Clean gums and fair scrums

19 October, 2011 / Infocus

There’s an old rugby union joke that says if a prop forward is drooling out of both sides of his mouth then you have yourself a level playing surface – the inference being he has taken one too many knocks to the head over the course of his playing career.

And, while this is perhaps too stereotypical an adage for the modern game, there is still no escaping the fact rugby players at every level face a higher risk of injury than participants in most other contact sports.

But while a lot of focus in physical sports such as rugby is on the conditioning and nutrition of its participants, the health of their teeth can often be overlooked.

Yet if Dr Fiona Davidson has her way, the toothless grin of the battle-hardened flanker could well be a thing of the past.

Fiona owns and runs SmilePlus Dentalcare, based in the leafy Edinburgh suburb of Corstophine. And, although it’s a standard private dental practice in the main, thanks to Fiona it also places a real focus on sports dentistry too.

Sports dentistry, she explains, is essentially looking at the prevention of dental disease and injuries in athletes of all levels, with particular focus on elite and professional athletes.

“We work with athletes to provide dental screening and management, all in a bid to avoid chronic and acute infection, which could affect their overall performance,” she said.

“We can prevent problems such as acute pericoronitis around partially erupted wisdom teeth, or pulpitis due to dental caries, causing problems at the wrong time, such as before an important competition.”

And Fiona believes athletes aged between 18 and 30, the years in which professionals are in their prime, can be particularly susceptible to dental strife.

“Young men, especially, tend not to go to the dentist unless they have a problem,” she said.

“Because they don’t go to the dentist regularly, any underlying problems they do have can get worse. These things can then flare up into an acute phase when the person is under stress – such as when they have to fly a long distance to an event or when competing in an important tournament.”

But to put the rugby-themed opening of this article into some perspective, Fiona is quite simply daft about the sport.

That is why she was in her element when invited by Scottish Rugby’s head of medical services James Robson to be the official dentist for the national team in 2007.

“Initially, I just provided match-day cover at Murrayfield internationals, but my role has grown to one where I provide dental screening and education, as well as providing routine and emergency treatment, for professional rugby players in Scotland,” she said.

This includes professional players with Edinburgh Rugby and Glasgow Warriors, in addition to the Scotland squad.

However, perhaps Fiona’s biggest challenge came when she was asked to get the current national squad “dentally fit” for this year’s World Cup in New Zealand.

“The International Rugby Board required all players to be signed off dentally prior to the World Cup,” she said.

“I think, in the past, a lot of this type of screening has meant a dentist going into the dressing room with a mirror, just having a quick scan, and not doing X-rays or anything too thorough.

“This time, we’ve done a thorough 30-minute screening of each player, with X-rays if required.”

And Fiona admitted screening the 38 players in the original extended squad proved interesting.

“Over half required some treatment so they could be signed off as ‘dentally fit’,” she said.

“The work mainly involved simple fillings, but some root canal work was required on the anterior teeth of two players due to previous trauma.

“Additionally, two players required root canal therapy on carious molar teeth.” And this proved Fiona’s theory that not every young man is up for having a dentist rummage about in his mouth.

“Generally, quite a few players were poor attendees at their own dentist, only visiting when they had symptoms,” Fiona said.

“Work still needs to be done in educating the players to attend their dentist regularly.”

Fortunately, part of Fiona’s role with Scottish Rugby is to host presentations for players on the importance of visiting a dentist regularly.

“I’m lucky that previous patients have become good ambassadors for me,” she said.

“A good example of this is when one of the current senior squad, about three years ago, a week before the Six Nations, came to me with terrible toothache that had flared up suddenly.

“This had been caused by an acute dental abscess, which in turn was down to dental caries. He had not seen his own dentist for many years.

“Rather than give him antibiotics and wait for the tooth to settle prior to extraction, as I normally would, I had to take the tooth out there and then or he wouldn’t have been able to compete.

“He now reinforces my message to his team-mates and I think a lot of people involved with the Scotland team, the medics and nutritionists, have learned that, although teeth seem trivial in terms of the bigger picture, they are capable of making a player unfit to play.

“You can spend years building up to one event through conditioning and nutrition, but if tooth pain flares up a few days before, it can prevent you from playing – or render you less than 100 per cent in terms of performance – and waste all that training.

“I think for this reason sports dentistry is becoming more important in the UK. It’s been big in the US for a number of years, but now sporting bodies here are taking it seriously.”

Fiona’s rubbing shoulders with the sporting elite hasn’t ended with the national rugby side’s participation in New Zealand either.

She is already assisting Tony Clough – the dental lead at the 2012 London Olympics – to co-ordinate the dental provision in the Athletes’ Village and other events that require such cover.

“There are about 400 dentists and dental care professionals who have volunteered their time and expertise for the Olympic Games,” she said.

“The Olympics will be massive. We’ll have eight surgeries running full time in the Athletes’ Village. In addition, we will be providing cover for events such as water polo and hockey, and there will also be a mouthguard programme.”

And mouthguards is an area Fiona is well versed in. She has spent time training with Dreve in Germany, the company that produces equipment for the manufacture of custom-made, pressure-laminated mouthguards, which Fiona and her team make for athletes.

“Dreve provide good, solid German engineering and I would say they have the best equipment for the manufacturer of mouthguards I’ve seen,” she said.

“A lot of dental technicians use a vacuum machine in mouthguard production, which heats the plastic material so it goes soft and is then sucked down by a vacuum.

“Dreve’s pressure laminator uses pressure instead of a vacuum and this provides a much tighter fit.

“We then trim the finished guard quite short, only as far as the first molar, and we do a lot of thinning on the roof of the mouth.

“You need the bulk of the mouthguard at the front of the mouth, but you don’t want it to become loose. If you have a tight fit, you can make it thinner at the back, so the wearer can breathe, shout and speak with ease. Dreve’s equipment allows for all of this to happen.”

Mouthguards aside, Fiona conceded she has spent so long looking at athletes’ mouths, she is now starting to become interested in their minds too.

“These people are very focused and very driven,” she said. “I’d love to study sports psychology one day, if I
get the chance.

“It would be great to see what makes these guys tick.”

So, as well as Fiona’s work being able to ensure our prop forward at the top of this article has a lovely set of gnashers, her remit may yet extend to preventing him being used as a human spirit level too.

Why sports dentistry?

As bizarre as it sounds, Fiona’s involvement in sports dentistry can be traced back to a cold wet Tuesday night in Rochdale.

Her father is an avid Bradford City fan, as well as being the team doctor, and he would take a young Fiona to some of the north of England’s less exotic football locales, where she would sometimes watch the Bantams do battle in front of crowds of just 1,200 people.

But far from kill her affection for sport, as such an act would many a young girl’s, Fiona said she loved it.

Fiona’s father was also a keen rugby player, but she admits her love of the game didn’t bloom fully until she was at university.

“I was at the Royal London Hospital and the team there won the Hospital’s Cup,” she said. “It was a big deal and received national press coverage. I got swept up in it all.

“My husband was a good rugby player too, as are my sons, so my love of the game has been kept alive through them.

“When the opportunity arose to become involved in sports dentistry it was too good an opportunity to miss.

“It was a real chance to marry a hobby I love with a profession I love.”


Fiona Davidson graduated in 1986 from the Royal London Hospital and worked up to SHO level in Oral Surgery.

Following that, she has worked in general dental practice, including in Edinburgh, since 2001. She attended the only sports dentistry course in the UK at the Eastman Dental Hospital in London from September 2008 to June 2009. She is married with three teenage children.

She enjoys all sports, although rugby is her passion, and she tries to attend as many international games as she can.

Fiona bought an existing established practice in 2007 in Corstorphine, Edinburgh, and upgraded it, naming it SmilePlus Dentalcare. The practice is exclusively private and Fiona works with a team, including associate John Clydesdale, whose main interest is implant dentistry.

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