Patterns of orodental injury and mouthguard use in Dutch field hockey

Protein Deposition on Sport Mouthguards and the Effectiveness of Two Different Cleaning Protocols

Objective: To determine which salivary proteins adhere onto sport mouthguards, and to evaluate the effectiveness of different cleaning strategies in removing deposited protein. Methods: Fifteen healthy volunteers used a mouthguard for 1 h. The deposited salivary proteins were analyzed using gel electrophoresis and Western blotting techniques and compared with the protein composition of unstimulated saliva. In addition, the effectiveness of two different cleaning strategies to remove proteins from the mouthguards were compared: rinsing the mouthguards after use with cold tap water and cleaning the mouthguard with a soluble effervescent tablet. Results: Gel electrophoresis showed deposition of proteins of 50-60 kDa and 14 kDa on the mouthguards used in the mouth for 1 h. Western blotting identified these bands as amylase and lysozyme, respectively. Rinsing the mouthguard with cold tap water after use removed 91% of the total amount of deposited proteins, while cleaning with an effervescent tablet removed 99%. Conclusions: During the use of mouthguards, salivary proteins are deposited on their surface. Because salivary proteins can potentially affect bacterial adhesion to mouthguards, proper cleaning after use is recommended. Cleaning the mouthguard with cold tap water or using an effervescent tablet both seem to be effective strategies to remove proteins deposited on sport mouthguards.

Knowledge about the emergency management of dental injuries among field hockey coaches

BACKGROUND/AIM

Field hockey is frequently associated with oro-dental injuries. In such acute situations, appropriate management of the injury by coaches can contribute to a better clinical outcome and prognosis. Therefore, the aim of this study was to investigate the knowledge of hockey coaches in the Netherlands about the emergency management of dental injuries.

MATERIAL AND METHODS

A 25-item questionnaire about the prevalence and management of oro-dental injuries was distributed amongst hockey coaches in the Netherlands. A sub-analysis was done regarding the knowledge on the management of dental injuries by using a 5-point scoring system.

RESULTS

Two hundred and six hockey coaches participated in this survey. A small majority (53%) of the coaches knew the treatment of choice in the event of a permanent tooth injury. The median score of coaches' knowledge regarding management of oro-dental injuries was 3.0 (2.0-4.0) points. Coaches with a (para)medical training/occupation, and coaches with >10 years of experience had significantly higher scores compared with the other groups (p < .01 and p = .03, respectively).

CONCLUSIONS

The knowledge level of hockey coaches in the Netherlands about oro-dental injuries needs to be improved, as many coaches are not aware of the appropriate first aid measures.

Stress Concentration of Hybrid Occlusal Splint-Mouthguard during a Simulated Maxillofacial Traumatic Impact: 3D-FEA

Mouthguards (MG) are protective devices that can reduce the risks of facial trauma. However, many athletes do not use them. Additionally, MG wear with coincidental parafunctional activity has not been considered. The aim of this study was to evaluate the stress distribution as a consequence of a direct impact comparing a conventional MG with a novel hybrid appliance (HMG). Using computer-aided design (CAD) software, a human skull was modeled with the teeth inserted into their respective alveolus. The models were divided according to the MG type (conventional or hybrid). The geometries were exported to the computer-aided engineering (CAE) software and the materials were considered isotropic. Fixation was defined at the base of the maxilla. The load was applied using a hockey puck. The total deformation (mm) and the von Mises stress (MPa) results were obtained for the MGs (conventional and hybrid), upper teeth, lower teeth, and maxillary bone. Despite the presence of an MG, it is still possible to observe generated stress in all structures. However, the hybrid design was more efficient than the conventional design in reducing the displacement during the impact and consequently the stress on the upper teeth, lower teeth, and maxillary bone. Higher stress magnitude was more concentrated at the inner portion of the hybrid design than the conventional device. The HMG appliance decreased the stress concentration in the teeth and in the bone, limiting the areas susceptible to injuries to the regions directly impacted by the hockey puck. Although the novel HMG may mitigate injury, some stress will still result, and any possible injury should be evaluated by a dental professional.

Effectiveness of the new mandatory mouthguard use and orodental injuries in Dutch field hockey

ObjectivesUp 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.MethodsA 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.ResultsIn 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.ConclusionAlthough 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.

Self-reported experience of orofacial injury, preventive practice, and knowledge of Iranian adolescent martial art athletes towards sports-related orofacial injuries

BACKGROUND

Increased engagement of adolescents in martial arts exposes them to a relatively high risk of experiencing orofacial injuries. We evaluated self-reported experience of orofacial injuries, preventive practice, and knowledge of management of sport-related orofacial injuries and related factors in adolescent Karate and Taekwondo athletes in Iran.

METHODS

This cross-sectional study was conducted on Iranian martial arts athletes including Karate and Taekwondo aged 11-17-year-old in 2020 via an online questionnaire. The anonymous self-administrated questionnaire had four parts: background (age, gender, duration of sports activity, training sessions per week, and previous education on orofacial injury); self-reported experience of orofacial injury; preventive practice including mouthguard and helmet use; and knowledge of emergency management of orofacial injuries. Preventive practice and knowledge scores were calculated by summing up the scores of corresponding questions (possibly range 0-7). A linear regression model and the Pearson correlation served for statistical analysis.

RESULTS

Totally, 295 athletes with a mean age of 14.56 ± 1.91 years participated in the study. A quarter (n = 74, 25.1%) of athletes stated that they had received training on prevention of orofacial injuries. Only 3.7% (n = 11) of the participants reported the use of custom-made mouthguards, and 62% (n = 183) reported a positive history of orofacial injuries. A significant relationship existed between self-reported orofacial injury and age (β = - 0.32, p < 0.001), hours of training per week (β = 0.12, p = 0.037), type of sport (β = 0.11, p = 0.049), and previous training on orofacial injuries (β = - 0.14, p = 0.010). No difference existed in the history of orofacial injury between females (n = 114) and males (n = 69) (p = 0.374). The mean score of self-reported preventive practice and knowledge of management of orofacial injuries was 3.53 ± 1.82 (out of 7) and 1.67 ± 1.10 (out of 7), respectively. Age (β = 0.19, p = 0.002) and history of orofacial injury (β = - 0.15, p = 0.010) were associated with the score of self-reported preventive practice. Female athletes (β = 0.11, p = 0.048) and athletes who exercised more per week (β = 0.15, p = 0.012) had significantly more knowledge on management of orofacial injuries.

CONCLUSION

Adolescent athletes had relatively undesirable preventive practices and a distinct lack of knowledge. The high occurrence of self-reported orofacial injuries indicates the importance of more education and stricter rules for the athlete population.

Mouthguard use and attitudes regarding dental trauma among elite cross-country mountain biking and field hockey athletes

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.

Milk microbial composition of Brazilian dairy cows entering the dry period and genomic comparison between Staphylococcus aureus strains susceptible to the bacteriophage vB_SauM-UFV_DC4

Brazil has the second-largest dairy cattle herd in the world, and bovine mastitis still can cause significant losses for dairy farmers. Despite this fact, little information is available about milk microbial composition of Brazilian dairy cows, as well as the potential use of bacteriophages in the control of S. aureus. Here, we investigated milk bacterial composition of 28 Holstein Fresian cows (109 teats), selected in the dry-off period, using 16S rRNA analysis. Furthermore, a representative S. aureus strain (UFV2030RH1) was obtained at drying-off for isolation of a bacteriophage (vB_SauM-UFV_DC4, UFV_DC4) and bacterial genomic comparison purposes. Our outcomes revealed that Staphylococcus was the third most prevalent genus and positively correlated with subclinical mastitis events. As a major finding, genomic analyses showed the presence of adhesive matrix molecules that recognize microbial surface components (MSCRAMM) in UFV2030RH1 and might indicate great biofilm formation capability. A minimum inhibitory concentration (MIC) assay showed that resistance to ampicillin was the highest among the antibiotic tested in S. aureus 3059 and UFV2030RH1, displaying values four and sixteen times greater than MIC resistance breakpoint, respectively. Together, our results suggest that Staphylococcus is highly prevalent in dairy cows at drying-off and the use of the phage UFV_DC4 as a biocontrol agent must be investigated in future studies.

Experience with mouthguards and prevalence of orofacial injuries among field hockey players in Catalonia

BACKGROUND/AIM

Orofacial injuries are a serious problem in field hockey. The aim of this study was to determine the prevalence of orofacial injuries in field hockey players in Catalonia, the frequency of mouthguard use, the types of mouthguards used and the degree of interference with oral function.

MATERIAL AND METHODS

In this cross-sectional study, 325 field hockey players (28% women) from all age categories completed a questionnaire about orofacial injuries occurring during their sporting lives, including dental injuries, oral lacerations and episodes of acute temporomandibular disorder (TMD) pain. The questionnaire also asked about the experience of using a mouthguard, the type of mouthguard used and any adverse effects of use. The degree of interference with oral function was compared by type of mouthguard (mouth-formed, custom-made and pre-fabricated mouthguards) using the Kruskal-Wallis test.

RESULTS

Half of the players (50.2%) reported at least one orofacial injury during their sporting lives. The mean number of oral lacerations, TMD pain episodes and dental injuries were 1.59, 0.24 and 0.18, respectively. In total, 310 players (95.7%) had tried a mouthguard, and of these 269 (86.8%) and 283 (91.3%) still used a mouthguard habitually during training and competition, respectively. Only 11 players (3.5%) had tried all three types of mouthguards, and 71 players (22.9%) had tried two types of mouthguard. By type, 217 players (70.0%) had tried mouth-formed (boil-and-bite) mouthguards, 156 (50.3%) had tried custom-made mouthguards and 30 (9.7%) had tried pre-fabricated mouthguards. Custom-made mouthguards were rated as more comfortable than the mouth-formed type (P < .05).

CONCLUSIONS

The prevalence of orofacial injuries among field hockey players is relatively high. Most players habitually use a mouthguard during training and competition, typically preferring custom-made or a mouth-formed types. Custom-made mouthguards were considered the most comfortable.

Risk of orofacial injuries and mouthguard use in water polo players

BACKGROUND/AIM

The incidence of orofacial injuries and the use of mouthguards in water polo players have not been well established. The aim of this study was to determine the incidence of orofacial injuries in water polo players. Frequency of mouthguard use, the types of mouthguards used and the degree of interference with oral functions were also assessed.

MATERIAL AND METHODS

In this cross-sectional study, 347 water polo players completed a questionnaire about the orofacial injuries suffered in the 2015-2016 season and the experience of using a mouthguard, such as the type of mouthguard used and the degree of interference with oral functions.

RESULTS

In the 2015-2016 season, 57.9% of the players reported at least one orofacial injury, with mean numbers of 2.7 oral lacerations, 0.4 episodes of temporomandibular pain and 0.06 dental injuries. Among the 35 players (10.1%) who had tried a mouthguard, only four (1.2%) used it habitually. Some players had tried more than one type of mouthguard; 26 had tried the mouth-formed type; 11 the custom-made type; and 7 the prefabricated mouthguard. Custom-made mouthguards were rated as more comfortable than the mouth-formed type (P < 0.05). The main disadvantages of mouth-formed mouthguards were interferences with speaking, breathing and swallowing.

CONCLUSIONS

The incidence of orofacial injuries in water polo players is high. Although some players had tried a mouthguard, mainly the mouth-formed type, most of them do not wear them routinely for training and competition.

Epidemiology of injuries in outdoor and indoor hockey players over one season: a prospective cohort study

Objectives

To determine the incidence and characteristics of hockey (‘field hockey’) injuries over the course of one outdoor and indoor season. Comparisons of female versus male players, outdoor versus indoor season and match versus practice were performed.

Methods

Female and male teams of the first, second, third, regional and youth divisions were recruited among a local hockey association in Northern Germany, and followed over an indoor and an outdoor season. Exposure times and location, type, severity and cause of injuries during practice and matches were documented by the coaches or medical staff and collected weekly. Prevalence and incidence rates were calculated.

Results

Of the 232 players (mean±SD age 20.7±4.7 years, 68.1% male, 31.9% first division), 84 players (36.2%) suffered 108 new injuries during the season. The overall incidence rate was 3.7 injuries per 1000 player hours (95% CI 3.0 to 4.4). The injury incidence was lower in practice (2.7 per 1000 player practice hours, 95% CI 2.0 to 3.3) than in matches (9.7 per 1000 player match hours, 95% CI 6.8 to 12.7), and was similar for female and male players as well as during the outdoor and the indoor season. Most injuries affected the lower limb (thigh, knee and ankle) and occurred without contact (58.3%). Severe injuries (n=34; 31.5%) were predominantly located at the knee and hand/finger.

Conclusion

Hockey players have a high prevalence and incidence of injuries, especially at the lower limb.