Pennwell web 350 254

A Bite for Performance

July 2, 2010
Patients visit their dentist on average four times per year, spending more time with their oral health professionals than their regular medical doctors.

Mouthwear controls stress level during physical activity

by William Balanoff, DDS, MS, FICD, and Anna Pankow-Wilson, RDH

Patients visit their dentist on average four times per year, spending more time with their oral health professionals than their regular medical doctors. As hygienists and dentists work with patients on a regular basis, they gain an understanding of overall behavior and habits that will affect their patients’ health. Whether a patient is physically active, a regular soda drinker, or a nonflosser, understanding the patient’s habits leads to educated recommendations on products and service offerings from the dental professional.

As patient relationships are built on conversations about lifestyle habits that affect oral health and overall wellness, the paradigm in dentistry becomes more than just teeth and gums. Patients may not be aware of the mouth’s interconnectivity with, and effect on, the rest of the body. As dental professionals, it’s our duty to provide them with all of the necessary information and tools they need to make oral health decisions that will have a positive effect on their entire bodies.

Oral appliances are an important new component of this education process. The influence of oral appliances on the body’s physiology is not a new notion. Rather, it’s an important area that the dental industry has only just begun to explore. Considerable evidence exists regarding the beneficial use of mouthguards. Studies have shown that not only can they protect from oral-facial injuries, but using a special type of mouthwear during physical activity may enhance performance and maintain stress at a baseline level.1

A new branch of science called craniofacial neurometabolic physiology has risen from the study of mandibular repositioning through wedge bite plates. Dental professionals are at the forefront of this science and technology, playing a key role in our patients’ improved quality of life and physical performance.

Stress and health

Cortisol is often referred to as “the stress hormone.” We all require a certain amount in order to manage inflammation and other stressful events, whether physical or psychological. However, chronic or excess amounts of this hormone can be harmful and detrimental to many body functions, including muscle strength, stamina, and visual and auditory acuity. When the body is overloaded by stress, such as the “fight-or-flight” response, it reacts by clenching the teeth. Completing a circuit, it is this clenching mechanism that leads to a chain of events in the body. When pressure is exerted on the temporomandibular joint (TMJ) due to teeth clenching, the brain signals the hypothalamic-pituitary-adrenal (HPA) axis to release several hormones.

Subsequently, the adrenal gland is activated and releases cortisol, the trigger for adrenaline and immediate energy. Cortisol serves as a positive, quick energy fix when the body is confronted with stress. Yet, when not properly balanced or chronic, it is this stress hormone that can lead to fatigue, a suppressed immune system, limited peripheral vision, a decrease in metabolism, and reduced muscle-building — all actions that hinder physical activity.2

A new kind of dental appliance, performance mouthwear, now gives the dental team an opportunity to help patients achieve optimal physical performance. Differing from a nightguard that is worn to combat bruxism, Under Armour Performance Mouthwear helps control the effects of stress during physical activity by working to maintain baseline cortisol levels and decrease lactic acid during exercise.

The mouthwear employs wedge bite plates that align the lower mandible through occlusal interception and stops the preconditioned “fight-or-flight” response in our bodies. By placing the bite plates over the first molars, the completion of the clenching mechanism is prevented, positioning the mandible in such a way that the head of the condyle is brought slightly out of the fossa. This relieves pressure on the TMJ and moves the lower jaw downward in a slight arc, creating the “optimal safety power position.” It is this mandibular positioning that leads to improved airflow, increased strength and endurance, and improved reaction time and visual acuity — all desirable outcomes during physical activity.2

Buy-in from your dentist

Offering new products and services to current and prospective patients is a great way to build your practice’s patient base and gain referrals. The first step in gaining a dentist’s support for any new product, including Under Armour Performance Mouthwear, is research. Cutting-edge products and service offerings help your practice stand out. Hygienists who actively seek out these new technologies play an integral role in building the practice image — something your employer will truly appreciate.

Once a new product or service is incorporated into the practice, training is essential. How can we tell our patients they need performance mouthwear if we ourselves don’t wear it and believe in its advantages?

To help aid in conversations with patients, our practice provided each hygienist and dental assistant with a trial mouthpiece, giving them the personal knowledge they needed to speak to the product’s benefits. Given their first-hand experience, staff are better equipped to talk to patients when prompted and can provide a more personable response. All patients want an affable and educational experience when they visit with their hygienists and we believe this was a positive step in increasing staff awareness and participation.

Inserting oral appliances into the conversation

Internal marketing by the entire dental team is a critical component in whether or not a consumer will purchase a product or service. Hygienists are key players in this.

With the hygienist’s unique role of really being able to get to know patients — whether they like to take yoga classes on the weekend, experience stress on a regular basis, or are avid golfers — it is easy to build rapport. It is this established trust that helps gain a patient’s acceptance of a new product or service, and positions the hygienist as a solutions provider.

When talking with patients about their oral health, performance mouthwear is a great way to transition the conversation to the mouth’s connectivity to overall health and wellness. With benefits of reduced stress, improved visual and auditory acuity, and increased strength and stamina, performance mouthwear is an “easy-get” for health-conscious patients. This audience appreciates new technologies that help them gain a better health status. Taking time in every appointment to listen to and understand patients’ needs is an important tool to help hygienists recommend the appropriate solutions.

Working toward a better understanding of the responses we experience during stress, dental professionals must continually seek out new technologies and services that enhance our patients’ overall health and wellness. Performance mouthwear is one such technology that has the potential to become a standard of care with the multitude of health benefits it provides users. Soon we may see partnerships being formed on behalf of performance mouthwear between physical therapists, medical doctors, dentists, and hygienists as we work to provide our patients with the utmost in care and services.

Bios and references

William L. Balanoff, DDS, MS, FICD, has successfully practiced dentistry for 26 years in south Florida. He received his doctoral degree from Northwestern University and has a Masters of Science degree in craniofacial research from Nova Southeastern University. He is a Fellow in the International College of Dentists and has published numerous peer-reviewed articles.Dr. Balanoff has helped propel the success of Bite Tech by spearheading the opening of the IMGA Fit Center, publishing performance mouthwear research, and creating a new branch of science: Craniofacial Neurometabolic Physiology.

Anna Pankow-Wilson, RDH, is a dental hygienist at Smile Perfect in Fort Lauderdale, Fla. She is an ADHA member, and has been a licensed dental hygienist for 10 years in south Florida and serves as an educational sales representative for Under Armour Performance Mouthwear.

Contact Dr. Bill Balanoff at [email protected] or Anna Pankow-Wilson at [email protected] to learn more.

  1. Garner DP. Effects of mouthpiece use on airway openings and lactate levels in healthy college males. Compend Contin Educ Dent. 2009 Jul-Aug:30 Spec No 2:9-13.
  2. Balanoff WL. Performance-enhancing mouth wear and craniofacial neurometabolic physiology. Compend Contin Educ Dent. 2009 Jul-Aug;30 Spec No 2:2-3.
More RDH Articles