Orthodontics/Mouth guard

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Question
Hi Dr Supan,

My name is Russ. my dentist gave me a soft mouthguard to use when sleeping since i have a tendency to bit my tongue while i sleep. thing is the material looks like some kind of plastic. with the warm temperature of the mouth and the enzymatic activity of the saliva is it possible that chemicals can leach out of the mouth guard? Was wondering if you could provide any info.  

Thanks so much

Russ

Answer
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Hi Russ,

Your question is incredibly timely. As I am sure you are aware, there have been many reports in the media regarding the release of certain chemicals, such as BPA, from plastic water bottles.

BPA stands for bisphenol A. It is a chemical that mimics the female hormone estrogen. Many of the chemicals which have been shown to leach out of certain plastics are estrogen mimicking and have been collectively called “endocrine-disrupting chemicals” (EDC). Bisphenol-A, phthalates, and other chemicals of concern have been discussed in the dental literature. The release of these substances can sometimes be triggered by heat from dishwashers or microwaves, or in the case of mouth guards, from heat during the molding process. Also, exposure to ultraviolet which is sometimes used during disinfection or sterilization or appliances can also trigger chemical releases. FDA does not require testing of dental materials for BPA

The dental profession is aware of these findings. Many years ago certain plastics used in dentistry also contained chemical monomers which caused allergic skin reactions. These were rapidly discontinued. Regarding the current plastics used in clear retainers and other oral devices, I am not aware of any which leach out significant amounts of EDC chemicals.

Russ, I think you should feel quite at ease with any current plastic intraoral appliances used in the US today manufactured by a modern dental lab. To put this all into perspective, certain regular white plastic disposable cups made of polystyrene have also been shown vent estrogenic active chemicals, albeit in very very minute amounts.

You noted:

“ … my dentist gave me a soft mouthguard …..  the material looks like some kind of plastic… “

I do not think that your soft mouthguard will be releasing any chemicals at amounts that are significant. I have looked at many ads from professional dental orthodontic labs, and have also spoken with my own commercial orthodontic lab. There are no materials used that either leach out BPA like substances or monomers in any significant amounts.  Endocrine disruptive activity or dermatological or mucosal reactions in the mouth are most unlikely.

So, to address your question:  “ … is it possible that chemicals can leach out of the mouth guard? … “ .  The practical answer is that whatever chemicals, if any, that might be leaching out of an oral appliance made in 2015 are going to be in really ultra minute levels. Moreover, the any negative clinical impact on health from such oral orthodontic appliance exudates has yet to be reported and demonstrated.

Russ, I believe you are to be commended for asking such a relevant and timely question. Sleep well using your new dental appliance knowing that all is well. Thank you for writing.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com

Please allow a week for a reply. Attaching images is often very helpful in allowing me to better respond to questions. I am in full time Private Practice, lecture on occasion, and involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

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Paul Supan, DDS, MA, MPH

Expertise

First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

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