August 18, 2016 -- When a U.S. Olympic archer who uses his mouth to hold his bow back fractured one of his front teeth and needed care so he could compete in the Rio Olympics, a volunteer dentist from the Academy for Sports Dentistry (ASD) stepped in to help.
Many athletes who compete in the Olympics have significant dental problems, according to Pennsylvania dentist Richard Knowlton, DMD, who heads the ASD's effort to provide free dental care for U.S. athletes. Dr. Knowlton provided free dental care to the members of the U.S. women's field hockey team before they left for Rio.
"I never really dreamed I'd have the opportunity to be involved on the Olympic level," Dr. Knowlton told DrBicuspid.com. "Even 1/100th of a second can make a difference between whether you're on the podium or not. If you're fighting significant gum disease or infections, it's like competing with a cold."
Many Olympic athletes have dental problems
Dr. Knowlton is the former team dentist for the Hershey Bears professional hockey team and has treated local high school and college teams near his Elizabethtown, PA, practice. He is a former president of the ASD, which includes more than 600 dentists who specialize in dental athletic injuries among players ranging from midget teams to professional sports teams.
Since working with the U.S. Olympic Committee (USOC) four years ago, ASD dentists have treated more than 350 U.S. athletes.
"The more we can do for athletes at home, the better chance they'll have," Dr. Knowlton said. "Our goal is to be the team behind the team and help them be the best they possibly can be."
Most dental sports injuries occur in basketball, baseball, and softball, where mouthguards aren't required, Dr. Knowlton said. While the USOC provides medical care for U.S. athletes, mainly when they're injured, there is no provision for their dental care.
What's more, the majority of Olympic athletes spend most of their time training and don't have jobs that provide dental insurance, Dr. Knowlton noted.
"As you get to know these young athletes, for four years or more they will train for about six days a week, 50 to 70 hours," he said. "Their lives are totally committed to trying to be the best they can be. All they do is eat, sleep, and train. Most live a very Spartan life."
Many athletes neglect their overall oral health, Dr. Knowlton said. They don't get regular checkups and often get dental care only on an emergency basis.
The majority (55%) of the athletes at the London 2012 Olympics had dental caries and nearly half (47%) had not received a dental examination or hygiene care in the previous year, according to a 2013 study.
About 30% of all visits to the medical facility at the Olympics are dental-related, based on Dr. Knowlton's experience.
"It's an extremely significant problem," Dr. Knowlton said. "There is widespread periodontal disease, gum infections, abscessed teeth, and caries among the athletes."
Importance of mouthguards
Most mouthguards worn by athletes -- usually the "boil and bite" kind -- don't provide much protection, according to Dr. Knowlton.
"All it does is give the athlete a false sense of security," he said. "They don't stay in the mouth, and the athletes can't really breathe very well. Most spend the majority of time chewing them like Stephen Curry," the NBA basketball star.
As the former team dentist for the Hershey Bears hockey team, Dr. Knowlton said only about half the team wore mouthguards. Some players wanted mouthguards that were especially designed to be clear and unnoticeable, because the opposing team would often try to attack players' faces if they could see that they were wearing them, he said.
"Except the big hatchet man who wanted me to make him a buck-toothed mouthguard; he loved that," Dr. Knowlton recalled. "He was the guy who got in all the fights."
Many boxers from poor countries have boil-and-bite mouthguards, and when they come to the Olympics, they discover that they can get custom-made mouthguards at the medical facility.
"They're all lining up saying, 'Can you make me a mouthguard?' and the dentists there will make them," Dr. Knowlton said.
The Rio medical facility has provided more than 1,000 dental checks so far, according to a USA Today story. Dentists have performed 450 dental x-rays and designed more than 300 specialized mouthguards.
Treating the local team
Dr. Knowlton has provided the women on the U.S. women's field hockey team with custom-made mouthguards, which are pressure laminated and have different layers of plastic.
When team member Caitlin Van Sickle chipped a front tooth and pushed another tooth out of alignment, Dr. Knowlton stepped up.
"He fixed my teeth," Van Sickle said, according to a Lancaster Online story. "And ever since then, he's given us free dental work and cleanings, whitening kits, [filled] cavities, all the works. He's so generous."
In addition to dental care, the USOC now has expanded the program to recruit medical professionals to provide physical therapy, psychiatry, chiropractic, and acupuncture care to U.S. Olympic athletes.
Helping U.S. athletes perform at their best, without oral pain or problems, allows Dr. Knowlton to share in their triumphs.
"I look back to when I was getting out of dental school, and to even have an opportunity to be associated with the Olympics is kind of a dream come true," Dr. Knowlton said. "We want to see the smiles on their faces when they're up on the podium, and if we can make a difference and help them along the way, it's a great opportunity for us as a profession."