TEETH DAMAGE ASSOCIATED WITH POOR DENTISTRY AND USE OF IMPROPER MOUTHGUARD
By Ed de la Vega, DDS
PhilBoxing.com
Wed, 05 Jan 2011
One of the many reasons why I am so passionate about the dental health of athletes and the use of custom designed, dentist-fitted athletic mouthguards was again validated.
A 20-year old boxer was referred to my offices by the folks at gym in Hollywood. The problem: ?loose front teeth?.
When he came to our offices, he was asked to fill-out the routine paperwork that allowed us among other things, a nice look at his medical and dental history. After that, he was ushered to one of our operatories where he was introduced to me by my staff.
I asked the young man what we can do for him. He indicated to me by pointing to his two front teeth that he has ?loose front teeth that are causing a lot of pain? and he wanted the problem corrected so he can continue training at the soonest possible time.
The patient stated that two weeks ago while sparring he was hit square on the mouth and he felt like his front teeth snapped but he paid no attention to it. Then on a subsequent sparring session, he was hit again and this time it hurt like heck and there was bleeding too.
Figure A.
As soon as I saw the teeth in question and did the initial examinations, I knew that the kid is in a lot of trouble. He had two porcelain crowns fused together to restore his two upper central incisors. (Fig. A) The teeth are oversized and too prominent in relation to his other teeth. Somehow I felt the design was in futile attempt to compensate for the front open bite the patient had. The two crowns were extremely mobile, a sure indicator that they are fractured.
Further questioning revealed that he uses a ?boil-n-bite? mouthguard he bought at a sports store and he molded it himself following instructions that came with the mouthguard material he bought. (Fig. B and C)
Fig. B.
Fig. C.
Fig. D.
Fig. E.
X-rays revealed root fracture at the middle third. (Fig. D) But worse, the teeth are now non-restorable and must be extracted and replaced by a more definitive restoration. (Fig.E)
Options and the pro and cons of each were explained to the patient including implants. The patient opted to restore the teeth with a removable partial denture mainly due to constraints of boxing.
After a through discussion of the options he had to correct the problem, it was agreed that surgical removal of the remaining root be done and a temporary denture (stayplate) be installed and used while the wound heals. The temporary denture if nothing else took care of temporary ?esthetics? problem.
The above was done and the patient was instructed to return for follow-up care. In due time, a more definitive restoration to replace the extracted teeth will be made to restore function and esthetics.
This particular case clearly demonstrates the importance of good oral health care and dentistry and the use of custom made, dentist-fitted mouthguards particularly in contact sports like boxing.
The poor dentistry and the use of a commercial over-the-counter mouthguard certainly have a lot to do with what happened to the patient.
I hope it never happens again.
Perhaps by continually pushing the issue and publishing actual cases to back up my arguments not only in dental publications but in boxing websites as well (even at the risk of being criticized by those that care, know and understands less) the powers-that-be will finally take notice and decide to institute changes in boxing, MMA and other contact sports like basketball and enforce the use of dentist-fitted, custom made mouthguards for the betterment of the dental health and the protection of the athletes.
Post Script: Complete consent was obtained from the patient in writing allowing us to use the above photos.
Click here to view a list of other articles written by Ed de la Vega, DDS.
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