Wear mouth guards on slopes: dentists

When Alexandre Bilodeau finished his high-flying Olympic freestyle moguls event to win the gold medal, the bright white of his mouth guard couldn't have been a better advertisement for the importance of wearing that hardware, experts say.

When Alexandre Bilodeau finished his high-flying Olympic freestyle moguls event to win the gold medal, the bright white of his mouth guard couldn't have been a better advertisement for the importance of wearing that hardware, experts say.

That's certainly the message of protection from the Canadian Dental Association, which foresees a big surge in children and teens, in particular, trying to emulate Olympic athletes on skis, snowboards and skates.

"I think it's aimed at everybody that's involved in a sport that can cause facial injury," says CDA president Dr. Don Friedlander, "but most importantly with the young people [is] to get them used to wearing mouth guards and understanding that, you know what, their heroes wear them, it's cool to wear one, it's smart to wear one."

Mouth guards, typically worn over only the upper teeth, can prevent potentially serious injuries from falls on the slopes, rink or other surfaces, or from being lambasted by a hockey stick, for instance.

"It's not 100 per cent protection, but we see a huge advantage, a huge reduction in injury," says the Ottawa dentist.

Smashing face-first into hard-packed snow or ice can cause a range of injuries, from broken or dislodged teeth to a lacerated tongue and lips to a fractured jaw.

Peter Judge, CEO of the Canadian Freestyle Ski Association, says the organization started requiring its elite athletes to wear mouth guards while training and competing about a decade ago.

"The mouth guards provide a cushion between the teeth," says Judge, noting that the upper and lower chompers can slam together as skiers bump down a moguls run at high speed or while airborne performing a gravity-defying trick.

 "First and foremost, we strongly recommend that mouth guards are used at any level, particularly at those younger levels, because being less-skilled athletes, the propensity or the probability that something can happen is higher."

Judge, based in Vancouver, says the national organization and its provincial counterparts have freestyle skiers that range from six-year-olds in the "bumps and jumps" entry level to five-time Olympic veterans.

Recreational participants are strongly advised to wear mouth guards when they take to the slopes, he says. "In the high performance program it's mandatory."

Concussion prevention unproven

Mouth guards, sported by Olympic competitors engaging in everything from skiing and snowboarding to skeleton and speed skating, are made of a type of plastic designed to absorb and dissipate force when the upper and lower jaws bang together.

It's widely believed that the devices' cushioning effect helps protect against concussion. But Toronto neurosurgeon Dr. Charles Tator, founder of the injury-prevention organization ThinkFirst Canada, says there's no definitive scientific evidence to support that idea.

"There is a good chance that they do, from reading the studies and getting the experts' opinions," especially when it's the front of the head in the jaw area that takes a knock, he says. "It's possible that mouth guards are going to reduce the forces on the brain."

But Tator doesn't believe the dental appliances would have much effect on limiting force generated by blows to the side or top of the head.

"I really don't see that a mouth guard could reduce concussion from blows in those directions."

Still, better safe than sorry, he says, advising that those who take part in any high impact-risk sport "would be better protected if they wore a mouth guard."

Custom mouth guards

The teeth-wrapping devices can be as simple as the over-the-counter stock models sold at most sporting goods stores, which come in a few sizes and are placed over the teeth "as is."

Giving a somewhat more individual fit is the "boil and bite" type, made from a horseshoe-shaped plastic template that becomes pliable when heated in water. The wearer clamps their upper jaw into the softened plastic, which moulds around the teeth before hardening into the required shape.

Friedlander recommends custom-fitted models made by dentists, saying they provide better all-round protection and greater durability.

Making a custom mouth guard is a pretty simple exercise: the dentist takes moulds of the upper and lower teeth and does a "bite registration" test to ensure a snug, comfortable fit. The gadget can be ready in as little as 24 hours, he says, and costs in the $100 range.

Mouth guards can be clear or plain white — or any colour of the rainbow, it seems. Some elite and professional athletes go all out, wrapping their teeth in neon-coloured or highly decorated mouth guards that become part of their signature gear.

Friedlander says recreational athletes should view oral protection in the same way they do head-trauma prevention.