Article by Ben Creighton courtesy of Dental Optimizer

Whether weekend warrior, fitness fanatic or serious athlete, a well-fitted mouthguard should be standard equipment. Here, a USC School of Dentistry expert outlines the benefits of mouthguards and how to find one that works.

Every August, a scattered stream of extremely large, athletic young men poke their heads inside the USC School of Dentistry's Center for Urgent Care, eliciting awed stares and whispered comments from the center's more standard-sized patients.

The young behemoths are looking for faculty member Ramon Roges, D.D.S., the center's director, and for the past decade, sole mouthguard manufacturer for the USC Trojans football team.

I also am on the sidelines for all their home games in case someone suffers an oral injury during the course of the game. I love football and I love dentistry, so this has always been a labor of love for me," says Roges.

But mouthguards aren't just for the collegiate or professional football player. While losing a tooth might not be the first thing you think about when you lace up your high tops or jump on your bicycle, for anyone who has suffered a severe blow to the jaw, it is an experience they won't soon forget.

Not only is there the immediate pain, but depending on the damage done to bone and dentition, it can be an injury that requires numerous dental appointments and several thousand dollars to repair. Over the course of an individual's life, one lost tooth can cost an estimated $10,000 - $15,000.

A properly fitted mouthguard is the best protection against such injuries. While store-bought mouthguards are available, they often offer minimal protection due to a poor fit. The best option is a customized mouthguard manufactured by a dentist. The relatively inexpensive device reduces the risk of dental trauma by nearly 200 percent, as the fit and function is much improved.

In addition, a dentist can make accommodations for variables such as future erupting teeth in adolescents, the type of sport played, the patient's medical history and potential obstacles such as orthodontic treatment.

"There is a lot to be considered when manufacturing a mouthguard. For best results, you really need to see your dentist," says Roges.

So who should be wearing a mouthguard?

While the toothless hockey player, stick in hand, grinning ear to ear, is an image we all readily identify, the list of sports where mouthguard protection is recommended includes some not so obvious inclusions.

According to the Academy for Sports Dentistry, not only do the major contact sports, such as boxing, football and martial arts require properly fitted mouthguards, but also less risky activities such as basketball, baseball, bicycle riding, rollerblading, soccer, wrestling, racquetball, surfing and skateboarding.

Despite the fact that mouthguards have been proven effective in preventing dental trauma, most athletes refrain from wearing the device-many claim that it inhibits breathing and talking- and few sports organizations require them as mandatory equipment.

"I hear all the time that mouthguards are uncomfortable or 'I can't breathe with it in my mouth.' With a professionally made mouthguard that is just not an issue. Their effect on performance is very minimal," says Roges. "Believe me, the alternative-possibly losing teeth-is much less desirable."

In the event of a knocked out tooth, a quick and informed reaction is key, says Roges. The tooth should be immediately retrieved and picked up by the crown or enamel portion, not the root, which can be easily damaged. If dirty, it should be rinsed gently, preferably with cold, whole milk or water.

After cleaning, the tooth should be reinserted into place within five minutes. Research shows that replacing the tooth quickly maximizes the chances the tooth will remain viable. However, if stored in whole milk or in a biophosphonate-a medium specially formulated to preserve root tissue-a tooth can still be reinserted up to one hour after being dislodged.

In the case of children, primary teeth should not be replaced as this may damage tooth buds of emerging permanent teeth in the gum tissue.

"In any case, you need to see your dentist as soon as possible. Of course, if you have a concussion, broken jaw or something of that nature, treat those injuries first. But if you've lost or damaged a tooth or damaged oral tissue, get to the dentist right away," says Roges.

One contested benefit of mouthguards is their ability to also minimize concussion. Advocates maintain that the device absorbs the force of upward blows to the jaw, reducing trauma to the brain.

While conclusive evidence of this added protection is hard to come by, several studies suggest that the device may reduce the acceleration of the head and, therefore, could have some efficacy in reducing the severity of concussive injuries.

"If you are going to be participating in sports, at whatever level, it is always a good idea to wear all safety equipment, and a properly fitted mouthguard should be part of that standard equipment," says Roges.