Biting research

We've all seen the movie scenes when someone -- a woman giving birth, a wounded soldier getting battlefield surgery -- is given something to bite on to help endure the pain.

Turns out there may be scientific proof that it works and the hub of research is taking place at The Citadel.

Dr. Dena Garner, an assistant professor in The Citadel's Department of Health, Exercise and Sport Science, has conducted studies on how mouthpieces reduce levels of the stress hormone cortisol, open airways and improve lactate threshold levels, thereby delaying the onset of physical fatigue.

Early studies indicate that mouthpieces do just that and, of course, justify the need for more study, including why mouthpieces have this effect. The latest study, published in the July/August 2009 edition of "Compendium of Continuing Education in Dentistry," suggests that future studies should focus on "jaw morphology and airway dynamics."

"It's really exciting whatever we find out because nobody else is doing this type of research. We've just scratched the surface of it," says Garner, who will start collaborating with Dr. Timothy Scheet of the College of Charleston's exercise science department on future studies.

If proven, then mouthpieces not only will have a role on the playing field but potentially on the battlefield as a natural performance enhancer.

Some in the dental and exercise science communities speculate the mouthpieces act by preventing teeth-clench, aligning the jaw and opening airways, thereby allowing more oxygen for working muscles. And a more relaxed jaw decreases stress.

"There is research to support improved breathing mechanics and reduced jaw fatigue," said Fabio Comana, an exercise physiologist with the American Council on Exercise, told The New York Times in a Dec. 16 article. "Depending on how you look at it, there is some truth to the claims."

Unlike regular mouth guards, which are available off the shelf and at modest prices, performance mouthpieces cost hundreds or even thousands of dollars and must be custom-fitted by a dentist. Ordinary mouth guards are usually dropped in boiling water and fitted to the wearer's teeth to protect against injury. With performance mouth guards, the idea is to reposition the jaw, anywhere from a few millimeters to a quarter of an inch sideways.

But even as the scientific jury remains out, one major sports apparel and equipment company, Under Armour, is running with it, and nearly a thousand professional and elite athletes are putting it to use in competitions.

Under Armour is marketing its "Performance Mouthwear" as "delivering a host of physical benefits that help athletes train harder and compete at a higher level than ever before. With safe, custom-built UA Performance Mouthwear, athletes in any sport -- from football to golf to hockey -- can capitalize on innovation that makes them stronger, faster and better."

Athletes, including superstars Derek Jeter of the New York Yankees and Adrian Peterson of the Minnesota Vikings, are wearing the mouthpieces, yet aren't making a big deal about it.

Unlike the protective mouth guards, such as the ubiquitous "boil-and-bite" guards, Under Armour's mouthwear is for the lower set of teeth. Currently, the company is offering only mouthpieces that are custom-fitted by a dentist and cost $495. In January 2011, Under Armour plans to offer a lower cost boil-and-bite version, ranging between $50 and $100.

The only local dentist currently listed on the Under Armour site for fitting the guards is Mount Pleasant's Dr. Timothy Assey, an avid golfer who noticed that many players on the Professional Golfers Association were wearing lower mouthpieces.

So when his dental supply salesperson from Patterson Dental, the exclusive distributor of the mouthwear, mentioned it, Assey was interested.

"I'm very early in the process," says Assey, noting that he has been offering the product for about three months and has conducted two fittings.

The company that started it all is Bite Tech, based out of Minneapolis, which signed a five-year exclusive deal with Under Armour last year after courting its chief rival, Nike.

"We're delighted to have an agreement with the hottest brand in sports," says Lawrence Calcano, chief executive officer of Bite Tech. "Under Armour is about performance. Everything they make is designed to increase an athlete's performance."

Calcano knows, however, the bigger picture extends from professional athletes to weekend warriors and people who work in stressful environments, including police officers, firefighters and soldiers. He also thinks the mouthwear may have uses for improving sleep by relieving snoring and sleep apnea.

Another benefit of Under Armour's support, Garner noted, is that researchers don't have to scramble for research dollars as much. UA has dedicated $200,000 toward future studies of the product.

"Before, we didn't have a budget and we did studies on a shoestring," says Garner. "Now, with Under Armour's name behind it, people are getting interested in it and we have more money to do the research and try to figure out how it works."

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