Football players require pads and helmets. Soccer players wear shin guards. Skateboarders wear elbow and knee pads.

But there’s one piece of safety equipment that spans all sports where there is risk of contact with players, equipment or hard surfaces: mouth guards.

As an orthodontist, I’m particularly interested in this piece of safety gear, because it protects the investment you’ve made in your smile if you’ve gone through orthodontic treatment. Who wants to go through a year or more of treatment to obtain a beautiful smile, and then lose a tooth – especially a front tooth?

Sadly, it happens all too often. I suspect that not nearly enough athletes wear mouth guards.

Tyler Johnson, a reserve guard for our beloved Miami Heat, was a reluctant mouth guard wearer who finally relented in November 2016 after oral surgery to address a missing tooth caused him to miss a game. A tooth lost in college had been replaced with a dental implant, and that implant got knocked out and required surgery to replace it.

“I can’t miss games because I’m missing teeth,” he told the Palm Beach Post at the time.

So for his next game, he donned a thin, black mouth guard. He said the streamlined mouth guard was more comfortable than he expected.

Prior to this, he had shunned the protective devices because he said they affected his breathing and his ability to speak. His teeth paid the price. The player has had seven teeth knocked out while playing basketball professionally and in college, he told campers at the Heat’s youth camp over the summer.

At some point between November 2016 and this past summer when he was discussing tooth loss with campers, I wonder if Johnson reverted to his old ways and ditched the mouth guard once again, or if he had a complication with his implant and it had to be removed.

Whatever the reason, Johnson is missing a front tooth these days, and while it doesn’t bother him, apparently his mother isn’t happy about it.

The Sun-Sentinel reported in August that Johnson’s mother has pushed him to replace the tooth. His track record of tooth loss has left him unenthusiastic about it, though.

“I don’t see why it’s necessary right now, because I’m sure eventually it’s going to get knocked out again,” he told the Sun-Sentinel. “I mean, if I play 10 years in the NBA, I’m pretty sure I’m going to lose it two, three more times. So if I leave it out now, then I just got to get one.”

Sports-related Dental Injury Statistics

The Journal of the American Dental Association reports that 13-39 percent of all dental injuries are sports-related. Males get these injuries twice as often as females, and the maxillary central incisors – your two front teeth – are the teeth most commonly injured.

There is a one in 10 risk of orofacial injury for sports participants in a single athletic session, according to the National Youth Sports Foundation for Prevention of Athletic Injuries.

You might be surprised to learn that more players suffer sports injuries while playing basketball than contact sports such as football and hockey, according to the Journal of Cosmetic Dentistry. Ball sports and stick-and-ball sports account for 59 percent of orofacial injuries.

Types of Mouth Guards

Wearing a mouth guard that fits properly is one of the easiest, most cost-effective ways to prevent oral injuries. There are several types of mouth guards from which to choose.

Over-the-counter – These pre-formed mouth guards tend to be less expensive than other options, but they cannot be adjusted, so one drawback could be the difficulty in finding one that is the right size for your mouth. Having a proper fit is necessary to provide proper protection.

Boil and bite – This is the style that we recommend to our patients who play sports. They come in a pre-formed shape that is adjusted to fit your bite. You boil the mouth guard in water, then bite into the warm plastic to create a customized fit. This kind of guard can be purchased at sporting goods stores.

Custom– Many dental offices offer this option. An impression is taken of the teeth, and this is used to create your mouth guard.

Youth who play sports should have their mouth guards inspected periodically to make sure they still fit properly. Last season’s mouth guard may not fit a growing child.

A mouth guard that fits properly should enable you to breathe and speak without great difficulty.

Orthodontics and Mouth Guards

If you play sports and wear orthodontic appliances, a mouth guard is particularly important. A blow to the face can damage more than your teeth; you also can damage the soft tissue inside your mouth when it is forced against your appliances.

Are you anxious to finish your orthodontic treatment on schedule? Then that’s another reason to wear a mouth guard. A blow to the mouth or face that breaks or bends your orthodontic appliances may set back your treatment.

 You Need to Replace Missing Teeth

Although I empathize with Johnson’s “why bother” approach to replacing his missing front tooth, given his propensity for having it knocked out, the reasons for addressing missing teeth go beyond mere aesthetics.

Your teeth serve important functions.

  • Eating – The front teeth are designed for biting into things, and the back teeth are for chewing.
  • Speaking – We speak by pressing our tongue and lips to our teeth to make sounds.
  • Healthy jawbone – When a tooth is lost and not replaced, that sends a message to the jawbone that its work is done and it begins to resorb.
  • Proper spacing and eruption – Teeth support each other and keep neighboring teeth in their proper places. A missing tooth that isn’t replaced leaves room for neighboring teeth to drift. A missing tooth also creates space where its counterpart in the opposite jaw can erupt more than it’s supposed to. That can lead to a host of issues for that tooth.

There are lots of options to replacing missing teeth, from bridges to dental implants. Cosmetic dentistry makes it possible to achieve dental restorations that match the color of your natural teeth, in addition to functioning like regular teeth.

Even though the technology is there to replace missing teeth, your first line of defense always should be protecting the teeth you have. So find a mouth guard that fits you well, and wear it faithfully each time you hit the field or the court.

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