| By Dr. Len Fazio

When thinking about what we will wear to our next tennis practice session or match, we are usually concerned with the comfort and style of our athletic apparel. After all, keeping comfortable during a workout is easily accomplished with all the moisture-wicking fabrics available to us today. And looking good while doing it … well, that’s a bonus! Both stylish and functional, tennis apparel has come a long way since the days of all-cotton, all-whites. So while we go to great lengths (and expense!) to purchase our outerwear and underwear, how many of us consider some “inner” wear? Inner-armour, as I like to call it, can also be stylish and functional. It can protect against injury, and for some players, actually enhance their performance on the court. This often overlooked piece of apparel is essential for virtually every sport. Of course, I’m talking about athletic mouth guards.

Mouth guards for tennis? Anyone?
While most of us would consider athletic mouth guards for traditional “contact” sports like football, boxing, hockey, lacrosse, martial arts, rugby, etc., as essential equipment, wearing a mouth guard for a tennis match would be considered unnecessary … overkill, perhaps. After all, tennis is a non-contact sport, right? Tell that to my patient, JoAnn C., who, during the third set of a mixed-doubles match, took a backhand from her partner’s racquet right in the mouth. Fortunately for her, this accident occurred at a time when I was in my office, so I was able to provide emergency care in a timely manner. Six stitches, one root canal and two caps later, she was able to return to her passion. But NOT without her custom mouth guard!
“Never in a million years would I have imagined something like this happening to me,” she later lamented. “I have been playing tennis competitively for close to 20 years, and I have never heard of anyone getting hit like that.”
It should be noted that dental injuries are the most common type of oral-facial injuries sustained during sports of all kinds. In JoAnn’s case, significant physical, emotional and financial pain could have been avoided with this seemingly insignificant piece of equipment.
An ounce of prevention
In sports, a major challenge is to maximize the benefits of participation, and to limit injuries. Prevention, via adequate preparation, is a key element in minimizing such injuries. Properly conditioned bodies, well-fitting protective equipment and correct techniques during competition can help minimize injuries.
Holistic sports dentistry has a major role to play in this arena. The holistic sports dentist should be concerned with providing proper injury prevention strategies and dental education. Properly-fitted and sport-specific custom mouth guards are the single most effective way of minimizing the likelihood of severe dental and jawbone injury, as well as concussion.
An athlete whose tooth is knocked out during a game and does not receive the proper emergency dental treatment within 30 min., may face a lifetime of dental costs estimated at between $10,000 to $15,000 per tooth, many inconvenient hours in the dentist’s chair, and possibly other dental and physical problems. Purchasing in a custom mouth guard, especially during this current economic crisis, may be the wisest investment you make!
A rose is a rose, is a rose, is a rose … right?
Not necessarily. Contrary to popular belief, all mouth guards are not created equally. A properly-fitted mouth guard must be protective, comfortable, resilient, tasteless and streamline. It should cause minimal interference with speech and breathing, and on top of that, have excellent retention and fit. Additionally, it must have sufficient thickness in critical areas of to disperse the forces of impact.
There are three popular types being used today.
1. Stock: The stock mouth guard, available at most sporting goods stores, come in limited sizes (youth, small, medium, large), are the least expensive, and the least protective. This type is ready to be used without any preparation. Simply remove it from the package and immediately place it in the mouth. They are bulky and lack retention, and so must be held in place by constantly biting down. This interferes with speech and breathing. This type of mouth guard is often altered and cut by the athlete in an attempt to make it more comfortable, further reducing its protective properties.
2. Boil and bit: Presently, this is the most common type of mouth guard on the market. Made from a thermoplastic material, they are immersed in boiling water and reformed in the mouth using finger, tongue and biting pressure. Available in limited sizes, these mouth guards often lack proper extensions for posterior teeth in adult athletes. Leaving those molars uncovered significantly reduces the effectiveness of the guard, making injury more likely. Additionally, this type of mouth guard is often further altered by the user to increase comfort, which may reduce its protective ability.
3. Custom-fitted: Custom-fabricated mouth guards are supplied by a dentist. Custom mouth guards provide the dentist with the critical ability to address several important issues in the creation of a device which satisfies the main criteria of proper fit, protection retention and comfort. The dentist can also take into account previous history of injury or concussion, missing or loose teeth, or orthodontic treatment. In the case of grade school athletes, mixed dentition of primary and adult teeth and ever-growing jawbones must be accounted for. These mouth guards are the most satisfactory of all types, and are the kind I recommend for my patients.
Find your sweet spot
In addition to providing protection from trauma, custom mouth guards can also have a positive effect on body strength. Oral orthopedics (custom mouth guards) have an effect on the entire neuromuscular/autonomic nervous system (ANS). Specifically, the position of the lower jaw—an afterthought with conventional mouth guards—is directly related to arm muscle strength and spinal alignment. Enhancement of the ANS is achieved by changing the “bite” to a more ideal position. This places the lower jaw into an optimal relationship with the skull which relieves pressure placed on the muscles, nerves, bones and blood supply. This can provide for postural equilibrium, which will affect the body’s response to pain, retraining and flexibility.
Benefits to tennis players would likely include: Hitting the ball with more authority, increased endurance and less pain after the match.
Joseph D., another patient of mine, said it best when he related his experience after wearing his new mouth guard for the first time. After enduring some good-natured ribbing from his opponent (“It’s a tennis match, not a boxing match!”), he said: “I felt like a kid out there. Then I promptly dropped a double bagel on him!”
To be sure, Joe D. was already an excellent tennis player and in great physical shape, so his experience may not be typical. However, persons of average ability may benefit in different ways ranging from pain reduction and quicker recovery, to better footwork, more powerful strokes and improved service.
Advantage … you!
A thorough evaluation by a sports dentist is the best first step in determining the most appropriate mouth guard for your needs. As a holistic sports dentist, avid sportsman and father of three sports-active boys, I can truly appreciate the requirements of today’s athletes. Manufacturers of tennis equipment have continually turned to science for the latest advancements in technology, which can give players a competitive edge. The sport-specific custom guards of today are no exception. If designed, fitted and cared for properly, these space age materials can provide long-term protection and an athletic advantage.

As more research is being conducted, it is becoming more apparent that conditions affecting any part of the oral-dental complex can, and do, have an impact on an individual’s physical health. So the next time you are ready to hit the court, bring your “A” game and bring your mouth guard!

Dr. Len Fazio

<p>Dr. Len Fazio graduated the NYU College of Dentistry in 1988 and has been practicing metal-free, mercury-safe, holistic dentistry since 1993. Dr. Fazio operates his practice, PowerPlay Holistic Sports Dentistry, out of Port Jefferson, N.Y, and serves as the official team dentist of the Long Island Lizards of Major League Lacrosse. He may be reached by phone at (631) 474-7477 or visit www.powerplaydental.com.</p>