Sports mouthguards: Contamination, roughness, and chlorhexidine for disinfection - A randomized clinical trial

Abstract The aim of the present in vivo study was to evaluate the bacterial contamination of sports mouthguards, surface roughness, and the efficacy of chlorhexidine gluconate spray in the disinfection of these devices. A randomized, blinded cross-over clinical trial was performed with twenty 9 to 13 years old children who practiced martial arts and participated in all phases of the study. They were instructed to wear mouthguards 3 alternated days a week for 1 hour and, after use, to spray sterile tap water or chlorhexidine 0.12%. The mouthguards were analyzed by MTT assay, Checkerboard DNA-DNA hybridization, and confocal laser microscopy prior and after use for 2 weeks. Data were analyzed by Wilcoxon and t-Student, and Pearson correlation tests, with 5% significance level. Were observed that mouthguards of the control group were more contaminated with cariogenic microorganisms than those of the chlorhexidine group (p<0.05). The mouthguards use of spray of chlorhexidine reduced significantly the bacteria contamination compared with control group (p = 0.007). The surface roughness of the mouthguards increased significantly after use, irrespective of application of chlorhexidine spray. A moderate correlation (r=0.59) was observed between surface roughness and the cariogenic microorganism's contamination only for control group. Sports mouthguards had intense microbial contamination and increased surface roughness after its use. The use of chlorhexidine spray was effective for reducing the mouthguards contamination used by children.

Resumo O objetivo do presente estudo in vivo foi avaliar a contaminação bacteriana de protetores bucais esportivos, a rugosidade da superfície e a eficácia do spray de gluconato de clorexidina na desinfecção desses dispositivos. Um ensaio clínico randomizado, cego, cruzado foi realizado com vinte crianças de 9 a 13 anos, que praticavam artes marciais, participaram de todas as fases do estudo. As crianças foram orientadas a usar o protetor bucal por 3 dias alternados durante 1 hora e, após o uso, borrifar água de torneira estéril ou clorexidina 0,12%. Os protetores foram analisados por ensaio MTT, Hibridização DNA-DNA e microscopia confocal a laser antes e após o uso por 2 semanas. Os dados foram analisados pelos teste de Wilcoxon, teste t de Student, e correlação de Pearson, com nível de significância de 5%. Observou-se que os protetores bucais do grupo controle estavam mais contaminados com microrganismos cariogênicos do que os do grupo experimental (clorexidina) (p <0,05). O uso de protetores bucais com spray de clorexidina reduziu significativamente a contaminação bacteriana em relação ao grupo controle (p = 0,007). A rugosidade da superfície dos protetores bucais aumentou significativamente após o uso, independentemente da aplicação de spray de clorexidina. Uma correlação moderada (r = 0,59) foi observada entre a rugosidade da superfície e a contaminação do micro-organismo apenas para o grupo controle. Os protetores bucais esportivos apresentam intensa contaminação microbiana e aumento da rugosidade superficial após o uso. O uso de spray de clorexidina foi eficaz para reduzir a contaminação dos protetores bucais usados por crianças.

Extractos de los documentos de posicionamientos y recomendaciones mexicanas en enfermedades cardiovasculares y COVID-19 / Excerpts from the documents of Mexican positions and recommendations in cardiovascular diseases and COVID-19

Resumen Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.

Abstract The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.

Sports Dentistry and Mouthguards.

Dental and orofacial injuries have been reported to be the most commonly occurring form of traumatic injury resulting from sport-related activities. Sports dentistry is the upcoming field in dentistry which is associated with the correct diagnosis, prevention and treatment of orofacial injuries and related oral diseases. This branch also deals with the collection and dissemination of information on dental athletic injuries and the encouragement of research in the prevention of such traumatic injuries. This article discusses an overview of sport-related injuries in orofacial and dental region, incidence, evaluation, treatment and their prevention. It also discusses the several functions and types of mouthguards. It stresses the prime role of dentist in educating the general public, parents/guardians, staffs of emergency department, coaches and athletes regarding health risks and benefits of mouth guards including the importance of emergency care for orofacial injuries.

Comfort And Acceptability of Different Types of Mouthguards Among 7-12 Years Old Children At Skating Rink.

Participation in sports activities, besides having many beneficial effects, often increases the risk of traumatic injury to the dental and oral tissues. The single most important device for protecting the teeth and mouth during athletic activities is the use of an intraoral mouth guard. The intention of this study was to survey 7-12 year old children participating in skating, mainly to evaluate the significance of utilization of mouth guard wear over a period of 8-10 weeks and also to determine the acceptability of the three different types of mouth guards used. The results drawn from this study showed that 13% orofacial injuries were experienced by children during skating, and irrespective of the type of mouth guard used over a period of 10 weeks, none of the skaters had experienced an oral injury and this shows a significant finding with p<0.01 (Z test for proportions). The custom mouth guard was readily accepted by the skaters and their extent of use was also high when compared to mouth formed and stock mouth guards with p value < 0.05, which is statistically significant.

Survey on the occurrence of dental trauma and preventive strategies among Brazilian professional soccer players

OBJECTIVES: The aims of this study were to verify the occurrence of dental injuries in professional Brazilian soccer players, the level of knowledge of the teams' medical departments about mouthguards, and the conducts adopted in cases of dental trauma during the match. MATERIAL AND METHODS: Closed questionnaires were sent to the physicians in charge of the medical departments of the 40 teams enrolled in the first and second divisions of the Brazilian professional soccer league in 2007. The data obtained were subjected to descriptive analysis to determine absolute and relative frequencies of answers for each one of the questions. RESULTS: Physicians from 38 (95 percent) of the 40 teams in the first and second divisions answered the questionnaires and 71.1 percent reported the occurrence of some type of dental injury during soccer practice, dental fractures (74.1 percent) and avulsions (59.3 percent) being the most prevalent ones. Regarding emergency conducts, approximately 50 percent answered that a successful replantation could be obtained in periods from 6 to 24 h after injury, and 27.8 percent were not able to answer this question. Regarding mouthguard use, 48.6 percent of the physicians did not know about mouthguards, and only 21.6 percent usually recommended their use by the soccer players. Among the physicians who do not recommend the use of mouthguards, 50 percent justified that it was not necessary. Almost 50 percent of the medical departments do not have a dentist as part of the health professional staff. CONCLUSIONS: It was possible to conclude that dental injuries are common during professional soccer practice and that there is a lack of information in the medical departments related to the emergency conducts and prevention of dental trauma.

Influence of mouthguards to speech intelligibility / 体力科学

This study was carried out to examine the influence of mouthguards on speech intelligibility. Nine male rugby football players with normal personal occlusion and normal speech served as subjects. All players took the speech intelligibility test while wearing self-adapted mouthguards, custom-made mouthguards and without wearing mouthguards.<BR>The ratio of correct judgments for speech intelligibility wearing self-adapted mouthguards was significantly lower than that of wearing custom-made ones or of not wearing one. When misjudged syllables were evaluated by using the manner of production for articulation, plosives had a tendency to be misjudged as flapped sounds or as other plosives while subjects were wearing self-adapted and custom-made mouthguards. When misjudged syllables were evaluated by the points of production for articulation, bilabials and velars had a tendency to be misjudged as alveolar sounds while subjects were wearing self-adapted and custom-made mouthguards, and alveolar sounds had a tendency to be misjudged as various sounds while subjects were wearing self-adapted ones.<BR>The findings showed that speech intelligibility with custom-made mouthguards was better than with self-adapted ones. Speech intelligibility may be better with mouthguards with reduced palatal thickness than with the current ones because points of prodution for alveolars and velars approach the normal points.