Impressive performance

March 1, 2005
Taking a look at the trends in professional sports dentistry

Taking a look at the trends in professional sports dentistry

Information provided courtesy of 3M ESPE Dental Products

As the intensity, speed, size, and even violent behavior of athletes among the majority of professional sports teams continues to grow, so too does the need for better preventive dental care and emergency dental treatment. Many professional sports teams today employ an official team dentist as part of their medical teams, equipped with the latest tools and techniques to meet the growing demand for impressive performance - both on and off the playing field.

Team dentists

Dr. Mark Roettger, past president of the Academy for Sports Dentistry, possesses a solid understanding of the demands of sports dentistry - at all levels. While attending dental school, Dr. Roettger began his work in sports dentistry assisting the team dentist for the University of Minnesota football and hockey teams with mouthguard fabrication. After graduation, Dr. Roettger opened a private practice in Stillwater, Minn., where he served as team dentist for the local high school football team for 19 years. On a professional level, he also served as coordinator of the Minnesota Vikings’ mouthguard program for a number of years in the 1990s.

According to Dr. Roettger, team dentists assume three basic areas of responsibility for their sports teams:

  • Preseason screenings and examinations. Comprehensive exams include a review of the athlete’s medical history; a dental review to diagnose caries, maxillo-mandibular relationship, and missing teeth; and an assessment of third molars to determine proper timing for extraction of these teeth and orthodontic concerns.
  • Emergency dental treatment. Team dentists must be readily available to provide emergency dental treatment for athletes, as the time between trauma and treatment is critical, with a direct result on prognosis. Over the years, advances in cell biology have helped refine treatments for dental trauma. By understanding the cellular mechanisms of trauma and healing, treatment strategies can be refined to improve outcomes.
  • Custom mouthguards. Fabricating a custom mouthguard with proper design serves to minimize orofacial trauma, a growing concern for professional athletes. Mouthguard design has improved, most notably through the introduction of the pressure lamination technique for mouthguard fabrication. Pressure lamination allows for creativity in mouthguard design, providing maximum protection as well as comfort. In addition, advances in science and research have enabled sports dentists to determine which designs will provide the maximum protection. Computer modeling of virtual trauma, for example, has helped sports dentists understand the mechanism of orofacial trauma and how to prevent this from occurring.

Safety and esthetics

When Dr. Joseph Perno began working as the team dentist for the Philadelphia Flyers in 1977, the players didn’t wear helmets, much less mouthguards. The focus was more heavily weighted on thrill and athleticism; players believed that safety equipment such as helmets and mouthguards hindered their performance. Since that time, however, protecting players’ teeth has become an increasingly important part of the job for professional sports team dentists. Today, according to Dr. Perno, most Flyers players wear mouthguards and take preventive measures to protect their teeth on the ice much more seriously.

Dr. Donald Salomon, team dentist for the New York Rangers, agrees. He cites a dramatic increase in demand for preventive treatments and protection among NHL players. In addition to treating player emergencies at home games, Salomon sees many of the Rangers in his office during the off-season for preventive care and check-ups.

“Today’s players are far more educated about protecting and taking care of their teeth and, in general, pay better attention to their overall physical health,” says Dr. Salomon.

Mouthguards have become increasingly popular as more and more players come to understand the importance of protecting the head from all types of injuries. Dr. Perno adds that a well-fitting mouthguard, in addition to protecting teeth, also can help prevent concussions - a major concern for his hockey players. Likewise, professional athletes are becoming more concerned with not only safety, but also with the overall esthetics of their smiles.

Dr. Salomon estimates that about 40 percent of current NHL players wear customized mouthguards. These mouthguards have improved significantly in recent years, largely because of higher-quality impression materials and procedures that result in a more accurate fit.

“Creating the impression is a critical stage in any treatment,” states Dr. Perno. He notes that using a tray that fits appropriately is an essential first step in taking an accurate impression, and using high-quality material also makes a difference. Dr. Perno relies on a variety of 3M ESPE impression materials to create high-quality impressions for his athlete patients.

High-quality results lead to high demand, and team doctors are seeing an increase in the number of restorative treatments professional athletes are seeking during their careers. In the past, when hockey players lost teeth on the ice, many would opt to wear full dentures until their careers were over rather than undergo reconstructive work. Now, professional athletes are opting for implants and more definitive dentistry. Salomon credits an increase in public appearances by NHL players and their concern with image, as well as the improved ability to protect dental work on the ice without sacrificing safety and esthetics. Thanks to advances in impression materials, athletes no longer have to choose between athletic performance and the performance of their mouthguard.


Whether on the field, court, or rink, high-quality impressions created by professional sports dentists help fabricate reliable mouthguards and, ultimately, support solid athletic performances for their teams. Gone are the days of poorly-fitted mouthguards that impede breathing or communication.

Dr. Ira Kotch began his work in sports dentistry designing mouthguards for the legendary Angelo Dundee Boxing Club. His lifelong love of sports led him to his work with professional teams. Today, Dr. Kotch is the official team dentist for both the Miami Dolphins and the Florida Marlins. In addition to maintaining a busy general and reconstructive practice in Pembroke Pines, Fla., Dr. Kotch is on call 24 hours a day for both teams, treating players on the sidelines, in the locker rooms, and in the office.

Beyond being a part of the action on game day and treating player emergencies, Dr. Kotch says that creating impressions is a crucial part of his work with the players. Impression accuracy and dimension stability are especially important, according to Kotch, because an impression will often be needed later in the season.

During the Miami Dolphins’ offseason, Dr. Kotch creates an impression for each player, which is archived for use as a reference or to create additional mouthguards during the playing season. Dr. Kotch uses Position Penta Quick Preliminary Impression Material from 3M ESPE for his impressions.

Preliminary impression materials make it easy to create an impression that is both accurate and reliable. These materials require fewer steps than traditional alginate impression materials, and save dental professionals valuable time in both the mixing and setting processes. In addition to time savings, preliminary impression materials offer other performance advantages over alginates, including increased strength, long-term dimensional stability, and the possibility of multiple pours.

“Custom mouthguards can only be as good as the impression from which they are made,” adds Dr. Roettger. A custom mouthguard may soon prove to be more significant than ever before.

Roettger currently is involved in research that seeks to explain how mandibular position can enhance athletic performance - a phenomenon that has been suggested for years.

“Neuroendocrinology has shown some promise in describing how jaw position may enhance athletic performance by improving endurance, enhancing recovery, and decreasing stress,” he reports.

The timing couldn’t be better, as interest in athletic performance is at an all-time high. Athletes are continually looking for ways to stay ahead of the game and, as pressure to improve athletic performance builds, mouthguard performance may become a key player.

Dental professionals have reached the conclusion that mouthguards should be worn during any athletic activity - by athletes at any level - in which there is a risk of injury to the head. An accurate and stable impression is essential for custom mouthguards or any other treatment where a correct impression is a decisive factor in achieving winning results.

Editor’s Note: Dental professionals who are interested in becoming team dentists are encouraged to contact the Academy for Sports Dentistry. For more information, please visit