Sports Medicine: Just the Facts

CHAPTER 31 • INFECTIOUS DISEASE AND THE ATHLETE 173

• Increased evidence has shown that a multilayer guard
  or laboratory pressure laminated may be preferred to
  a single layer. These can either be made by the dentist
  in office if proper materials are available or need to be
  sent to a qualified laboratory.


• When properly worn helmets and facemasks will
  increase safety and decrease morbidity. They protect
  the skin and bones of the head/face.


• The ADA recommends mouth guard use for these
  sports: acrobatics, basketball, boxing, field hockey,
  football, gymnastics, handball, ice hockey, lacrosse,
  martial arts, racquetball, roller hockey, rugby, shot
  putting, skateboarding, skiing, skydiving, soccer,
  squash, surfing, volleyball, water polo, weightlifting,
  and wrestling (Kvittern et al, 1998).


• Injury rates in football rates have gone from 50% to
  less than 1% since the onset of mouth guard and face
  mask use (Kvittern et al, 1998).


• In athletes who are undergoing orthodontic treatment
  (braces are a greater risk for orofacial injuries) a custom
  mouth guard is indicated (Kvittern et al, 1998).


• Compliance can be a problem with mouth guard use—
  coaches, parents, and athletic trainers are encouraged
  to explain to the athletes the benefit of mouth guard
  use (Ranalli, 2002).

DENTAL MAINTENANCE

• It is important for athletes as well as the general public
  to have regular dental checkups. An initial compre-
  hensive dental examination should be performed,
  including chief complaint, health history, intraoral and
  extraoral examination, and radiographs where appli-
  cable; then the dentist will recommend a recall sched-
  ule as needed dictated by the evaluation.


• Oral jewelry has become a recent fad with the youth
  of this country. Dental professionals are advised to
  give these patients information about the problems
  that can occur with the jewelry. Tongue piercing can
  cause teeth fractures and also gingival stripping.
  Dental professionals should also inform patients that
  the jewelry should be removed prior to any contact
  sporting participation.


• Dentists can also screen patients who are using
  smokeless (spit) tobacco and inform them it is not a
  safe substitute for smoking.


• Anorexia and bulimia nervosa can also be picked up
  during routine dental checkup. The clinical signs are
  erosion of the lingual enamel of the teeth, bilateral
  swelling of the theparotid gland and floating amalgam
  because of quicker erosion of enamel versus metal.


• It is important for patients to follow through with any
  recommended dental treatment thereby preventing
  any future problems.

REFERENCES

Cohen S., Burns RC., et al: Traumatic injuries, in Cohen S, Burns

RC (eds.): Pathways of the Pulp, 8th ed. St. Louis, MO,

Mosby, 2002, p 605.

Dorn SO: Sports dentistry for Endodontist. J Endod28:9,

2002.

Douglas AB Douglas JM: Common dental emergencies. Am Fam

Phys 67:3, 2003.

Kenny DJ Barrett EJ: Recent developments in dental traumato-

logy. Am Acad Pediatr Dent23:6, 2001.

Kvittern B, Hardie NA, Roettger M, et al: Incidence of orofacial

injuries in high school sports. J Public Health Dent58:289,

1998.

Lee JL, Vann WF, Sigurdsson A: Management of avulsed perma-

nent incisors: A decision analysis based on hanging concepts.

Pediatr Dent 23:3, 2001.

Padilla RR: Sports dentistry online. http://www.sportsdentistry.com,

10 Jan. 2003.

Ranalli DN: Sports dentistry and dental traumatology. Dental

Traumatol18:231–236, 2002.

Roberts WO: Field Care of the injured tooth. Phys Sportsmed

28:1, 2000.

Tesini D Soporowski N: Epidemiology of orofacial sports-related

injuries, in Holland, Kerry (eds.): The Dental Clinic of North

America Advances in Sports Dentistry. Philadelphia, PA,

Saunders. Jan. 2000. p 8.

Trope M: Clinical management of the avulsed tooth: Present

strategies and future directions. Dental Traumatol18:1–11,

2002.

31 INFECTIOUS DISEASE

AND THE ATHLETE

John P Metz, MD

INTRODUCTION

• Among 170 surveyed marathoners, 90% definitely or
  mostly agreed they “rarely got sick” (Nieman, 1995).
  Ninety percent of nonelite athletes who engaged in
  regular, moderate exercise reported they rarely got
  sick (Pedersen and Bruunsgaard, 1995; Eichner, 1993;
  Nieman, 1999). In a 1989Runner’s Worldsurvey,
  60.7% of subscribers reported catching fewer colds
  since starting running, while 4.9% reported catching
  more (Nieman, 1994).


• Elite athletes feel that intense training lowers their
  immunity and increases their vulnerability to illness
  (Eichner, 1993; Nieman, 1999).