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Mouth orthotics can increase balance, strength and flexibility

It is not often a dentist is asked to help improve the performance of athletes in their respective sports. Yet new technologies mean dentists can make an impact on balance, flexibility and strength with sport enthusiasts of all calibres.

Bode Miller uses a different PPM for each type of downhill event he competes in.

Dental orthotics balance jaw and neck muscle activity, improving head posture and decreasing neural activity associated with an unbalanced jaw-clenching position. Using dental orthotics, athletes are finding their jumpshot is better, their running time is faster and their golf shot is more consistent.

This dental orthotic may take the form of an upper mouthguard for contact sports or a lower dental appliance for training and non-contact sports. The orthotics that appear to make the most improvement in performance are custom-made using computer technology to find the most neutral bite possible. There are also less-expensive options, known as "boil and bite" mouthguards, which provide protection and are touted as performance enhancing.

One branded neuromuscular dental device is leading the way in high-performance sports - Pure Power Mouthguard (PPM) by the Makkar Athletics Group.

"The vision of the company is to change the way the game will be played in sports and for athletes to experience their true potential," says Dr. Anil Makkar, the Canadian dentist who founded the company.

Indeed, PPM has some high-performance endorsement. Shaq O'Neal wears one when he plays basketball. NFL player Terrell Owens works out with one and has another to wear for each game. Olympic and World Championship gold medallist skier Bode Miller had one made for each type of downhill event during the Vancouver Winter Olympics, depending on the tuck position he required.

So, how can a dental orthotic change your game? How can having a mouthguard make you skate faster or jump further?

Simple. Form follows function. Or the reverse: function follows form.

For any mechanical system to work properly, all of its parts need to be sized properly, in their proper place and able to freely perform their function. It is true of a car engine, and it is true for your body.

A PPM mouthguard or orthotic is based on the fact many people's jaws don't naturally fall into the most comfortable, relaxed place where the facial, neck and shoulder muscles don't have to overwork. This imbalance can cause severe jaw joint pain, neck problems, cracked teeth and headaches.

As part of his Calgary dental practice, Dr. Volinder Dhesi fits clients with PPM mouth orthotics.

"In neuromuscular dentistry, we find a harmony between the way the muscles want the jaw joints and the jaws to function," Dhesi says. "We find out that the neck aligns better and the muscles relax and even in some cases an airway can open some more, and the patient will have better posture and certainly not damage their teeth."

When the muscles in your face aren't straining to keep your neck, head and back aligned, they can focus their energy into other areas.

The process of properly aligning the jaw position is based on the principles of neuro-muscular dentistry. A"good" bite is achieved when the muscles of the face, jaw and neck are at their most efficient state, which is a restful state. What we have observed, and demonstrate, is an immediate improvement in posture, range of motion, flexibility, balance and strength.

In a study funded by a grant from Pure Power Athletics, Inc., Rutgers University researchers found a neuromuscular dentistry-based mouthguard enhanced peak power output, performance and repeated maximal efforts. While it may not enhance sustainable power output, athletes in power-based sports were found to benefit from wearing a neuromuscular dentistry-designed mouthguard.

The researchers tested a neuromuscular dentistry-based mouthguard versus a standard, custom-fit mouthguard with anaerobically trained professional and Division I college athletes who participated in a double-blind, crossover study. Subjects completed two separate sessions in which they completed three performance tests, which included vertical jump, bench press and a 30-second Wingate Anaerobic Test while wearing the assigned mouthguard.

Postural imbalance will affect your function as an athlete because the way our bodies work are interconnected. Posture can be affected from the bottom up - for instance, flat feet - or from the top down, such as a poor bite.

Now take a thin plastic pen. Place it between your teeth, either just behind or just in front of your canines or "eye" teeth. Assume the position again, with your arms out to your side at shoulder height, and have your helper pull down on your arms while you clench on the pen.

Most of you will see there is more strength in your arms and shoulders while biting on the pen. This kinesiology test alludes to the improvement a balance bite can give you. The same results can be seen with balance and with flexibility.

Now you could run your next race with a pen between your teeth, but that is not practical. Instead, a dentist trained to find a neuromuscular bite can, using computerized jaw-tracking, active muscle monitoring and special low-frequency relaxation machines (similar to those at a physiotherapist's office), find an optimal bite that will improve your balance, strength and flexibility.

Remember PPM is not the only mouthguard available for athletes. The cost of PPM mouthguards ranges from $1,100 to $1,600, depending on the age of the athlete and the level of game played. There are also several options for players of impact sports. The lower end of the scale includes the "boil and bite" mouthguards available from most sport stores. These inexpensive mouthguards won't give a custom fit, but for very young players and those who have braces on their teeth, they are an inexpensive option. These range in cost from $30 to $75.

Most dentists can provide the custom-fit mouthguard made with impressions of the player's mouth and fabricated in a dental laboratory. These custom-fit mouthguards replicate the habitual bite position of the athlete and can be very colourful. Costs range from $150 to $300, depending on the level of impact protection required.

Another option is the Under Armour mouthguard. Under Armour mouthguards have 1.5-mm thick pads for the back teeth. While delivering the same bite to every client, Under Armour claims to also have a benefit to a player's ability. The UA mouthguards range in cost of $500 to $1,000, depending on the type made.

The performance-enhancing benefits of a mouth orthotic doesn't mean you can stop training, just that you can train better and enjoy your sport more, all with a balanced bite.

About the Author

Dr. Curtis Westersund is a Calgary dentist providing treatment for TMJ disorders, cosmetic dental concerns, as well as PPM mouthguards.

"Better Bite Leads to Better Performance" first appeared in the 2010 July/August Summer Sports Issue of IMPACT Magazine.