Protecting your mouth

The WKA requires a fitted mouth guard for intermediate to advanced karate-ka. While children’s development requires frequent fittings and extra costs, we strongly encourage this as a safety precaution as soon as permanent teeth are developed.

This recommendation is in keeping with the WKA Medical Committee recommendations to the USA NKF and Dr. Sako’s recommendation as Chair of the USA NKF Medical Committee.

The National Youth Sports Foundation for the Prevention of Athletic Injuries, Inc. reports several interesting statistics. Dental injuries are the most common typed of orofacial injury sustained during participation in sports. Victims of "total tooth avulsions who do not have teeth properly preserved or replanted may face lifetime dental costs of 10,000-15,000 dollars per tooth, hours in the dentist's chair and the possible development of other dental problems such as periodontal disease" reports the Foundation. It is estimated that mouth guards prevent approximately 200,000 injuries each year in the sports of high school and collegiate football alone.

It is part of the USA-NKF rules and regulations as well as the International Federation rules, to require mouth protection. There are three types of these mouth guards:

Stock Mouth Guard

The stock mouth guard that is available at most sporting good stores. These come in limited sizes (usually small, medium and large) and are the least expensive and the least protective. Prices will range from three to twenty-five dollars. These protectors are ready to be used without any further preparation and can be used directly from the package. Although they can be used immediately (its only recommendation), they are bulky and must be held into place by a constant biting down. This type of mouth guard is often self-altered and cut by the athlete in an attempt to make it more comfortable…further reducing the protective properties of the mouth guard. Children often will have abrasions and cuts in the mouth from these alterations before the parents become aware of the ill fit. Too often the younger athletes can be seen in the constant activity of pushing/pulling the guard in and out of the mouth during the competition! Younger athletes have created an ongoing habit of chewing upon the mouth guard! All of this is the unconscious habit of trying to make the piece more comfortable. Clearly, this is a very vulnerable and dangerous situation for Karate athletes who run the risk of facial contact.

Boil and Bite Mouth Guard

The mouth formed or Boil and Bite mouth guard is another popular option. Presently this is the most commonly used mouth guard on the market for all sports. Most marketing and advertising in the past has been for this type of mouth protection. Made from thermoplastic material, these guards are immersed into boiling water and formed by suing finger, tongue and biting pressure. Available in limited sixes, these mouth guards often lack proper extensions and repeatedly do not cover all the posterior teeth. Dental mouth arch length studies have shown that most "boil and bite" mouth guards do not cover all posterior teeth in a majority of high school and collegiate athletes. Another problem, is the self-fitting that goes on causing cuts and abrasions within the mouth along with a limited protective property. When the athlete cuts the posterior borders or bites through the mouth guard during forming, the athlete increases their chance of injury, especially concussion, from a blow to the chin. It has been reported by Joon Park, PhD Et Al, at the First International Symposium on Biomaterials (1993) that these mouth guards provide a false sense of protection due to the dramatic decrease in thickness occlusally during the molding and fabrication process. He further stated, "Unless dramatic improvements are made, they (boil and bite mouth guards) should not be promoted to patients as they are now".

Custom Mouth Guard

For Karate practitioners, it is very noticeable that there is an obstruction to clear breathing with these mouth guards. Children are unaware of the extent of the obstruction to their breathing as they regard this obstruction as a "natural" issue associated with wearing mouth protection. Parents should simply listen to the child's breathing in order to make an assessment. The mouth should be able to close comfortably, and the breathing should remain absolutely normal!

A dentist supplies the custom-made mouth guards. Custom mouth guards provide the dentist with the critical ability to address several important issues in the fitting of the mouth guard. Several questions must be answered before the custom mouth guard can be fabricated:

• Is the mouth guard designed for the particular sport being played?
• Is the age of the athlete and the possibility of providing space for erupting teeth in mixed dentition (ages six to twelve) going to affect the mouth guard?
• Will the design of the mouth guard be appropriate to the level of the competition being played?
• Does the patient have any history of previous dental injury or concussion, thus needing additional protection in any specific areas?
• Is the athlete undergoing orthodontic treatment?
• Does the patient present with cavities and/or missing teeth?

Without the help of a qualified dentist, these questions cannot be adequately addressed.

Types of custom made mouth guards include:

• Vacuum Mouth guard (made from a stone cast of the mouth)
• Pressure Laminated Mouth guard

In conclusion, it can be said that even one dental injury in our sport is one too many. Accidents will happen in any sport, but not having a properly fitted mouth guard should not be considered an accident. The safety of our athletes is one of our primary concerns and responsibilities. So, the USA-NKF Medical Committee recommends the custom-made mouth guard to be made at the dental office where it is individually designed and constructed by a dental professional. While this will be a bit more expensive in the short run, there is no substitute when it comes to its exceptionally good fit, its lack of interference with speech or breathing and overall maximum protection from a traumatic force.

CARING FOR YOUR MOUTH GUARD

• Rinse under cold water after each use
• Occasionally clean your mouth guard in a solution of soap and cool water
• Store your mouth guard in a container so that it doesn't get damaged or lost
• Like any other sports gear or equipment, mouth guards can tear or wear out…remember to check periodically with your dentist about replacing them (on a yearly basis is a general guideline).
• Children will need re-fitting and/or re-examination with each regular check up in order to ensure that the mouth guard is still offering optimum protection and comfort.

For further information regarding these and other health related issues in Karate, please feel free to contact the USA-NKF Medical Committee and to periodically check the HEALTH section of the USA-NKF web site.

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