A new field is born
The third International Sports Dentistry Symposium, organised by the European Association for Sports Dentistry (EA4SD) and meeting in Edinburgh on 24-25 November, aims to bring together sports dentistry and medicine – and analyse how they work together for athletes’ health. Sports dentists and physicians will highlight the important elements in preventing injuries and monitoring health.
Sport has always been a part of human activity and culture and it has become a key way in which to maintain and improve our health. Sport is health. But does this come without any conditions? No. Sport can be healthy, fun, exciting and emotional – but there is one important condition; that it is practised safely.
We cannot expect an athlete with a knee injury or heart disorder to practise sports because in such cases, it means putting his/her health at risk. In the same way, how can we expect an athlete to exercise or compete while having a periodontal abscess, extensive caries, injured teeth or jaws?
The scale of care for sports people is significant. FIFA estimates there are more than 300,000 professional players and 300,000,000 amateur players around the world. This is only in football! In the UK Premier League alone, the financial cost of injuries was estimated to £269,000,000 in season 2014-15.
According to the Bureau of Labor Statistics in America, around 218,000,000 people engage in daily physical exercise. That is 66 per cent of the population. In the US, dental injuries from recreational sports account for more than 600,000 emergency visits each year.
In the early nineties, a new medical field – sports medicine – was developed. Now, a detailed medical examination of athletes is conducted, prevention takes an important lead, specialised protocols of field emergencies are created and – most important – sports medicine has become multidisciplinary. Physicians and health professionals from different specialties form the medical team and are responsible, for the sports team, to work systematically on the prevention and treatment of the sport-related injuries.
The research about the exercising human body is growing; the scientific evidence linking physical exercise to pathologies, injuries and performance in a two-way pattern has opened new horizons to medical science and athletes have started to benefit from a healthier participation. From the 2002 to the 2014 FIFA World Cup, the incidence of injuries decreased by 37 per cent.
When I started to treat professional football players and other athletes in my dental clinic, I soon realised that the existing examination and treatment protocols were not enough to provide the best possible dental care to athletes who were traveling at least twice a month, exercising hard every day, and competing at their maximum twice a week.
The athlete had no time, or the motivation, for dental treatments. The coach wanted the athlete available for training. The team physician wanted the minimum ‘return-to-play’ time (the decision-making process of returning an injured or ill athlete to practice or competition). Overall, there was a complete lack of awareness in sports about the importance of oral health in the overall health and physical activity.
It was a challenging time to be a dentist treating sports people. What would a football player in possession of the ball do while being challenged by an opponent? He would look for teammates. Luckily, there were a lot of dentists in a similar situation, so there were ‘teammates’ on the field.
It did not take long to agree with colleagues from different countries about the European Association for Sports Dentistry (EA4SD), based in Paris. We were motivated by our common vision to adapt our science to athletes’ needs, conduct research, create a network, and present scientific evidence on how the oral health has an impact on sports. Soon, membership in Europe – and the rest of the world – began to grow.
As cofounders of the EA4SD, we agreed on the principle of creating an association where its members will have the opportunity to actively participate with their ideas, research and projects to our common goal, sports dentistry’s international development and integration in sports medicine. The following milestones were achieved:
- In 2017, the EA4SD became an official partner of the European College of Sports and Exercise Physicians (ECOSEP) which is the first international sports physicians’ association to create a sports dentistry committee.
- In 2018, the World Dental Federation (FDI) created the first official guidelines and toolkit of sports dentistry1, available to more than one million dentists and 200 national dental associations in more than 130 countries. Sports dentistry is now officially recognised by the FDI.
- In 2019, the EA4SD became an official partner of the Academy for Sports Dentistry in the USA (ASD), thus creating a global network of sports dentistry and starting a strategic cooperation in terms of development and network.
- In 2020, the first Consensus Statement on sports dentistry integration in sports medicine, was published in Journal of Dental Traumatology, by the EA4SD, ECOSEP and ASD.
The current picture
Oral health and dental treatments have an immediate and visible impact on the body, including the cardiovascular, respiratory, and musculoskeletal system, plantar arch, muscle strength, posture, and gait. Caries and periodontal disease are found in highly elevated incidence in athletes.
In professional American football alone, 100,000 to 200,000 oral injuries per year are prevented using mouthguards. We can now screen and treat our athletes using combined technologies, such as CBCT scan, facial electromyography, digital occlusal record and impressions, mouthguards and splints materials and devices of cutting-edge technology providing optimal injury prevention.
Today, thousands of dentists in Europe and around the world are interested in and benefit from this new field in dentistry. The research and scientific evidence about oral health in sports is increasing rapidly, sports dentistry has become continuing education, specialization, post-graduate diploma in dental faculties, present in major sports medicine and dentistry international conferences.
Sports dentistry began as an innovation, continued as a sustainable integration in sports medicine and now it is an emerging global trend in the dental and medical field.
Dr Thanos Stamos (DDS, Greece) is the co-founder & executive vice-president of the European Association for Sports Dentistry (www.ea4sd.com) and the co-author of World Dental Federation (FDI) Sports Dentistry Guidelines and Toolkits.