Search

Traumatic dental injuries (TDI) are a prevalent public health concern, requiring preventive measures as well as timely and appropriate interventions to prevent adverse outcomes and optimize patients' prognosis. Although dental trauma injuries require prompt clinical intervention, some challenges persist in effectively managing these injuries. In dental traumatology, the implementation of public health policies assumes critical importance, these policies play an important role in addressing preventive measures and mitigating the repercussions of TDI. This review aims to emphasize the importance of developing comprehensive public health policies in dental traumatology, recognizing the strategic importance of this approach and its benefits. By proactively addressing issues associated with dental injuries, these policies have extensive implications for individual quality of life and public health in general. Furthermore, this review will present a suggested structured framework for the development of public health policies, encompassing key domains including prevention, intervention, and education in dental traumatology. The creation and implementation of these policies will address dental trauma through prevention programs, research, and development, and will provide a significant step toward enhancing the well-being of the population and dental trauma victims' prognosis promoting a more resilient healthcare system., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Perianaesthetic dental trauma is a common anaesthesia-related complication. Theprevious studies have shown a lack of knowledge regarding mouthguard usage and controversial results related to perianaesthetic dental trauma prevention. This study aimed to conduct a finite element analysis of the compressive and tensile stresses on the tooth-periodontal ligament-bone complex using custom-made mouthguards of different thicknesses and glass fibre splints to prevent perianaesthetic dental trauma. Custom-fitted ethylene-vinyl acetate mouthguards of two different thicknesses (2 and 3 mm) and glass fibre splint were modelled. A linear static finite element analysis was performed by applying a rigid Macintosh laryngoscope to the palatal surface of the maxillary central incisors at 150 N. The model without a mouthguard and glass fibre splint showed the highest stress values at the palatinal root surfaces during the impact. Increasing the mouthguard thickness significantly decreased the stress-strain values regardless of the presence of the glass fibre splint. Maximum stresses in the group using the 3 mm mouthguard were the lowest compared with the other groups.

Background/aim: Contact sports-related oro-dental trauma contributes to a significant proportion of sports injuries among school children. Oro-dental trauma imposes a detrimental impact on the oral health-related quality of life. However, the burden of oro-dental trauma among contact sports players and their practices of mouthguards remains a research gap in Sri Lanka. The current study bridges that while providing evidence for contextual changes such as initiating sports dentistry., Materials and Methods: The study was conducted among 1340 adolescent contact sports players in Colombo district, Sri Lanka; 63.1% males and 36.9% females (age 13-18), who were enrolled in football, rugby, hockey, boxing, basketball, and martial arts in the school setting. A checklist was administered to obtain demographic information, sports practices, and the use of mouthguards. An oral examination was conducted for those who experienced oro-dental trauma during the last 12 months., Results: Self-reported oro-dental trauma pooled prevalence of the contact sports players was 35.9% (95% CI = 33.3-38.5), with males' preponderance. Dental trauma was present in 23.8% (n = 319), while 15.8% were uncomplicated and 8% were complicated. Soft tissue injuries were present in 12.1% (n = 162). Oro dental trauma (ODT) was highly prevalent among boxing, rugby, and hockey players. Only 20.8% (n = 279) of players used mouthguards. However, 91.0% (n = 254) of them were using ready-made mouthguards. Mouthguard use and the type of mouthguard showed statistically significant associations across the type of oro-dental trauma among contact sports players., Conclusions: Contact sports-related oro-dental trauma prevalence is as high as 35.9% among Colombo district school children in Sri Lanka. However, their level of mouthguard usage is shallow at 20.8%. Further research is necessary to investigate the reasons behind this, and national guidelines should be developed to prevent and manage sports-related accidental injuries., (© 2023 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Introduction: Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals., Aim: To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs., Methodology: A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS)., Results: Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable., Conclusion: The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports., (© 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background/aims: Athletes are susceptible to oral injuries. To reduce the incidence and severity of oral trauma, a custom-made mouthguard, a device positioned in the mouth to prevent damage to teeth and surrounding structures, is recommended. In field hockey, according to the international rules of this sport, using mouthguards is not mandatory, but it is recommended to wear them at all times while practicing this discipline. We aimed to determine characteristics and differences regarding mouthguard usage among field hockey players from different countries participating in the XII ODESUR Games., Methods: We conducted a cross-sectional study that included 78 voluntary hockey athletes that met the inclusion criteria. The questionnaire used was validated by Panam Sports, collecting information on the type of mouthguard (custom-made or prefabricated), and the time of use of the mouthguard (range of 5 years)., Results: Of the total number of athletes, 96% used mouthguards, of which 64% were custom-made type, and 32% were prefabricated (p < .001). Custom-made mouthguards were used by 100%, 89%, and 64% of athletes in Argentina, Chile, and Peru, respectively, while only 40% of athletes in Paraguay and Uruguay used them. It has also been observed that more than 50% of the individuals have not controlled and replaced their intraoral devices for more than 10 years., Conclusions: Our results reveal a problem with a public health dimension and thus invite the standardization of guidelines with an educational approach to promoting and adopting good sports practices. This report is the first on using mouthguards in high-performance athletes during an international multisport event., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The Guidelines for Prevention of Traumatic Dental Injuries were reviewed and approved by the Board of Directors of the International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Objectives: Traumatic dental injury occurs during sports competitions, training, and practice and can be prevented by the use of mouthguards. For this reason, this study aimed to evaluate the knowledge and attitudes of sports science faculty students, physical education teachers, and athletes about mouthguards., Methods: Five hundred thirty-two participants were reached via social media. In the questionnaire consisting of 20 questions, questions about the sociodemographic characteristics of the participants were asked in part 1, and questions about their level of knowledge and attitudes about the mouthguards were asked in part 2. Descriptive statistical analysis and a chi-square test were used to evaluate the data., Results: The number of people who think that mouthguards protect the athlete from traumatic dental injury is 381 (71.6%). The number of people who think that mouthguards affect the performance of the athlete is positively 228 (42.9%). To protect against traumatic dental injury, 51.48% of the participants preferred the custom-made; 39.3% of them preferred the boil-bite; 33.22% of them preferred the standard/stock type mouth guard; and 22.96% of them preferred the helmet, and 18.26% of them preferred the face mask., Conclusions: The knowledge and attitude of sports science faculty students, physical education teachers, and athletes are low about mouthguards. Since these people who are engaged in sports have a high exposure to traumatic dental injuries, education should be given to increase their awareness about mouthguards., (© 2023. The Author(s).)

Traumatic dental injuries (TDIs) occur commonly in children and young adults with one in three adults having experience of a TDI to their permanent dentition. Although the management of TDIs have evolved vastly, the consequences of TDIs can still be profound and generally carry a high burden for the patient, family, or carer, as well as the clinician and healthcare services. Hence, prevention of TDIs where possible is key. It is important to ensure that all risk factors for dental trauma are fully explored to allow preventative advice to be tailored to each patient. General Dental Practitioners are well placed to establish a rapport with patients owing to the continuity of care that is commonly seen in dentistry, however, it is imperative that the appropriate questions are asked.This article aims to review dental trauma highlighting the significance of identification of clinical and social risk factors and prevention of TDIs. These risk factors are further divided into modifiable and non-modifiable risk factors which can guide the clinician on what further action is required and when other members of the dental or medical team should be involved. The importance of patient education in prevention of TDIs, including use of mouthguards in sport, and mouthguard design will be discussed.

Objectives/aim: Sports-related dental injuries occur frequently among athletes due to inadequate knowledge and prevention measures. The aim of the study was to assess knowledge, attitudes, and practices of active soccer players from all leagues in Croatia regarding traumatic dental injuries and the use of mouthguards., Material and Methods: 393 respondents completed a questionnaire-based online survey from March 2022 to April 2022. The questionnaire consisted of 37 questions divided in four sections: demographic characteristics, experience with orofacial injuries, knowledge of emergency therapeutic procedures for dental injuries, and behaviors related to the use of a mouthguard., Results: Insufficient knowledge was confirmed by a total score of 2.8 ± 2.8 points, with a possible maximum of 11. Respondents' better knowledge can be associated with educational level (p = .002), playing position (p = .046), and personally experienced injuries to the face and jaw (p ≤ .001) and teeth (p = .022). Less than 40% of respondents suffered facial and jaw injuries while playing football and 18.6% suffered dental injuries. Although most respondents (93.9%) were familiar with mouthguards and 68.9% believed that they help prevent injuries while playing football, only 16% used them., Conclusion: The study revealed significant gaps in knowledge regarding dental injuries and the practice of mouthguard usage among Croatian soccer players. Therefore, it is evident that additional education is needed to prevent dental injuries and take proper procedures when taking care of them among the examined population., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Mouthguards (MGs) are essential devices for the protection of sports-related orofacial injuries. Mapping of the literature on this subject may help to guide future studies; therefore, this review aimed to characterize the research trends of studies related to MGs and dental injuries in sports activities through bibliometric analysis of in vivo studies concerning the frequency of MG use; knowledge, awareness, perception, and/or attitude about MGs; and adaptation (fit) of MGs in the mouth and/or prevention of traumatic dental injuries (TDIs). A literature search was performed in 6 databases for studies published up to April 2022. Text mining and analysis software was used to extract and evaluate data related to the study author, country, keywords, journal of publication, and year. Additionally, data related to the type of study, outcome, study population, age group, evaluation method, type of MG, sport classification, and sport category were extracted and analyzed. Of 6140 records identified, 222 were included in the analysis. Most of the articles came from the United States (n = 39; 17.5%) and dentistry journals (n = 145; 65.3%). The journal Dental Traumatology (n = 60; 27.0%) presented the highest number of publications. Most studies were observational (n = 195; 87.8%) and evaluated the frequency of MG use (n = 163; 44.4%). Studies were carried out in athletes (n = 181; 82.6%) and adults (n = 169; 49.1%) using questionnaires or interviews for assessment (n = 206; 84.1%). Only 89 (40.1%) studies evaluated the type of MG, mostly involving contact sports. Custom-made MGs were most commonly studied. More studies involving coaches, dentists, and child and teenaged athletes are warranted to help prevent sportsrelated TDIs in young teeth, mainly through interventional studies on the perceptions of and knowledge about MGs among these populations., Competing Interests: No conflicts of interest reported.

Competing Interests: None declared

Purpose: We compared the effect of an educational pamphlet and a mobile application regarding prevention and emergency management of sport-related traumatic dental injuries (TDIs) on knowledge and self-reported preventive practice of 11-17-year-old Karate and Taekwondo athletes., Methods: Participants were invited through an online link published by the Public Relations of the corresponding federations. They completed an anonymous questionnaire consisting of demographics, self-reported experience of TDIs, knowledge of emergency management of TDIs, self-reported preventive practice of TDIs, and the reason for not using mouthguard. The respondents were randomly allocated to pamphlet or mobile application group with the same content. Three months after the intervention, the questionnaire was completed by the athletes again. Repeated measures ANOVA and a linear regression model served for statistical analysis., Results: In pamphlet group, 51 athletes and in mobile application group 57 athletes completed both baseline and follow-up questionnaires. At baseline, the mean score was 1.98 ± 1.20 and 1.82 ± 1.24 (out of 7) for the knowledge and 3.70 ± 1.64 and 3.33 ± 1.95 (out of 7) for practice in the pamphlet and application group, respectively. In 3-month follow-up, the mean score of knowledge and self-reported practice was significantly higher compared to baseline in both groups (p < 0.001) with no statistically significant difference between the two groups (p = 0.83 and p = 0.58, respectively). Most of the athletes were very satisfied or satisfied with both types of the educational intervention., Conclusion: Both pamphlet and mobile application seem to be useful to improve awareness and practice regarding TDI prevention in adolescent athletes., (© 2023. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Sports mouthguards are proven devices that reduce both the probability of and damage to orofacial tissues. While commonly used, clinicians may be unaware of the different sports mouthguard materials, proposed fabrication techniques, design recommendations, and newer digital fabrication methods. An overview of existing sports mouthguard standards is presented. It identifies that identify that the present requirements, while historically chosen in good faith, appear to be arbitrarily selected and not from clinical evidence-based derived data. In addition, identified sports mouthguard heterogeneous testing and data acquisition methods distinguishes that little possibility is afforded for the correlation of results. Furthermore, updated evidence with concussion prevention and/or alleviation is presented with evidence provided by sports mouthguard imbedded technology. The need for continued research is stressed to provide evidence-based data for concussion alleviation/prevention, digital fabrication methods and materials, and clinically based information for the revision of existing standards., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The shape of the working model is one of the major factors affecting the thickness of thermoformed mouthguards. The aim of this study was to clarify the priority of model trimming to prevent thinning during mouthguard thermoforming., Materials and Methods: Mouthguards were thermoformed using 4.0 mm thick ethylene-vinyl-acetate sheets and a vacuum forming machine. Working models were trimmed so that the angles of the labial surface to the model base were 100°, 90°, and 80°. The posterior height was unified to 30 mm, and the anterior heights were 30 mm (A100-L), 35 mm (A90-M), and 40 mm (A80-H), respectively. When the sheet temperature reached 100°C, vacuum forming was performed. Six specimens were formed for each condition. Mouthguard thickness (incisal edge, labial surface, cusp, and buccal surface) was measured using a specialized caliper accurate to 0.1 mm. Differences in thickness reduction rate due to model shapes were analyzed by one-way ANOVA and Bonferroni's multiple comparison tests., Results: At the incisal edge, there were no significant differences in the reduction rate of the thickness of the mouthguard according to model shapes. On the labial surface, cusp, and buccal surface, the smaller the model angle, the smaller the reduction rate of thickness, and significant differences were observed between A100-L and A80-H, and A90-M and A80-H. On the labial and buccal surfaces, A80-H was more than 7.1% thicker compared with A100-L and more than 5.6% thicker compared with A90-M, and the thickness reduction rate was reduced when the model was trimmed to an acute angle. At the cusp, A80-H was more than 4.3% thicker than A100-L and A90-M., Conclusions: It is useful to trim the model at an acute angle in order to prevent thinning during mouthguard thermoforming, even if the anterior height of the model is increased., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: Traumatic dental injuries occur during participation in sports. Prevention of these injuries by wearing a mouthguard (MG) is desirable, especially in a paediatric population. There are several types of MG available, and their effectiveness depends on device design. The aim of this study was to examine the features of MG worn by children playing a contact sport (Gaelic football), and to determine whether these MG fulfilled recommendations for adequate dentoalveolar protection., Methods: A cross-sectional observational cohort study design was developed. Dentists were trained and calibrated in assessing MGs, both qualitatively (retention, extension, integrity) and quantitatively (thickness). A convenience sample of male and female subjects aged 9-16 years was selected for MG assessment via their sports clubs. Data were collected anonymously and analysed using descriptive and comparative statistics., Results: One hundred and six children presented with their MG for assessment. Two-thirds were wearing mouth-formed MG (N = 71, 66.96%). Only four were wearing custom MG (3.77%). Most MG had inadequate retention (N = 86, 81.13%) and labial extension (N = 89, 83.96%), with a significant relationship between MG type and retention. Mouthguard thickness varied widely at each site. Mouth-formed MG were significantly thicker than both stock and custom MG., Conclusions: Mouth-formed MG were the most common type followed by stock MG. Most MG did not have appropriate retention or labial extension. Parents and coaches need to be aware of MG features that maximise protection. If mouth-formed MG are provided in this age group, education on how to adapt them is essential. Paediatric dentists should check MG routinely for appropriate fit., (© 2022. The Author(s).)

Objective: Factors related to perioperative dental injury have likely changed as a variety of airway devices and preventive measures have been introduced. This retrospective chart review used data from an institutional registry to evaluate the incidence, timing, and contributing factors of patient self-reported dental injury and to assess the impact of dental injury on patient satisfaction., Methods: Multivariate logistic analysis was performed on the records of 14,820 patients using the incidence of dental injury as the dependent variable and covariates in the anesthesia registry and a postoperative questionnaire as independent variables to investigate factors significantly associated perioperative dental injury. In addition, satisfaction with the anesthesia service was compared between patients with and without injury using a matched-pair population., Results: A total of 101 dental injuries were identified. Of those, 25% were associated with intubation and extubation in the operating room, while most other injuries occurred postoperatively. Duration of anesthesia (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.03) and emergency surgery (OR, 1.92; 95% CI, 1.11-3.30) were independently associated with perioperative dental injury. Dental injury did not significantly decrease a patient's satisfaction with the anesthesia service (P = .441)., Conclusion: Most perioperative dental injuries are unrelated to anesthesia procedures. However, the duration of anesthesia and emergency surgery were significantly associated with perioperative dental injury, while decreased patient satisfaction was not.

Aim: To investigate awareness and frequency of use of mouthguards in children and adolescents who engage in high-risk sports in various federated sports clubs in different provinces of Catalonia (Spain)., Materials: A total of 207 athletes aged between 6 and 18 years who belonged to one of the various official sports clubs across Catalonia (Spain) took part in the study. The participants completed a survey that included 13 anonymous questions to assess their awareness and use of a mouthguard while engaging in high-risk sports, the person who recommended its use, and among other variables, the dental history of sports-related injuries. Statistical analysis was performed using the chi-square test; Fisher's exact test and analysis of variance (ANOVA) were used to determine the relationships among the variables. A p-value of 0.05 and a 95% reliability were considered statistically significant., Conclusion: Use of a mouthguard as a preventive measure in sport was very low. One of the main reasons for this was the large amount of disinformation about this type of protection. It would be beneficial to enforce mandatory use of mouthguards in all high-risk sports.

Background/aims: Up to 40% of dental injuries in children occur during sports and may be prevented by using mouthguards (MG). The use of mouthguards is mandatory in some sporting organizations. Knowledge of the benefits of protection does not always result in mouthguard use. The aim of this observational cross-sectional cohort study was to measure and compare knowledge of 9-16-year-old Gaelic football players and their parents on MG use and compliance with MG rules., Materials and Methods: A convenience sample of players and their parents was identified and were assessed at their sports facility. Parents completed a questionnaire while children were asked standardized questions and MG type was verified by a dentist. Data were analysed using descriptive statistics and binary logistic regression analysis for comparison., Results: One hundred and twenty-one children with 118 parents participated in the study. According to players, MG use during competition (N = 119, 99.2%) was greater than during training (N = 97, 80.8%). As age increased, children were less likely to comply with MG rules during training (OR =0.18, p < .001). Children played a median of 2 contact sports (IQR = 1). Only 32 parents (27.1%) and 17 children (14%) reported that the child wore a MG for all sports. Only four children (3.8%) had a custom MG even though most parents (N = 87, 73.7%) believed that they provided superior protection. Knowledge of players and their parents on how to care for the MG was variable., Conclusion: Compliance with the Gaelic Atheletic Association's MG rules was lower during training than competition. Children were less likely to comply with MG rules during training as they grew older. Most parents believed a custom MG would best protect their child's teeth, yet few children had a custom MG. Players and parents had variable knowledge in relation to MG hygiene., (© 2021 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Objectives Up to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards.This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey. Methods A 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression. Results In total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p < 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased. Conclusion Although mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable.

Background/aims: Contact sports such as handball may lead to orofacial injuries that can often be prevented by the use of a properly fitted mouthguard. Several studies have investigated orofacial injuries during contact sports in different countries, but there is a lack of data that is specific for French handball players. Therefore, the aims of this study were to determine the prevalence of orofacial injuries and the proportion of handball players using a mouthguard in Eastern France., Material and Methods: Data were collected from handball players aged over 15 years old from five handball clubs in the Lorraine Region (Eastern France). A questionnaire containing 26 questions about the general characteristics of participants, orofacial injury experiences, emergency procedures following tooth avulsion, and use of mouthguards was self-administered., Results: Two hundred and sixty-three handball players, of which 76.8% (202) were males, aged 23 ± 8 years on average, with a mean playing experience of 11 ± 6 years, participated in the study. Among them, 24.7% (65) reported at least one orofacial injury. A total of 237 orofacial injuries was declared. The main types of orofacial injuries including lip, cheek and tongue injuries were reported by 18.6% of handball players (49); dental injuries were reported by 9.9% (26) and injuries to the temporomandibular joint were reported by 4.9% (13). Most participants knew about mouthguards (97.3%, 254) and considered them efficient for preventing dental injuries in handball (95.3%, 242/254), but only 3.0% (8) used them., Conclusion: The prevalence of orofacial injuries among French handball players was high while mouthguards were very rarely used. Information should be provided to handball teams regarding mouthguard use and the management of dental injuries., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Properly fitted mouthguards reduce the risk and severity of orofacial injury, to both hard and soft tissues, preventing thousands of dollars of trauma management. In this review, findings from recent research will be evaluated to discuss the strengths and limitations of the different types of mouthguards, including their indications by sport. Design, ideal dimensions, and other characteristics will also be explored. Additionally, patient education and motivation will be examined, with a focus on the dentist's role in this regard. Finally, in addition to proper oral hygiene, the importance of proper mouthguard maintenance and evaluation will be discussed. This review will therefore be able to act as a guide for dentists looking to provide patients of all ages with personal protective equipment and stay up-to-date on recent developments in this branch of the sports dentistry field., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Adenotonsillectomy is a common pediatric surgical procedure with a well-defined safety profile. Major complications from this procedure include bleeding/hemorrhage, infection, pain leading to dehydration, and airway obstruction or edema. Though rare, oral endotracheal intubation and oral retractor placement may result in injuries to the teeth and the surrounding soft tissue. We describe a rare case of delayed tooth decay in a 3-year-old female following an otherwise routine adenotonsillectomy., (Published by Elsevier Inc.)

Background/aim: Although orofacial injuries are frequent in water polo, fewer than 10% of players use mouthguards. The aim of this study was to determine the degree to which coaches and sports club managers encourage mouthguard use in water polo and to explore their opinions regarding other strategies designed to reduce the prevalence of orofacial injuries., Material and Methods: This was a cross-sectional study in which the coaches and sports club managers of 16 water polo clubs in Catalonia were invited to participate. An online questionnaire was administered to the coaches to obtain general data, to determine whether they had recommended mouthguard use to their players and to record their opinions on other strategies designed to reduce the prevalence of orofacial injuries. Sports club managers were interviewed about the facilities offered by their clubs for players to obtain mouthguards and about their attitudes regarding the prevention of orofacial injuries., Results: The questionnaire was administered to 72 coaches who trained 111 teams during the 2019-2020 season, together with 14 sports club managers. Coaches of only 11 teams (10%) recommended mouthguard use to their players. Two clubs (14%) offered some facilities to their players to obtain mouthguards. Interestingly, only 18% of the coaches believed that mouthguard use should be mandatory, in contrast to 50% of the sports club managers (p = 0.017; Fisher's exact test). Most coaches and sports club managers believe that a video monitoring system should be used to identify dangerous play and that orofacial injuries should be reported under a surveillance programme., Conclusions: Few water polo coaches recommend mouthguard use to their players and very few clubs offer facilities to obtain custom-made oral protection. However, most coaches and sports club managers agree that the rules should be modified to protect players from aggressive play., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aims: Sports-related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well-being and psychological status. Such injuries may also lead to the fear of re-injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries., Methods: The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad-based search using text words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk-of-bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool., Results: Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross-sectional, used convenience sampling, and were interview-based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk-of-bias in six studies., Conclusion: The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aims: Cross-country mountain biking and field hockey are two Olympic sports that pose a potential risk for dentofacial trauma. However, mouthguard use is not mandatory in either of these sports and knowledge about tooth rescue among athletes is often neglected. The aim of this cross-sectional epidemiological survey was to evaluate the prevalence of sports-related dentofacial injuries, mouthguard use, and attitudes regarding tooth rescue among cross-country mountain biking and field hockey athletes participating at pre-Olympic competitions held in Rio de Janeiro, Brazil., Materials and Methods: A convenience sample of 217 athletes from 33 countries participating in cross-country mountain biking (n = 82; mean age = 30.96 ± 8.52 years) and field hockey (n = 135; mean age = 19.72 ± 2.46 years) pre-Olympic competitions were examined clinically, and they answered a questionnaire regarding previous history of sports-related dentofacial injuries, attitudes toward mouthguard use, and tooth rescue., Results: There were 120 (55.30%) males and 97 (44.70%) females who participated in the study. The prevalence of facial trauma was higher in mountain biking (54.88%) than in field hockey (26.66%, P < .001). Fracture was the most prevalent facial injury in mountain biking (80%), while laceration was the most prevalent in field hockey (30.55%). Extensive dental injuries occurred more often in mountain biking (47.37%) than in hockey (12.50%). The teeth most often affected were the maxillary central incisors in both mountain biking (57.89%) and field hockey (93.75%). Mouthguard use was more frequent among field hockey athletes (41.48%) than in mountain biking (1.22%, P < .001). The overall knowledge about tooth rescue was low, and most of the athletes in both sports did not know what to do in case of an avulsed tooth., Conclusions: Prevalence of dentofacial injuries among XCO-MTB and field hockey athletes participating at this pre-Olympic event was high. The majority of the athletes in this study did not use mouthguards and were unaware of recommendations in the case of an avulsed tooth., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: Rugby union represents a high-risk sport for orofacial trauma due to its impact collisions and repetitive tackles. The aim of this study was to investigate the prevalence of orofacial trauma according to mouthguard use among a sample of Brazilian rugby union players., Methods: An online questionnaire was sent to the 16 best rugby union clubs in Brazil. The questionnaire contained questions about the training history of each athlete, prevalence of orofacial trauma, and details about mouthguard use. Only participants who reported using a mouthguard were selected for this analysis., Results: A total of 244 individuals were included. The prevalence of orofacial trauma was 34.4%, and 61.9% of them did not wear a mouthguard at the time of the incident. The only type of mouthguard reported was the pre-fabricated ("boil and bite" and "ready-to-wear") type. A stronger association was observed between the reason for using a mouthguard and the outcome, whereas a lower proportion of trauma was observed among individuals who claimed mandatory mouthguard use at the gym/sport (20.0%). Time since the respondent started playing rugby union and who instructed them to use a mouthguard were not associated with orofacial trauma., Conclusion: Prevalence of orofacial trauma was high among this sample of rugby union players from Brazil, even with the use of pre-fabricated mouthguards. This study encourages further investigation on the use of custom-made mouthguards in rugby union and the role of coach/physical educators to reduce the prevalence of orofacial trauma., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The majority of traumatic dental injuries (TDI) in childhood and adolescence occur in schools. Since school teachers are often the first responders, their knowledge about the emergency management of TDI needs to be adequate. The aim of this systematic review was to assess and analyse the global status of this knowledge as reported in previous studies and to provide recommendations for future research., Methods: The protocol was designed as per PRISMA guidelines and registered in PROSPERO. A broad-based search using text-words and MeSH terms was performed in established databases as per a predefined strategy. Cohort-studies, cross-sectional, case-control studies and randomized/non-randomized trials without any distinction of language and year of publication were included while those without details of sampling strategy, validity and reliability were excluded. Data extraction was performed, risk of bias assessment was done by the Joanna-Briggs-Institute's critical appraisal checklist and meta-analysis was performed for four question stems using a random effects model., Results: Twenty-three studies were included for qualitative analysis. Most of the studies had been conducted in Asia from 2009 to 2019. Ten studies used case-based questionnaires, mostly adapted from previous studies. Moderate to high risk of bias was observed in 14 studies. Less than 50% of teachers had witnessed a TDI in 8 studies and >75% desired to know more about TDI management in most studies. Less than 50% of teachers in 5 out of 6 studies knew about immediate replantation of avulsed permanent teeth, <25% knew about storage of an avulsed tooth in 16 studies and <50% knew about cleaning of a dirty avulsed tooth in 8 studies. Meta-analysis revealed I 2 values of >95% with 17% of teachers having previous dental-trauma first-aid training and 38% knowing about replantation within 30 minutes., Conclusion: The awareness level in several areas of the world is unknown. Studies lacked well-designed questionnaires and teachers exhibited low self-belief and knowledge level in the majority of studies., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: Few studies have explored the oral health training needs and professional self-efficacy (PSE) in both pharmacy support staff and pharmacists related to managing children's dental problems. This study assessed community pharmacy staff perceptions of their (i) training experiences and interests; (ii) PSE; and (iii) whether this was influenced by the pharmacy being part of a minor ailment scheme (MAS), where staff could directly offer advice and issue prescription medications without patients seeing a doctor., Methods: All of the 1851 community pharmacies across London, UK, were invited to participate in an online questionnaire. Staff rated their prior training, perceived need for further training and confidence in giving parents advice related to three dental problems in children (dental pain, mouth ulcers and dental trauma). Information was collected about staff roles and whether the pharmacy was a MAS., Key Findings: From 752 community pharmacies, 846 community pharmacy staff participated. Positive experiences of training were variable but interest in further training for all three dental problems was high. Pharmacy support staff had significantly lower PSE scores than pharmacy professionals (P = 0.009). A significant interaction showed that pharmacy staff who had poorly rated prior training on advising parents about managing their child's dental pain and who did not work in a MAS had lower PSE scores than staff who had highly rated training and who worked in a MAS (P = 0.02)., Conclusions: Minor ailment scheme pharmacies may be an optimal environment for frontline pharmacy support staff to develop higher PSE when combined with good quality oral health training., (© 2020 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.)

Background: Concussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question., Objective: To determine the association between concussion and mouthguard use in youth ice hockey., Methods: Nested case-control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy., Results: Among cases, 236/315 (75%) were wearing a mouthguard at time of injury, while 224/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95% CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95% CI 0.22 to 1.10). No dental injuries were identified in either cohort., Conclusion: Mouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background : The objective of this study is to evaluate the application of National guidelines for prevention and clinical management of traumatic dental injuries (NGPCMTDI) in developmental age published by the Italian Ministry of Health. Methods : In the present retrospective and multicenter study, 246 patients who underwent dental injury were selected to assess the management of the traumatic event compiled with the protocol provided by the National guidelines. Each health worker involved completed a form related to the dental injury in order to standardize the collected data. Two reference centers have been identified for data collection. Analyses for comparisons between groups were performed using the X 2 test for categorical variables or by Fisher exact test as appropriate. Statistical significance was assumed at p < 0.05. Results : Evaluating the distribution by age we concluded that: 27.24% of the enrolled patients were aged 1-5 years, 51.63% 6-10 years, and 19.92% 11-17 years. The dental injuries occurred in 10.16% of the situations at home, 50.81% at school, 28.86% during recreation, and 9.35% at the gym. The deciduous dentition is involved in 34.96% of the traumas while the permanent dentition is involved in 69.51%. Conclusion : From the present study it emerged that the National guidelines are not uniformly applied.

Dental trauma is a frequent occurrence in children and adolescent and a correct diagnosis and treatment are essential for a favourable long-term prognosis. The present Guidelines aim to formulate evidence-based recommendations to assist dentists, paediatricians, surgeons, teachers, school and sport staff, parents in the prevention and first aid of dental trauma in children and to provide a careful assessment of the medico-legal implications, reviewing the first draft of the guidelines published in 2012. A multidisciplinary panel on the behalf of the Italian Ministry of Health and in collaboration with the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan, developed this document. The following four queries were postulated: 1) Which kind of precautions the health personnel, parents, sports and educational personnel must activate in order to prevent the dental trauma damage? 2) How an orofacial trauma in paediatric patients should be managed either in the Emergency Care Unit and/or in private dental office? 3) What criteria should be adopted by a dentist private practitioner to fill in a certificate in cases of dental and/or tempomandibular joint trauma occurring in children and adolescents? 4) What are the elements that should lead clinicians to suspect a non-accidental dental trauma? A systematic review and analysis of the scientific literature published in English, Italian and French from 2007 to 2017 regarding dental trauma in children and adolescents aged 0-18 years was performed, and about 100 papers were analysed and included. The following four domains were analysed and discussed: Dental Trauma Prevention Strategies and Health Education, First aid in orofacial and dental trauma, Certificate of the dental trauma, Oral and dental signs of child abuse and neglect. Twenty-eight recommendations were draw up and codified by the panel according to the Methodological handbook, produced by the Istituto Superiore di Sanità, in order to guide physicians in the prevention and first aid of dental trauma in children and adolescents. In addition, a careful assessment of the medico-legal implications is reported in this document.

Dental trauma is a common complication of tracheal intubation. As existing evidence is insufficient to validly assess the impact of different laryngoscopy techniques on the incidence of dental trauma, the force exerted onto dental structures during tracheal intubation was investigated. An intubation manikin was equipped with hidden force sensors in all maxillary incisors. Dental force was measured while 104 anaesthetists performed a series of tracheal intubations using direct laryngoscopy with a Macintosh blade, and videolaryngoscopy with a C-MAC ® , or the hyperangulated GlideScope ® or KingVision ® laryngoscopes in both normal and difficult airway conditions. A total of 624 tracheal intubations were analysed. The median (IQR [range]) peak force of direct laryngoscopy in normal airways was 21.1 (14.0-32.8 [2.3-127.6]) N and 29.3 (17.7-44.8 [3.3-97.2]) N in difficult airways. In normal airways, these were lower with the GlideScope and KingVision hyperangulated laryngoscopes, with a reduction of 4.6 N (p = 0.006) and 10.9 N (p < 0.001) compared with direct laryngoscopy, respectively. In difficult airways, these were lower with the GlideScope and KingVision hyperangulated laryngoscopes, with a reduction of 9.8 N (p < 0.001) and 17.6 N (p < 0.001) compared with direct laryngoscopy, respectively. The use of the C-MAC did not have an impact on the median peak force. Although sex of anaesthetists did not affect peak force, more experienced anaesthetists generated a higher peak force than less experienced providers. We conclude that hyperangulated videolaryngoscopy was associated with a significantly decreased force exerted on maxillary incisors and might reduce the risk for dental injury in clinical settings., (© 2019 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)

Background/aims: Mouthguard retention could potentially increase an athlete's motivation to wear the device, due to potential improvements in physical comfort. The aim of this study was to examine the retentive properties of selected customised mouthguard designs, during normal conditions (dry) and within the presence of artificial saliva (wet). Additionally, the correlation between thickness and retention was investigated., Material and Methods: Six different custom mouthguard designs (MG1-MG6) reported in previous studies, were pressure-formed with 2 and 4 mm blanks accordingly. Thickness was measured 10 times at seven anatomical points and the mean (±SD) was recorded. A novel rig was fabricated to connect the mouthguards to a Hounsfield H10KS Tensometer, which was used to fully displace each device from the model at a constant rate of 50 mm/min. The test was repeated under both dry and wet conditions., Results: Retention forces recorded at the anterior region demonstrated higher measurements under wet conditions than dry (P < 0.001). The total retention of the mouthguards was influenced by alterations in their design. Trend analysis indicated that 64% of MG retention could be explained by their thickness under dry conditions and 55% when wet., Conclusions: Design and thickness of mouthguards are key factors in retention. Mouthguard fabrication techniques should be considered in order to minimize dislodgment of the devices as well as potentially increasing the wearability of mouthguards during sport., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)