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Youth Sports and Tooth Loss: Is The Risk Real, or Imaginary?

We’ve all heard horror stories about how one sport or another is “the worst” when it comes to dental injuries, but separating fact from hearsay isn’t easy. The scale and diversity of youth sports makes it easy for one person’s anecdotal experience to differ dramatically from another’s, and the statistics have varied wildly over time. If you’re a concerned parent or a curious reader, here are the reliable facts on youth sports and tooth loss.

How Many Teeth Are Lost Per Year In Sports?

Before we dive into the applicable information, it’s important to clarify the statistics. Sport-related dental injury rates haven’t stayed the same year-over-year, and outdated sources are the main source of confusion among parents.

15 million Americans experience dental injuries each year, and they lose around five million teeth per-year in sports-related accidents. Sounds scary, right? Kinda. Percentage wise, those 15 million Americans are just 4.6% of the total population, and those five million teeth aren’t divvied out one-a-piece. Meanwhile 21 million kids play youth sports everys year, and 65 million adults play some kind of group sport. In-context, that’s not that bad. But that doesn’t mean the risk is negligible.

The overall odds of someone sustaining a sports-related orofacial injury sits at 10% per-season. While the “perfect world” odds are usually less than one percent, the vast majority of athletes do not use mouthguards properly (or at all), increasing their potential injury rates by up to 50%. Non-contact sports that don’t mandate the use of mouth protection, consequently, pose a greater risk than full-contact sports where mouthguards are ubiquitous.

The end result? Kids aren’t losing teeth every day, but the ones they do lose are usually lost to preventable risks.

Yes, They Really Do Need That Mouthguard

Mouthguards might not be the most aesthetic part of a sports uniform, but they are a critical one. They’re often one of the cheapest parts, too.

Since the actual odds of tooth loss are relatively low, it’s easy to assume that a mouthguard is overkill. But that’s a bad assumption. Full tooth loss is only a fraction of the overall set of orofacial injuries that can be mitigated by a mouthguard, and the cost offset is significant when you compare even a $200 guard to a $20,000 corrective procedure.

You just need to make sure they actually use it.

The Gameday Fallacy

From an hourly perspective, athletes spend more time practicing than competing — which means that they’re most likely to receive an injury during practice. The actual competition might be more intense (and athletes are more likely to ignore an injury during competition, leading to later complications), but the raw time difference is the critical factor here.

The gameday fallacy is the assumption that the formality of an event is the largest risk determinant, and that practices and warm ups are inherently less risky than competition. Athletes who commit this fallacy tend to underestimate the importance of wearing their mouthguard (and other equipment) during practice, and end up increasing their chances of injury.

And we all know how level-headed children are when it comes to preventable risk.

Are All Mouthguards Built The Same?

The short answer? No. The longer answer? Any guard is better than no guard, and it’s better to always have some kind of guard than it is to inconsistently or improperly use “the best” guard.

At the cheapest end of the spectrum, mouthguards are just pieces of plastic you put between your teeth. They don’t fit tightly and they’re relatively thin. Cheap mouthguards protect against chipped teeth (by keeping the teeth from directly impacting each other), but they don’t do much for larger impacts that may crack, impact, or otherwise damage teeth.

A common step up from a cheap stock mouthguard is what’s commonly referred to as a “boil and bite” mouthguard. These mouthguards, as the name implies, are made out of a plastic that becomes malleable when it’s boiled, which allows athletes to get an at-home custom fit at a fairly low price. These mouthguards fit tightly enough to stay in place (in reasonable situations), and they’re better at diffusing larger impacts, but they need to be replaced somewhat frequently. Their malleability makes them fairly easy to chew through. They are a good option for children, because their mouths are constantly growing and changing.

The financial gap between boil and bite guards and custom-made guards can be intimidating, but the benefits are equally large. Custom mouthguards are made by dentists (like Dr. Halsema!) using professional molds and imaging, which means that they can be fine-tuned in ways that other guards can’t. Custom guards often use multiple layers of materials with different densities, which makes them the best at protecting against a wide range of dentofacial trauma.  They can also be built to accommodate braces, which is fairly important.

As a middle ground between boil and bite guards and dentist-made custom guards, you can also order a custom guard from online retailers. These retailers send out an at-home mold kit that’s then used to create a 3d printed mouthguard. These guards are becoming increasingly popular, however the materials and and manufacturing methods vary significantly between different companies. A common complaint with online custom mouthguards is that they don’t include enough putty in the at-home mold kits, and that the mouthguards don’t cover enough of the gums to actually prevent injury.

Is it Worth the Hassle?

The risk factor for losing a tooth while playing a specific sport is largely shaped by whether or not mouthguards are mandatory. The rate of tooth loss for full-contact sports is actually lower than other sports because of mouthguard rules. The risk might not be imaginary, but it is fairly arbitrary.

If you’re a concerned parent, the answer is simple: as long as they’re consistently using a properly built mouthguard, their chances of losing a tooth is low. You just need to convince them to use (and clean) their mouthguard.

If you have any questions about mouth guards please don’t hesitate to call Dr. Halsema.