How many emergency dental appointments have you seen due to traumatic dental injuries (TDIs)? As much as 25% of school-aged children and 33% of adults experience a TDI to their permanent teeth. And of course these events never happen during optimum times, so these emergency appointments need to be made as parents call out of work and kids have to leave school early. But the real problem with an untreated TDI is the possible long-term effects of a missing or damaged tooth.
TDI often occurs in the maxilla with the central incisors injured more frequently than the lateral incisors. In the primary dentition, a luxation or displacement injury is more common than a fracture. TDI actually happens most frequently between the ages of 1 1/2 and 3 1/2. This makes sense because toddlers are beginning to walk and experience the world around them. Between the ages of 8 and 10 children experience flared and spaced maxillary incisors because they engage in more high-contact activities, including sports.
So how can we reduce the risk of TDI? Proper education has to come from the dental hygienists and dentists. A great resource about mouth injuries can be found at the Academy of Sports Dentistry and the American Academy of Pediatric Dentistry. Both of these sites will encourage the use of protective gear such as custom mouthguards.
The American Dental Association (ADA) promotes the use of well-fitting mouthguards too. This is the best protective device for sports-related TDIs.
There are three major categories of mouthguards. A Type I mouthguard is a ready-made thermoplastic tray that fits very loosely around the teeth. It is clinched into place by the jaw and usually delivers poor retention while restricting breathing and speech. A Type II mouthguard is a typical boil-and-bite. These mouthguards can be found is nearly every athletic store or section. This remains inexpensive and gives better retention than the type I mouthguard, but still has many faults when it comes to ultimate protection. Finally, is the Type III mouthguard, which is laboratory or dentist fabricated. This type of mouthguard provides the best protection and is most widely accepted because of the unparalleled cushion and retention. These materials, including Pro-form mouthguard material, are made with ethyl vinyl acetate (EVA). This durable material is vacuumed formed around a mold of the patient’s mouth. This provides a very tight fit for maximum protection.
Of course, this third type of mouthguard is more costly, but so is the repair of TDIs. Prevention is the best way to avoid those late-night emergency dental visits.