Archive - November 15, 1999 to May 23, 2002
What is sportsdentistry and Sports Dentistry?
----- Original Message ----- From: Maria Teresa Flores To: SportsDDS@SportsDDS.com Sent: Tuesday, May 28, 2002 10:16 AM Subject: Re: New Pamphlet Dear Dr. Kurtz, Thank you so much for e-mailed me the new pamphlet for hockey players. In Chile, only students from english schools play hockey (not ice) and there are many in Santiago and Vi�a del Mar. I think this pamphlet will be useful for all these players. It is so important to educate the public on prevention of dental injuries! Also of interest is to try to come up with consensus opinion of wich mouthguard is the best for the mixed dentition. Is there any long term study on this subject? Kind regards, Marie Therese Flores, D.D.S. Associate Professor Pediatric Dentistry Children's Dental Traumatology Service University of Valparaiso-Chile
----- Original Message ----- From: Tom Coreno To: SportsDDS@SportsDDS.com Sent: Tuesday, May 28, 2002 12:46 AM Subject: Re: New Pamphlet I too have run into the problem with parents being hesitant to purchase a custom-made mouthguard that has a "limited" life time. I have dealt with it by two approaches: 1. Blocking out for changing dentition, but not too much to compromise retention, it gives them about six months of use. It is important to know your patient's growth patterns. The parents usually are more frustrated with the young athlete losing it first; and 2. Education during presentation, illustrating the benefits of a properly fitted custom made mouthguard, showing and comparing will convince the parent and athlete to make the right choice then and in the future. Kudos' on the pamphlet design, any item to educate is extremely helpful and greatly appreciated.Tom Coreno, D.D.S., Chagrin Falls, Ohio. See all in San Antonio
----- Original Message ----- From: JJLEVIN@aol.com To: mdkurtz@SportsDDS.com Sent: Monday, May 27, 2002 11:22 PM Subject: mouthguard boil and bite type may be a good alternative.... also good for the adolescent patient with adult dentition, but with fixed orthodontic appliances Jeff Levin, DDS email@example.com 419-865-0424
----- Original Message ----- From: bistulfi To: SportsDDS@SportsDDS.com ; Ejax17@aol.com Sent: Monday, May 27, 2002 4:17 PM Subject: Re: New Pamphlet Dear Dr. Jackson You have to use the "block out" in the primary teeth BEFORE you press the model with the 0.80, so the patient can use the Mouthguar for a longer time Best Regards Dr Bistulfi, DDS S�o Paulo, Brazil
----- Original Message ----- From: SpencerZF@aol.com To: mdkurtz@SportsDDS.com ; Ejax17@aol.com Sent: Monday, May 27, 2002 3:35 PM Subject: Re: New Pamphlet DR Jackson I have been on the bench as a team manager and trainer for a youth hockey team for a number of years. My son currently plays as a center for his high school and also plays travel hockey at the midget level. He has also played Lacrosse at the youth travel level. He has given that up to concentrate on hockey. My son currently plays over 100 games a year between his high school, travel and summer league schedule. Fortunately in all my years on the bench, I have never had a player lose or fracture a tooth. Concussions - yes but no joint or tooth problems. For the most part the kids have used the over the counter products. As they get older, I am getting them to go towards the custom mouthguards. When he was younger, I tried everything on him to see what I could recommend to my team and to my league. I have made him mouthguards from both Glidewell Lab and from Space maintainers laboratory. We were happy with the fit and his comfort level with both of these products. BUT, I could not see making them for him while he was in a transitional dentition or in active Orthodontic therapy. There is another lab that makes custom mouthguards in Indiana that is cheaper than these 2 places but I have not tried them as of yet. I will be trying them this year just to compare the various options that we have.We have found a comfort level for our teams with the shock doctor products made by e-z guard. They are easy to make and not expensive so changing them constantly is not a complaint with our parents. I do not recommend them over a custom mouthguard but during transition or during Ortho they will work out. I have players on my team who can chew through a mouthguard in a few games. But they just have to replace them constantly. In our sport the team gets a penalty if a kid doesn't have his mouthguard in. I also keep mouthguards on the bench. In an emergency, kids just put them into there mouth and they form into place. We have had numerous players (including my son) try the WHIPPS type mouthguards, but I have never had a player use it for more than a few games. There is too much trouble with communications on the ice with it and most of the athletes have found them too cumbersome. In fact our dental society has a free mouthguard program every February to make parents aware of the importance of using a mouthguard and to give them out. I hope that I didn't confuse the issue more. If you have any questions please don't hesitate to contact me. Spencer Forman DMD SpencerZF@aol.com
----- Original Message ----- From: Ejax17@aol.com To: mdkurtz@SportsDDS.com Sent: Monday, May 27, 2002 11:09 AM, Subject: Re: New Pamphlet what type of mouthguard do you recommend for children in a mixed/transitional dentition? the type 3 may be good for only a few months, and i find that parents are extremely hesitant to purchase this expensive mouthguard knowing that as the child's teeth fall out, the mouthguard will need to be replaced! thanks for your help. dr. eddie jackson, dmd, pediatric dentist
Unfortunately, I will not be able to make this meeting. I am dissappointed that it is the same time that the NATA has their meeting this year and I will be going to that one instead. I have a few concerns that I would like to bring up or maybe they have been, to the ASD. I am a big advocate for mouthguards and as an athletic trainer I would like to be able to make them. Unfortunately, do to the issues of the licensure laws for both ATC and Dentistry I am not able to do this without a DMD present. It's sad because I have been trained by my denstist that I work with as well have attended a conference where Dr. Padilla spoke. I also took his mouthguard fabrication course in Boston two years ago. Hate to say it but I was the only one who made a really good mouthguard at that seminar. Some of the people who attended had no idea. This is something I would like to see the ASD to examine. Can we put an addition to the laws if we have been trained. There are people who are doing it and I hope that they don't get caught. I work very closely with my dentist to make sure this is done professionally, correctly and within the laws. Enjoy Boston, it's a great city!
Dr. & Mrs. Bruce Gordy, I ran across this site on the web looking for school
The following few e-mails refer to the first ever dental health report issued by the Surgeon General of the United States, May 25th, 2000.
I heard about the report on the radio and found the news distressing--that poor
kids are not getting the dental care they need because the reimbursement is so bad. I
think there is also a need to educate the public on proper nutrition--the need for
vitamins and minerals to keep teeth healthy. I have a sort of dental coverage thru my
union plan but if I do not use their panel dentists, the reimbursement is very poor. but I
like the dentists I use, and they are keeping my mouth trouble free--isn't that worth a
great deal when one discusses reimbursement? the insurance carriers only consider the
cost, not the result-- However, I am glad that the report calls attention to a serious
Dear Doctor Michael Kurtz, I literally just got back from the Buffalo State Convention moments ago and I was going through my e-mails when I came across your e-mail. Obviously you are in a much better position to judge the accuracy of this report but unless you tell me otherwise it certainly has the ring of truth to it. If a significant portion of the population is neglecting a key aspect of its health because of a lack of education about both the relative importance and the fact that they are eligible for coverage there are clearly meanungful steps the legislature and executive agencies can implement in short order. A first step might be to ask or require the Board of Education and the State Dept of Health to increase/expand its dissemination literature/info/workshops/curruclumn on the importance of regular check ups/good hygiene. A user friendly booklet/guide/directory of Medicaid partipating dentists should be included in that distribution. Such could also be automatically made available at various gov't office's including the DMV, Social Services, Child Welfare etc. Finally adequate incentives should be built in to reward denists for their participation in both this education process and in Medicaid itself. Good dental hygiene and early detection are not just quality of life matters or merely altruism. Preventive measures could probably save the taxpayers millions over the long haul not to mention the pain and hardship experienced by the disadvantaged. If you have a different take on this or other ideas please share them with me. If you agree with my assessment and blueprint for action let me know that too. Your insight would be extremely helpful as I am currently developing strategms for tackles healthcare and other public interest issues. Best Regards Vince Tabone Esq. State Committeeman 36 A.D.
Dear Mike- Yes, I am well aware of this concern being a past president of the
Dental Hygienists Association of the State of NY. We are lobbying very proactively
for an access bill which would allow RDH's in NY to do preventive services and screenings
in underserved populations without the supervision of a dentist which would greatly
increase the percentage of people that at least
Dr. Kurtz, As a dentist since 1978, I have practiced in the private sector in 2 states and have been a dental provider at the downtown Phoenix dental clinic run by Maricopa County treating welfare children. I feel that the statistics mentioned in the report you sent me may be somewhat understated regarding the numbers of cavities in low income children, at least in the Phoenix area. A large majority of the patients we saw in the county system were of Hispanic origin with many in the region of the city I worked in being black. I would estimate that perhaps 10% were Caucasian. It was not uncommon to have the average child (I personally saw children from age 3 through age 17) with 6 to 14 cavities, many requiring pulpotomys and stainless steel crowns. Very few children had less than 4 to 6 cavities. In the welfare program in Maricopa County the families had a choice of several different programs to receive medical and dental care. Many of the patients I saw on Maricopa Health Plan, the program provided by the county for whom I worked from 1984 through 1989 told me that the treatment they had received when they were receiving their care through a different program than the one in which I worked was less than acceptable in the dental area due to the fact that the dentists were not interested in treating patients on welfare programs, as stated in the report. As a dentist now in private practice the only patients in state funded programs I treat are foster children. The compensation for the treatment I provide under that program is reasonable and livable. I would like to be able to justify treating those on other Medicaid programs but the compensation makes it impossible for me to justify, even as a dentist who has worked in the welfare system as a full time provider and has seen the dental health problems that welfare recipients have. In the private sector one must, sad to say, look at the bottom line and justify the use of chair time that may not provide the income that pays for that time. I feel that those who determine compensation for treatment provided need to take a step back and examine the fees they are expecting doctors to accept for the time they are providing. The Good Samaritan principal can only go so far. Mike Braegger, D.M.D.
Dear Dr. Kurtz, I don't know what your geographic location is, however, I am in California where we have a state run program called Dentical for low income families. I have been a dentical provider since 1979. In those days less then 1% of the dentists in Calif. were providers. A few years ago, as a result of litigation over access, the state was required to raise dentical fees to 80% of UCR. It never happened due to budgetary constraints, we only reached 65%, however, even at that level, more providers participate. Having spent 21 years practicing in low income communities there is absolutely no question that dental disease is rampant among this population. I routinely see 3 to 6 year olds with 10 to 14 decayed or missing teeth. Virtually every adult patient I see needs periodontal treatment beyond an ordinary prophy. I use caries disclosing agents in examinations routinely as it is my philosophy that if I miss anything in these individuals it will likely result in the loss of the tooth as these patients do not return for routine care. They only come when they have pain as a general rule. Despite all the reports of high incidence of disease in this population, the state of California regularly attacks those of us who service this population for our "Abnormal" utilization. I have challenged the administrators in Sacremento, who have not practiced wet fingered dentistry in 20 years to get out from behind their desks and visit me in my practice to see what I see on a daily basis. Based on what I see, quite frankly, it surprises me that the figures are as low as they are. Obviously, the 57% who have no caries do not seek care of any kind because we rarely see that type of patient in this population. Best Regards, Robert J. Houchin, DDS, Ontario, California
The following few e-mails refer to an internet article written for the Redwoods Insurance Group. It focuses on the most common elements of a cause of action brought by injured athletes against their coach, an example of a case brought against a coach for dental injuries, ADA statistics on dental injuries, and the importance in having a custom fitted mouthguard to prevent serious injury. Kurtz, MD, DDS & Breitweiser RF, ESQ, Protect Yourself and Your Athletes By Requiring Properly Fitted Mouthguards as Standard Equipment, http://www.redwoodsgroup.com/articles-8.asp April, 2000.
I applaud the report and think that the situation is actually much worse than
what is reported. I have practiced for 29 years and find that the "real"
situation is not at all what is seen in the private practices. I have worked in
private practice, public health, and did the research in the low birth weight study and
know that the "average" dental professional has no concept of the epidemic of
oral disease currently being felt by the average citizen in this country. I donated
my time during the World Special Olympics last year in North Carolina making custom
mouthguards, and am donating a weekend in June for the same purpose during the North
Carolina Special Olympics for the Special
I thought the report was great and long overdue! I work as a Head Start dental hygienist in Montgomery County and I can attest to all the problems of the poor and minority children. We need to have most of these children treated by a pediatric dentist. Most of these kids who end up seeing a dentist that take their insurance(medical assistance) never have treatment ....reasons???? ...the dentist doesn't want to treat these kids or is not equipped to treat these kids..... Jane Casper, RDH
Dear Mike; Having referreed youth ice hockey for about 5 years I can attest to the degree that oral mouthguards prevent injury not only to the teeth but to the cranium when a player receives a blow to the chin. But, no matter how often the coaches reminded the players, who would put on all of their other protective gear, they would leave their mouthguards out. Before I would start the game I would talk to the players, those that answered too clearly because they didn't have their mouthguards in would be asked to leave the ice, could not return without a mouthguard or continue in the game. Sharing was often found to occur, but it was my job as referree to keep the game moving but more importantly to prevent injury. Liability of the coach relates to checking for proper equipment of every player before the game starts. The intent is at least give the player the opportunity to prevent injury in contact sports. STUFF HAPPENS!!! Have a great holiday. Sincerely, Irwin J. Katz DDS , Brooklyn College '68, NYU '72
Mike: I read the article and have the following comments: As a division one basketball official and softball official I can tell you that from a legal point of view the criteria would be whether or not mouthguards are required would be specifically in the rulebook of the sport involved. To my knowlege that does NOT exist in either college or HS basketball. As an official in what is allegedly a non contact sport I can understand the problem and have stood by helplessly when an "accidental" elbow finds its mark. Re: the Notre dame study: It has never been replicated and I still question its veracity. regards: Jeffrey Krantz D.D.S. firstname.lastname@example.org
Dr. Kurtz: Excellent article. Amongst other things, I am also a Little League
Good article. I think it should be required reading by all coaches and sport
This was received from Ronald Neer, DDS, Expert Witness, Dental Malpractice Negotiator on Saturday, March 19th, 2000
Mike, I am sure that there may be some studies somewhere but I have not seen them. I personally believe that custom made mouthguards would greatly reduce tmj injuries. I suggest to do your own studies with your sports program and other colleages that you have at other schools to keep track of the tmj injuries or the lack of with a good guard or a cheap one. let me know what you find. thanks Sincerely Dr Ron Neer DDS
This was received from Jennifer K. Blake, CDA, EFDA, ADAA Education Manager on Tuesday, February 15th, 2000.
----- Original Message ----- From: JenBlakeCDA@cs.com To: SportsDDS@sportsdds.com Cc: email@example.com ; firstname.lastname@example.org ; email@example.com Sent: Tuesday, February 15, 2000 9:59 AM Subject: Letter
Michael D. Kurtz, DDS
This was received from BJ of New Braunfels, Texas on Monday, November 15, 1999.