Q: Who are the inventors of Toothche'?
A: Caring for pediatric patients over the past forty years makes the inventors of Toothche' more than just a couple of dentists with a great idea to help guard patients from accidental biting. A father and son team of dentists, David L. Morgan D.D.S., and his son D. Scott Morgan D.D.S., are professionals who saw a biting problem within their own practice and developed a solution to address the problem.
David L. Morgan, D.D.S. is a graduate of the Indiana University School of Dentistry and completed his Pediatric Dental Residency at James W. Riley Hospital for Children. He is a member of the American Dental Association, the American Academy of Pediatric Dentistry, the Indiana Dental Association, the Indianapolis District Dental Society and the Indiana Society of Pediatric Dentists. Dr. Morgan has staff privileges at St. Vincent's Hospital as well as at Peyton Manning Children's Hospital at St. Vincent's.
D. Scott Morgan, D.D.S. is also a graduate of the Indiana University School of Dentistry and completed his Pediatric Dental Residency at James W. Riley Hospital for Children. Additionally, he completed a General Dental Practice Residency (GPR) at Indiana University (Wishard Memorial Hospital). Dr. Morgan is a member of the American Dental Association, the American Academy of Pediatric Dentistry, the Indiana Dental Association, the Indianapolis District Dental Society and the Indiana Society of Pediatric Dentists. He is board eligible for the American Board of Pediatric Dentistry. Dr. Morgan has staff privileges at St. Vincent's Hospital as well as at Peyton Manning Children's Hospital at St. Vincent's.
Q: What about Patient Education? Do you have handouts available?
A: Yes. There are Patient Handouts (PDF's) that can be found here and also inside the Instruction Link.
Q: How are patients reacting to Toothche'?
A: Extremely well...patients and parents appear to like the mouth guard and appreciate the fact that we've given them a little extra TLC.
Q: What is the best method for heating the mouth guard?
A: The best results can be obtained by immersing the mouth guard for about 15 seconds in water heated from a Coffeemaker. Coffeemakers are, more or less, standardized and are designed to heat water at a consistent temperature, thus they deliver the best results without causing the mouth guard to become deformed or making the material so hot that it would cause burning of the oral mucosa. Water heated in a Microwave Oven or through a Hot Water Tap can be done, but is NOT RECOMMENDED, because they can deliver inconsistent results (due to the variations that are inherent to these heating methods), that require adjustments in the amount of time that the mouth guard remains immersed. If the water is too hot the mouth guard can become deformed, if left in the hot water too long. It is important to avoid deformation of the mouth guard. So, DO NOT OVERHEAT the material.
Q: How hot do I have to get the mouth guard?
A: The Toothche' mouth guard will become moldable at about 150 degree F. Due to the fact that the temperature of the water it is inserted into will vary (even when from the same hot water tap), the easiest way to determine that it has reached this temperature is to observe the vertical side walls / flanges of the mouth guard for changes in their shape. When the mouth guard material reaches the desired level of temperature for optimal molding, the outer edges will start to shift and curve towards the lingual aspect of the mouth guard. Once this shifting begins, the mouth guard is hot enough for proper molding to the mouth and should be removed from the water, even if the time in the water is less than 10 seconds. However, this usually requires at least 10 seconds to occur. If this does not occur within 30 seconds, then the water is probably not hot enough to make the mouth guard hot enough for proper molding.
Q: Do I need to shape it around the buccal of their teeth?
A: This is not absolutely necessary but is helpful to maintain the best fit and the best possible protection.
Q: What do I do when the child does not want to wear the mouth guard?
A:There are always children who will refuse to do anything that is asked of them, even when given a good explanation. However, these children aside, we have found that the vast majority of children who initially refuse to wear the Toothche' mouth guard respond very well to a Tell-Show-Do (TSD). We simply explain the purpose of the mouth guard while holding it out in front of them (after it is molded to their teeth) and say something along the lines of:
"This is a mouth guard that has been molded to fit around your teeth on this side (pointing to the side that is getting numb), where your teeth are going to be sleepy so that we can work on them. Your lip and cheek (and tongue) are going to get sleepy too. We do not want you to bite your lip or your cheek (or your tongue) after they are asleep from the sleepy juice. So, we are going to use this mouth guard to protect them from getting hurt by your teeth because you can bite yourself after the sleepy juice has started working. This (mouth guard) is not for you to 'CHEW' on. You need to 'HOLD' it in place, in it's 'comfortable position,' by keeping your teeth together and biting down on it gently. It would be best if you did not talk while it is in place. If you do need to talk to us when it is in your mouth, then you will need to talk by keeping your teeth together and 'TALKING LIKE THIS' (demonstrating that talking with the teeth together can be done and what it looks like to the child)."
Most children respond very nicely to a little TSD and actually find that it is a fun new challenge to talk with their teeth together.
Q: What are the legal implications of using such a device?
A:There is always some risk of potential liability for the use of any product when providing dental care and Toothche' is no different than any other product in this respect. Nonetheless, when used properly and as intended, the Toothche' mouth guard assists the dental practitioner in the treatment of their patients in much the same fashion as the athletic mouth guard, the rubber dam, or, more pertinently, a piece of gauze or cotton roll inserted between the teeth to prevent biting after dental treatment. Some practitioners have, however, expressed the concern that the patient may swallow the Toothche' mouth guard. Although ingestion or aspiration of the mouth guard always remains possible, we believe that the risk of this occurrence is comparable to the risk involved in having a patient swallow an athletic mouth guard during a sporting event. Also, if used when fitted with a tether to a patient's clothing, the likelihood of ingesting or aspirating the Toothche' mouth guard further decreases and such usage presents significantly less risk than use of an untethered cotton roll or piece of gauze. Given the size and shape of the Toothche' mouth guard and the fact that it can be tethered to a patient's clothing, we believe that the risk of ingestion or aspiration is most similar to that of a tethered athletic mouth guard or a tethered pacifier.
Additionally, in the event Post-Anesthetic Oral Soft Tissue Protective Devices become a "Standard of Care" following dental treatment, a further legal consideration is any potential negligence and/or liability which may arise for breach of care when the Toothche' mouth guard is not used and a patient sustains a bite injury after dental treatment or application of local anesthetic.
Q: Does using this device fall within the standard of care for pediatric dentistry?
A:This is a simple, but complicated question. We believe that the Toothche' mouth guard falls within the group of dental devices that have gained the status of being considered the "Standard of Care." In the establishment of a "Standard of Care" the practitioner would be considered negligent if a significant number of "responsible doctors" consider the practice prudent for good patient care and the practitioner decided not to follow this generally accepted practice. Thus, a significant number of dentists need to consider the Toothche' mouth guard as an important part of prudent patient care for it to be established as a "Standard of Care." While the Toothche' mouth guard is currently too new a device to have met this qualification, we believe that this may happen in the future.
Q: What ages are more apt to benefit and wear the guard?
A: Patients of all ages, children through adults, have benefited from the use of Toothche'. However, we have found that children aged 2 years to 12 years have benefited the most, given the fact that they are more likely to bite themselves based on statistical evidence.* On average, children less than 12 years of age are about twice as likely to bite themselves after dental treatment than persons 12 years of age or greater
Q:Is the Toothche' mouth guard safe for patient's who are allergic to Latex?
A: Yes, it is safe for latex allergic patients. The mouth guard is made of a non-Latex material.
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