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Use of Mouthguards by Amateur Basketball Athletes in Greece and the USA Elena-Lito Exarchou1*, Ioannis Kotsanos2 and Nikolaos Kotsanos1

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Use of Mouthguards by Amateur Basketball Athletes in Greece and the USA Elena-Lito Exarchou1*, Ioannis Kotsanos2 and Nikolaos Kotsanos1 ISSN: 2469-5777 Exarchou et al. Trauma Cases Rev 2019, 5:071 DOI: 10.23937/2469-5777/1510071 Volume 5 | Issue 1 Trauma Cases and Reviews Open Access ORIGINAL ARTICLE Use of Mouthguards by Amateur Basketball Athletes in Greece and The USA Elena-Lito Exarchou1*, Ioannis Kotsanos2 and Nikolaos Kotsanos1 1Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Greece Check for updates 2Fitness and Wellness Program, Park University, USA *Corresponding author: Elena-Lito Exarchou, Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Sp.Spyridi 2-6, 38221, Volos, Greece, Tel: (+30)-2421181088 Abstract Introduction Background: Mouthguard use reduces the consequences Over 30% of all dental trauma can be attributed to of oral trauma in sports with intense physical contact. The sports injuries. Although dental-related injuries occur use of mouthguards is recommended by the Academy for less frequently than other sport injuries such as sprains Sports Dentistry for all sports involving physical contact and collision, and by the American Academy of Pediatric and strains, treatment is invariably costly [1]. Moreover, Dentistry for sports in which orofacial injury can occur, e.g. players with dental injuries can suffer more permanent basketball. The aim of this study is to evaluate mouthguard damage, which can affect both their ability to play and use and relative knowledge by male amateur Greek and their well-being [2]. For these reasons it is important collegiate American basketball athletes. that dental-related sports injuries be addressed. Methods: In total 215 questionnaires were completed by almost equal numbers of male athletes from mainland It is acknowledged that basketball, which is played Greece and central US colleges (mean age 20.5 and by 11% of the world’s population, is a sport that 20.8 respectively). They included closed and open-ended involves direct and indirect physical contact between questions on the awareness, usage, acceptance and players as well as between ball and player, with a high effectiveness of mouthguards. Answers were listed and rate of orofacial injuries as a result [3]. Many studies analyzed with descriptive statistics and chi-square tests. maintain that basketball players suffer the highest Results: The use of protective mouthguards in basketball degree of dental injury [4,5]. Given the potential risk was low (12% in both samples) despite high percentages of informed athletes (54.8% Greek, 86.5% American). The of orofacial trauma, the Academy of Sports Dentistry dentist played a significantly (p < 0.01) more active role in and the American Academy of Pediatric Dentistry both promoting mouthguards in the USA (43.5%) than in Greece advocate mouthguard use for basketball players in their (18.8%). The most commonly reported anatomical locations guidelines [6]. When used, mouthguards safeguard the of injury were the same in both countries: Lip injuries teeth and soft tissue by: a) Preventing laceration of followed by trauma to the teeth and tongue. All athletes wearing a mouthguard felt protected from more serious tongue, lips and cheeks, b) Lowering the risk of injury to injury. both anterior and posterior teeth and c) Reducing the likelihood of concussion resulting from impact to the Conclusions: Mouthguard use by Greek and USA samples of young amateur basketball athletes was low. There is a jaw [7]. A decline in the incidence of dental injuries has strong argument for improving awareness and encouraging been documented in sports activities such as American mouthguard use promotion by dentists, especially in football and ice hockey, where mouthguard use is Greece. compulsory [8]. It seems to follow therefore that the Keywords rate of dental injury in basketball could be reduced by Mouthguard, Basketball, Injuries promoting mouthguard use for all basketball players [9]. It is noteworthy that in spite of their ease of Citation: Exarchou EL, Kotsanos I, Kotsanos N (2019) Use of Mouthguards by Amateur Basketball Ath- letes in Greece and The USA. Trauma Cases Rev 5:071. doi.org/10.23937/2469-5777/1510071 Accepted: April 09, 2019: Published: April 11, 2019 Copyright: © 2019 Exarchou EL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Exarchou et al. Trauma Cases Rev 2019, 5:071 • Page 1 of 6 • DOI: 10.23937/2469-5777/1510071 ISSN: 2469-5777 use, effectiveness, low cost and wide availability, This was done to check the reliability and validity of the mouthguard use in basketball is not widespread [2,10]. questionnaire in both languages. It was then tested on The prevailing attitude of basketball players, especially part of the sample before being distributed to all the among adolescents, is that they regard the risk of injury, athletes. It was designed to be taken autonomously in especially dental injury, as low or even non-existent. five minutes or less and each player was asked to fill it in Moreover, there is a general prejudice against taking individually to prevent common answers or the sharing any protective measures due to the perception that of information. a mouthguard may either impact negatively on their The questionnaire consisted of five demographic ability to play or be uncomfortable to wear. These questions which required single word answers (age, attitudes may explain why previous efforts to promote length of training, team, level and city). All athletes mouthguards in basketball have largely been ineffective were then asked if they had heard about mouthguards [7,11]. Moreover, despite substantial research into the (Yes/No) and to state from where they had first heard benefits of mouthguard use in contact sports, there has about them (teammates, TV, the internet, dentist, been little focus on basketball, where mouthguard use coach). Subsequently, athletes were asked: “Do you is limited [2]. wear a mouthguard?” (Yes/No). Twelve multiple choice Greece and the U.S.A are two countries where questions followed to ascertain players’ attitudes and basketball is a very popular sport and a large section experience of mouthguard usage, as well as basketball of the youth population is involved in amateur play. injury experience. For those answering affirmatively The purpose of the present study is to ascertain the (that they use a mouthguard), some of the questions current level of mouthguard use in competitive amateur were as follows: “Where did you get your mouthguard basketball, comparing Greek and American male (dentist, store, other)?”; “Do you use your mouthguard basketball players and their general attitudes towards during training, competition or both?”; “Are you mouthguard protection. satisfied with its use?”; “Is there something about it that bothers you?”; “If yes, please explain (speech difficulties, Methods breathing difficulties, inconvenience, other)”; “Have Ethical approval for the study was obtained by the you ever suffered a mouth injury while wearing a Human Research Ethics Committee of the Aristotle mouthguard?”; “If yes, do you think it protected you?”. University of Thessaloniki, School of Dentistry, Greece, For those who stated that they do not use mouth- where the study was registered. The convenience sam- guards, some of the questions were: “Why have you ple comprised 215 male amateur basketball players: chosen not to use a mouthguard (cost, lack of comfort, 107 were from amateur league male teams from two not convinced, negligence, other)?”; “Do you have any cities of central and northern mainland Greece (Volos, plans to use a mouthguard after this survey?”; “Have pop. 80,000 and Thessaloniki, pop.1,000,000 respec- you ever experienced a dental injury in basketball?”; “If tively); 108 were from male teams participating in the yes, what kind of dental injury (tooth fracture, jaw frac- American Midwest Conference of the National Associa- ture, tooth laxation, lip laceration, tongue laceration, tion of Intercollegiate Athletics (NAIA) Division I League other)?”. (pop. 5,576,606) . They were contacted in person and asked to participate in the study during the academic Statistical Analysis year of 2015/16. Relevant coaches agreed to allow their The data were processed by an SPSS v.15.0 (SPSS players to take part in the study during normal training Inc., Chicago, IL, USA) database. Descriptive statistics sessions. The average age of participants was 20.5 ± 4.3 were used. The chi-square test was used to determine years (ranging from 16 to 32) for Greek players and 20.8 the significance of association between variables and ± 1.8 years (ranging from 18 to 27) for American players. Fisher’s exact test was used for the determination of The purpose of the study was fully explained to all par- the sample. The level of significance was determined to ticipants and informed consent was obtained. be p < 0.05. The Questionnaire Results The original questionnaire was prepared in the En- According to the results of the questionnaire, 54.8% glish language and questions were derived from previ- of Greek amateur basketball athletes and 86.5% of USA ous studies published in English which included relevant were informed about mouthguards and the difference questions [7,12,13]. The original version was translated between Greek and USA players was statistically into Greek by one translator and back into English by significant (p < 0.01).Figure
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