory. The difference is huge in terms of effects. If you've got something that fits properly, is comfortable and protects, people are more likely to wear it.
Protective mouthwear is normally made for the upper jaw, but it can be done on the lower teeth if it's constructed properly. There has been 'upper and lower' mouthwear experimented with in the past, but these are too difficult to wear.
You get a certain amount of protection with mouthwear for the upper jaw. There are even controversial articles discussing whether or not they prevent concussion - the jury's out on that, it hasn't been definitively proven one way or the other. There is another argument that suggests the number of traumatic incidents is the same with or without mouthguards. However, I am convinced they do make a difference – I certainly wouldn't let my children play rugby, hockey or lacrosse without one.
I have recently sent off impressions to get non-contact Under Armour Performance Mouthwear for myself that I can use while running. In the past I played rugby and football but had to stop because of various injuries. I still wanted to keep fit, so I took up running. But I needed to have some kind of a purpose so I did the 1982 London marathon, and I've been running marathons ever since.
The mouthwear I'll be using is not a protective appliance; it's worn on the lower teeth. When you bite on the mouthpiece, you're putting the muscles of your jaw, head and neck 'at rest'. Protective mouthwear is used on the upper teeth and is not really there from a muscular point of view, but to cover and protect the teeth, and the maxilla a little bit.
When we close our teeth tightly together, there's a certain amount of tension in areas such as the upper back, neck and shoulders. Patients have come to the practice with problems on the way they bite their teeth together – resulting in backache and headaches, and it's largely down to muscle tension. Using mouthwear, as you bite down, the appliance stops your teeth from coming completely together. As a result, the muscles are not fully together, so they are 'at rest'. The action of clenching the teeth produces lactic acid, which in turn causes fatigue, aches and pains. Clenching also sends a signal to the brain to produce cortisol – the stress hormone. By putting muscles 'at rest', it enhances performance, because they're not so tense and don't suffer the side effects of lactic acid and cortisol. It's particularly relevant with people such as golfers – a lot of their activity is located in the upper back, neck and shoulders. If those muscles are more relaxed they are freed up to perform better.
I have just become an authorised provider of Under Armour Performance Mouthwear from Bite Tech and I'll start by targeting my existing patient list for custom-fit mouthwear. There is a practice newsletter that gets sent out twice a year giving news and updates, so we'll make use of that and place other literature in the waiting room.
It'll be interesting to see how the service is received at the practice and who takes up the option. I do have a lot of golfing patients who may consider using it, especially for competitions, to give them an edge.
Once the service has bedded in, I'll look further afield to spread the word. I'll certainly include it in future presentations that I do; it's so important to keep people up-to-date on significant developments.