Keep your head, watch your mouth Published Aug. 4, 2011 By Capts. Alexandra Leis and Zachary Perry 48th Dental Squadron ROYAL AIR FORCE LAKENHEATH, England -- According to the National Youth Sports Safety Foundation, an estimated 15 million dental injuries and 5 million cases of traumatically avulsed teeth occur every year in the U.S. Nearly one-third of these dental injuries are sports-related. The Academy of General Dentistry reports athletes are 70 times more likely to sustain damage to teeth when not wearing a mouthguard. During a single athletic season, athletes have a one in 10 chance of suffering a facial or dental injury. However, according to the American Dental Association, more than 200,000 oral injuries are prevented annually in the U.S. by sports mouthguards. Wearing a mouthguard can prevent a variety of injuries, such as broken and dislodged teeth, lacerations to soft tissue, and fractures of the facial bones, especially the cheek bones and mandible. A mouthguard not only protects teeth, but it can also protect the brain. Mouthguards reduce the risk of concussion by creating a space between the lower jaw and the base of the skull. This space helps prevent the lower jaw from exerting excessive force on the base of the skull (and brain) upon impact. Both children and adults should wear a mouthguard when participating in any sport or recreational activity where injury to the mouth can occur. A properly fitted mouthguard is also especially important for people who wear braces. A blow to the face could damage the fixed orthodontic appliances. A mouthguard also provides a barrier between the braces, cheeks and lips, limiting the risk of soft tissue injury. A mouthguard should be comfortable, remain securely in place while in use, and not restrict your speech or breathing. Stock mouthguards are the least expensive, often coming pre-formed and ready-to-wear. Unfortunately, stock mouthguards can be bulky and uncomfortable. They also offer the least protection because they do not adapt to the teeth very well. This type can make breathing, drinking, and speaking difficult, as well as cause gagging and significant drooling. "Boil-and-bite" mouthguards may offer a better fit than stock mouthguards, and are a good choice if you need one quickly. When heated and placed in the mouth, the material molds to the teeth and then sets. It is important to follow the directions carefully, or you can wind up with an ill-fitting mouthguard. On the downside, "boil-and-bite" mouthguards are still rather bulky and can make it difficult breath, drink, and speak. Drooling can also be a problem with these as well. Custom-fitted mouthguards are made using impressions of your own teeth. These lab-fabricated appliances offer the best protection, fit, and comfort. They are less bulky, which makes breathing, drinking and speaking easier. The major disadvantage is that they are also the most expensive. Though they are initially more expensive, the cost of a mouthguard is significantly less than the lifetime dental rehabilitation costs of a lost tooth, which has been estimated at $15,000. Active-duty members and their dependents can schedule to have a custom mouthguard fabricated. Additionally, boil-and-bite mouthguards are sold at the RAF Mildenhall base exchange or can be obtained at the dental clinic.