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Dental Hygiene and Sport (Part 2)

From the floor: In figure skating, we have the example of an athlete who has real dental problems, but to whom we do nothing.

Philippe BOISSONNET : The postural disorder can be well compensated. The slightest intervention can then prove very disruptive. I followed a high-level athlete to whom I only gave one splint. I did not want her to undertake orthodontic treatment when she was at the top of her abilities.

My work allowed him to improve his performance. She will do her orthodontic treatment later, when she has left the circuit, otherwise she risks suffering the same fate as Carl Lewis, who was at the bottom of the wave when he was following his orthodontic treatment.

From the room: Could this result in the appearance of tendinitis?

Philippe BOISSONNET: Tendinitis results either from a hydration problem or from a poorly treated dental infectious source , either from poor maintenance of dental hygiene (brushing) or from a drainage problem in the liver.

In Chinese medicine, the liver is the organ of tendons and ligaments.

From the room: How to breathe with a splint?

Jean-Luc DARTEVELLE: The gutter is suitable and takes up little space. It is placed in the mandible. The athlete can speak and breathe completely normally with his splint in his mouth. This is not comparable to the bulk of a mouthguard.

Patrick HESCOT: Jimmy Vicaut, European junior 100m champion and vice-world champion from the 4x100 m relay, joined us. He is accompanied by his trainer Guy Ontanon, who also trained Christine Arron.

Guy ONTANON : When I start working with an athlete, I have him perform a complete check-up, both muscular and dental. Too often, athletes arrive with shoes that they do not change.

A simple change of brand can cause tendinitis. I also train Ronald Pognon, who has had major dental problems.

Solving these problems contributes very significantly to improving the physical condition of an athlete: injuries are fewer, tendinitis disappears.

Jimmy VICAUT : I joined INSEP three years ago years. I don't know if the cause is dental, but I always hurt my hamstrings. I don't know where the problem comes from.

Jean-Luc DARTEVELLE: I took care of Jimmy last spring. The care has been carried out: home treatments, occlusion adjustments, caries treatment... We now have to wait but Guy Ontanon will confirm that the injury which motivated his visit is a bad memory.

Guy ONTANON : I have a coaching question to ask you. Wouldn't it be helpful to brush your teeth after a workout, when the saliva is acidic?

Jean-Luc DARTEVELLE: The easiest way is to rinse your mouth with water, even if it means spitting it out afterwards.

Guy ONTANON: All my athletes drink water. I would like to know what kind of little advice I could give them.

Jean-Luc DARTEVELLE:It is always useful to brush your teeth. If the acidity level is really high at the end of the session, it is always possible to reduce it by chewing sugar-free gum.

Patrick HSCOT : If it is not possible to brush your teeth, you must, in case of high acidity, rinse your mouth with water and chew sugar-free gum for 20 minutes.

This significantly reduces the risk of decay.

Jean-Luc DARTEVELLE: I would like to emphasize the fact that the first rule for a surgeon- dentist must not touch an athlete who is well, apart from the care of cavities or hearths. You should always avoid making major dental modifications on a balanced, high-performance athlete.

From the floor: I am a dental surgeon in Pau. Can wearing a splint while relaxing allow a healthy athlete to improve their performance?

Have athletes ever done it?

Philippe BOISSONNET : If the occlusion is perfect, which is rare, and there has good respect for neuro-muscular balance, the relaxation splint will not bring anything. In someone who needs it, the splint can improve explosive strength.

Athletes who have tongue shifts (between the arches, when swallowing for example) could perform less well in the starting phases because the position of their tongue can cause a problem at the postural level.

From the room: Does an athlete who tenses up, therefore who has clenched jaws, really lose efficiency compared to an athlete who relaxes his muscles?

Guy ONTANON : Yes. Jimmy Vicaut can assure you of this. He tended to run very tensely. So we worked on loosening up, which made him progress.

On the other hand, I don't know if a splint is a plus during or outside training. The specialists will tell you.

From the room: We put splints on tense patients, especially at night, to encourage muscle relaxation. This could perhaps also be useful for a tense athlete.

Philippe BOISSONNET: Daytime tension and nighttime tension are not at all the same. Muscular powers exercised during the night are a way to eliminate stress.

They are much more important than the powers exercised during the day, while awake.

At night, just by clenching their teeth, some people manage to knock out perfectly healthy living teeth. Furthermore, we instinctively tend to clench our teeth in the event of violent effort.

  With a perfect occlusion, the power will be good. If the occlusion is not good, the effort will not be effective.

From the audience: Was the correction of Jimmy Vicaut's occlusion accompanied by technical modifications, at the level of the supports for example, on the track?

Guy ONTANON : We make changes throughout the year. His attitude, his running technique and his relaxation have evolved. Is it related to the correction of his occlusion, the technical work or the work with the physiotherapist, who saw him regularly for other problems? - It's hard to say.

All of these actions are common. It’s a set of things that have made Jimmy Vicaut progress.

Dr Sophie DARTEVELLE: In the example of archery, the measurements are made in static position. It is therefore possible to concretely observe the effects of the repositioning gutter.

In the case of sprinting, this type of measurement in a static position does not make it possible to measure the impact of occlusal adjustments. Many other factors come into play during the race.

Dr Jean-Luc DARTEVELLE : The work of the physiotherapist cannot really succeed if significant dental problems exist and are not treated . It really takes teamwork. Caring for athletes is a multidisciplinary job.

From the floor: I am a dental surgeon The athletes we see are young. I don't understand why wisdom teeth problems, which can knock an athlete to the ground, are not systematically detected.

A dental panoramic seems necessary to me. Why is this not systematic? Furthermore, I would like to know if athletes from other countries are monitored in the same way as French athletes at INSEP.

Jean-Claude VOLLMER : Dental panoramic is not obligatory in regulatory medical follow-up, but we do a lot about young people in the making.

In regional centers, there is no dental office, which poses the problem of the cost of the operation.

 There has been a real dental polyclinic in the Olympic village since the Sydney Games in 2000. In 1992, 600 dental examinations were carried out during the Barcelona Games.

Four years later, in Atlanta, there were 900. It was from there that the Olympic Committee decided to install a real dental clinic in the Olympic village. This is therefore a very recent development.

 The IOC has even issued recommendations in pre-competition monitoring.

The equivalent of INSEP exists in each country, perhaps not as large and perhaps not as focused on the dual project as us, since we have the desire to “bring out” competitive athletes, but also graduates who will find a job.

 On the medical side, I think we are the only center in the world to be so well equipped and to have so many staff, both medical and paramedical.

General health, dental health as well as awareness of the athlete's dental hygiene is essential and essential at INSEP. The importance of the choice of toothbrush for an athlete is essential. It is also an element of permanent control.

Source: national conference report at INSEP and UFSB Oral Health

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