Abstract
PURPOSE: The purpose of this study was to isolate and identify the bacteria, yeasts, and molds found in protective athletic mouth-guards (PAM) and to correlate these microorganisms with potential oral and systemic diseases. METHODS: After obtaining informed consent, 62 Division 1 football players were divided into 4 groups with 2 groups wearing their PAM all season and the other 2 groups having their PAM changed at mid-season. All PAM were collected at the end of the season. Clinical oral examinations were performed on each subject at pre-season and at season-end. Each device was aseptically cultured for the presence of bacteria, yeasts, and molds. The PAM were cut and their surfaces and depths were touched to Blood agar (BAP) and Sabouraud dextrose agar (Sab). The BAP were incubated at 37°C for 24 hours while the Sab were incubated for 2 weeks at ambient temperature (22-23°C). Positive cultures were identified using standard laboratory methods, including molecular biological techniques. RESULTS: The 84 PAM retrieved during the entire study yielded a total of 164 gram positive cocci, 158 gram positive bacilli, 13 gram negative cocci, and 23 gram negative bacilli. Of the 164 gram positive cocci, 82 were methicillin-resistant. The PAM yielded a total of 21 yeast and 108 mold isolates. These microbes have been implicated in a wide range of oral and systemic diseases, including diseases of the heart, GI tract, bones, and lungs (pneumonias and exercise induced asthma). CONCLUSIONS: The results of this study confirm that PAM are contaminated with a variety of bacteria, yeasts, and molds which may act as a source for both oral and systemic infectious diseases. While the authors of this study firmly advocate the required use of such devices, PAM should be sanitized daily to reduce the number of microorganisms and replaced at least every 2 weeks or when damaged.
Published Version
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