Dentist in the multiprofessional athlete monitoring team: essential to mitigate the severity of head concussions?

Abstract

During the 4th International Conference on Concussion in Sport, held in 2012, in the city of Zurich, Switzerland, a consensus statement on concussion in sport was built, based on the principles described in previous documents [1]. The statement brings an additional understanding concerning the risks, diagnosis, and prevention of sports concussion in the amateur or professional athlete. Due to the importance of this topic for the health of sports players, the document is addressed not only to doctors but to all health professionals involved in preventive care and rehabilitation for this population [1].

It is well known that concussions could occur in any sport, with a higher prevalence in contact sports [1]. Due to the potential risk of neurodegenerative effects by recurrent exposure to concussion or chronic exposure to head impacts, it is of great importance that this problem is addressed with a multi-professional approach [2]. In dentistry, personalized mouth guards (PBP) can be an interesting tool to reduce the neurodegenerative effects resulting from concussions. This is because PBPs have biomechanical properties to absorb and dissipate forces resulting from impact [3].

Concussions result from the acceleration-deceleration process that occurs after the action of biomechanical forces that are transmitted to the brain tissue. The use of PBP can help to control cervical muscle activity, which is increased with trauma, contributing to reduce the severity of concussions after impact. In addition, PBP can distance the condyle of the mandible from direct contact with the mandibular fossa of the temporal bone, preventing this region from absorbing the full force of traumatic impact [3].

Although it is impossible to eliminate all chances of concussion occurrences during sports practice, it is very important to create strategies aimed to reduce the number and severity of this situation. Pre-participation assessment and post-trauma follow-up should follow stricter criteria, with the participation of dentists in the multi-professional team that accompanies the athletes. This multi-professional interaction offers additional benefits in the preventive and rehabilitation spheres, as suggested by Sacramento et al. [4].

Another strategy that could help prevent concussions is expanding current research, with more robust cross-sectional and longitudinal observational studies, assessing the etiological and epidemiological profile of sports trauma. Especially in youth sports, there is still insufficient research that explores this topic, since most research is directed at professional adult athletes, where the surveillance of these injuries is best performed [5].

Finally, we believe that educational and clarification measures for athletes and coaches, about the importance of including the dentist in the multi-professional team, can help prevent concussions from being more harmful, as well as helping athletes to have better outcomes, improving recovery strategies following injury [4]. This could also decrease the athletes' recovery time and ensure a safer return to sports practice.