Definicja Ochraniacze

Co znaczy OCHRANIACZE: ochraniają zęby szczęki,żuchwy i stawy skroniowo-żuchwowe,utrzymują stały przepływ powietrza nawet przy zaciśniętych zębach,są indywidualnie dopasowywane dzięki technologii "boil&bite",
stanowią część wyposażenia zawodników we wszystkich sportach kontaktowych /sztuki walki,koszykówka,hokej,football,tenis,baseball/
ponadto aparaty zmieniające położenie żuchwy /mandibular orthopedic repositioning appliances MORA/ mogą zwiększać siłę ramion i podnosić wytrzymałość organizmu /powiększenie wielkości ruchu w stawie barkowym w ruchu prostowania i obrotowym na zewnątrz/,
Stomatologia Sportowa
The 1990 report of the "Better Health Program" entitled, "Sports injuries in Australia, Causes, Costs and Prevention" estimated that sports injuries cost Australia (population 18 Million) about $1.4 billion per year and that between 30-50% of these injuries are preventable. Multiply these numbers for the United States (population 260 million). Participation in exercise and sport whether positive or negative, will always remain a major consideration in the health of a national population.
In sports, the challenge is to maximize the benefits of participation and to limit injuries. Sports dentistry has a major role to play in this area. Prevention and adequate preparation are the key elements in minimizing injuries that occur in sport. For sports dentistry the prevention of oral/ facial trauma during sporting activities can be helped aby many facets. Included are teaching proper skills such as tackling technique, purchase and maintenance of appropriate equipment, safe playing areas and certainly the wearing and utilization of properly fitted protective equipment.
In some sports, injury prevention, through properly fitted mouthguards are considered essential. These are the contact sports of football, boxing, martial arts and hockey. Other sports, traditionally classified as non contact sports, basketball, baseball, bicycle riding, roller blading, soccer, wrestling, racquetball, surfing and skateboarding also require properly fitted mouthguards, as dental injuries unfortunately, are a negative aspect of participation in these sports.
The National Youth Sports Foundation for the Prevention of Athletic Injuries, reports several interesting statistics. Dental injuries are the most common type of oral facial injuries sustained during participation in sports. Victims of tooth avulsions who do not have the teeth properly preserved or replanted will face lifetime dental costs estimated from $10-15,000 per tooth, the inconvenience of hours spent in the dental chair and possibly other dental problems. (See "What to do when a tooth is knocked out" Section)
Treatment of oral/facial injuries, simple or complex, is to include not only treatment of injuries at the dental office, but also treatment at the site of injury, such as a basketball court or football or rugby field, where the dentist may not have the convenience of all the diagnostic tools available at their office. Knowledge and ability to do "on site" differential diagnosis is essential, withoutthe use of radiographs and dental operatories, to determine the future treatment and prognosis of the injury.
Preseason screenings and examinations are essential in preventing injuries. Examinations are to include health histories, at risk dentitions, diagnosis of caries, maxilla/mandibular relationships, orthodontics, loose teeth, dental habits, crown and bridge work, missing teeth, artificial teeth, and the possible need for extractions for orthodontic concerns or wisdom teeth. These extractions should be done months prior to playing competitive sports as to not interfere with their competition or weaken their jaws during competition. Determination of the need for a specific type and design of mouthguard is made at this time.
Mouthguard design and fabrication is extremely important. There are four types of mouthguards according to the dental literature. Stock, Boil and Bite, Vacuum Custom made, and Pressure Laminated Custom made. (See Mouthguard Section).
First of all, it is essential to educate the public that stock and boil and bite mouthguards bought at sporting good stores do not provide the optimum treatment expected aby the athlete. These ill fitting mouthguards cannot deal with idiosyncrasies athletes and children may have. If everyone had the same dentition; were of the same gender; played the same sport under the same conditions; had the same experience and played the same position at the same level of competition, and were the same age and same size mouth, with the same number and shape of teeth, prescribing a standard mouthguard would be simple. This is the precise reason why mouthguards bought at sporting good stores, without the recommendation of a qualified dentist, should not be worn.
Idiosyncrasies are to be noted during mouthguard design and fabrication. These may include jaw relationships where mouthguards may have to be designed on the mandibular arch such as a Class III prognathic bite. Otherwise, where possible, mouthguards should be built on the maxillary (upper) arch.
Erupting teeth (ages 6-12) should be noted so the mouthguard can be designed to allow for eruption during the season. Boil and bite mouthguards do not allow for this eruption space.
For patients with braces, special designs for the mouthguards are essential to allow for orthodontic movement without compromising on injury prevention and fit. This can only be achieved through consultations with your dentist.(See mouthguard section for further information on types and designs for mouthguards.)
Sports Dentistry also includes the need for recognition and referral guidelines to the proper medical personnel for non dental related injuries which may occur during a dental/facial injury. These injuries may include cerebral concussion, head and neck injuries, and drug use. We are NOT suggesting that dentists treat these injuries, but as health professionals dentists should be able to recognize these entities and refer these patients to the proper medical personnel. For example, if a patient comes into the office for a broken or knocked out tooth, dentists must rule out the possibility of a head injury or concussion before treating the patient for the dental injury. If certain symptoms are present, such as persistent head aches or nausea, immediate referral to medical personnel is essential. (See concussion section).
Smokeless tobacco should also be included and addressed under Sports Dentistry. Smokeless tobacco is often associated with certain sports, and the public should be educated on the dangerous properties and consequences of using smokeless tobacco. (See Smokeless tobacco section.)
Is not uncommon for dentists to recognize the symptoms of anorexia and bulimia through dental examination. Eating disorders are not as infrequent as one may think in female athletics. Woman's gymnastics, volleyball, and basketball are just a few sports where eating disorders have been documented in the medical/dental literature. Erosion patterns in the teeth, caused aby gastric acids, often help dentists in the differential diagnosis of eating disorders. These patients need to be referred to the proper medical and psychological health professional.
As you can see sports dentistry deals with much more than just mouthguards. Visit the other sites on Sports Dentistry On Line for other specific information on these topics. The development of caries and dental erosion is in many respects related to lifestyle factors. Many athletes can be considered to be at high risk for both these type of lesions. In order to gain sufficient amounts of energy and liquid, an increased intake of foods with a high calorie value, particularly those containing sugars, are often consumed aby athletes. In addition, sports drinks are used for rehydration and electrolytic replacement during or directly after highly aerobic sports.
Caries is related to the intake of fermentable carbohydrates. These can be broken down aby oral microorganisms to different organic acids, which results in a pronounced pH fall below the critical pH for enamel (pH 5.5) and dentine (pH 6.2). Dental erosion on the other hand is defined as a loss of dental hard tissue aby a chemical process without involvement of bacteria. It is the net result of an exposure to an acidic source. This may be extrinsic, such as the intake of acidic food and drinks, or related to intrinsic factors, for example regurgitation and reflux disorders. While dental caries prevalence has decreased during recent decades worldwide, the prevalence of erosion is increasing.
A deterioration in oral health of athletes has been suggested1, 2, which is believed to be related to a high intake frequency of both sugar and acid-containing products. In addition to a high intake frequency, products are often consumed during or directly after intense exercise, resulting in breathing hard through the mouth and reduced salivary secretion rate. pH on the tooth surface may reach even lower levels and the duration of a low pH is prolonged during such dry mouth conditions. The risk for dental erosion is believed to be particularly high as acidic drinks are most often consumed during this physical condition. The site specificity of dental erosion in relation to type of exposure is still under debate, but during extreme conditions all surfaces will be affected, as well as enamel and dentine. The method of drinking will influence the impact of a drink on the dentition. Prolonged consumption increases the risk.
Risk Evaluation
Many athletes can be expected to have an increased risk of developing dental caries and dental erosion, but this risk in not evenly distributed within this population. This means that some athletes can have a high and some a low or even no risk. For the dentist it is therefore important to carry out an individual risk evaluation.
The clinical examination of the buccal, lingual and occlusal surfaces is very important in order to find early signs of both dental caries and dental erosion. Bitewing radiographs should also be taken. With regard to dietary habits, the interview should focus on the frequency of consumption of relevant products. In this context, the dentist should ask the athlete about eating and drinking habits both when exercising and when not exercising, i.e. the rest of the day. The patient’s oral hygiene habits should be discussed in detail. One way to better get information about the athlete’s brushing habits, rather than just interviewing, is to ask him or her to brush with toothpaste in the clinic and to observe the ‘toothpaste technique’. Thus, the amount of toothpaste, the spreading of the paste in the dentition and the post-brushing water rinsing should be registered and if necessary improved.
As a supplement to clinical examination and interview, a saliva and microbiological test is of great value for risk evaluation. A low saliva secretion rate and a low salivary buffer capacity implies a high risk of developing both dental caries and dental erosion. In addition, high counts of mutans streptococci and lactobacilli are often associated with high caries risk.
Prevention of Caries and Dental Erosion
The prevention programme for an athlete should include the following three parts:
1. Dietary advice including appropriate use of sugar-free products.
2. Fluoride treatment both at home and at the clinic.
3. Oral hygiene instruction - in some cases professional toothcleaning.
Dietary advice
The athlete should avoid unnecessarily frequent intake of products such as snacks and sport drinks and not to keep the products too long in the mouth. A long retention time will increase the risk both for dental caries and dental erosion. The possibility of using sugar-free chewing gums and sugar-free lozenges after eating or drinking occasions should be discussed. These products stimulate saliva, shorten the oral clearance time of sugar and acids in the mouth and increase the pH on the tooth surfaces. In relation to erosion, the use of chewing gum should not be exaggerated because of risk for abrasion.
Fluoride treatment
Independent of the caries and erosion risk, all athletes should be informed to increase their daily use of fluoride. Thus, toothbrushing twice a day with fluoride toothpaste and with an improved ‘toothpaste technique’ should be stressed. Daily mouthrinsing with 0.05 percent NaF can also be recommended to all athletes. For high risk patients, the dentist may encourage the athlete to brush the teeth with fluoride toothpaste at one extra occasion during the day and to increase the daily rinsing with 0.05 percent NaF to two to three times per day. Fluoride chewing gums and fluoride tablets are available in some countries. These products can be used several times per day, both after and between the meals. For very high risk patients (regarding both dental caries and dental erosion), fluoride gel application will give the teeth extra protection. The dentist may also apply fluoride varnish two to four times per year.
Oral hygiene
In order to improve oral hygiene, an electric toothbrush can be recommended to some athletes. It is important, however, that the brushing is combined with fluoride toothpaste. The toothbrushing should be carried out after breakfast and just before bedtime with no eating or drinking up to one to two hours afterwards. In order to avoid tooth abrasion, brushing should not be carried out directly after using an acid product, like a sport drink. If the oral hygiene is poor, professional tooth cleaning using a rubber cup, a mild polishing fluoride-containing paste and dental floss is carried out two to four times per year followed aby fluoride varnish application.