“Excuse me,” Julian Blackmon interrupts, incredulous at what he’d just heard.
“Poop … in your mouth?”
Nyheim Hines hears the list, in all its gruesome glory, and the Colts’ fourth-year running back responds like this: “I hope I forget all of the information you just told me.”
Parris Campbell says nothing at first. The man is silent. He’s thinking.
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“OK, I have to admit this,” the wide receiver finally musters, “but one game, I remember taking my mouthguard out and seeing blood on it. Then I realized I wasn’t bleeding anywhere.
“So I’m like, ‘This blood has to be mine, right?’ At least it better be mine … ”
Spill the sickening details to another Colts’ wideout, Zach Pascal, and his eyebrows nearly jump off his forehead. Pascal’s skeptical at first, same as the rest. He knew the mouthguard he slips in before every play — practice and games — gets dirty. He was fine with that. He just never imagined it would get this dirty.
Bacteria, blood, sputum, saliva, tobacco spit, even animal feces …
“Animal feces?” Pascal asks. “Is that … ?”
Yes, he’s told. It’s what you think it is.
Eventually, he just shrugs. Cost of doing business, he figures.
“In the heat of the game, man, I might grab it and give it a look and be like, ‘What the fuck is on this?'” Pascal says. “But then it’s time to play and I’ll just put it back in my mouth.”
He’s not alone. These are NFL players. There are more important matters to attend to. Which is partly why an essential football instrument — the mouthpiece — is so often overlooked, even ignored. They are crucial safeguards against concussions, let alone opposing helmets that can (and will) jar a tooth loose from time to time.
Just ask the Bucs’ Vita Vea.
Vita Vea LOST A TOOTH 🦷 pic.twitter.com/Dfc1AxPTSJ
— Warren Sharp (@SharpFootball) November 28, 2021
But the thing about mouthguards: They’re gross. Really, really gross.
Scientific studies paint the filthy picture. Mouthguards can be exposed, typically through handling and contact with the playing surface, to anything that finds its way onto a football field. It’s an ugly assemblage: dirt, blood, mucus, chemicals, tobacco discharges and, yes, in outdoor stadiums, even animal excrements.
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“That’s mind-blowing, man,” Campbell says. “Like, how?”
“My first thought, ‘None of that is getting on my mouthpiece,'” Pascal adds. “That stuff would freak me out.”
One examination, headed by Richard Glass, a professor of forensic sciences, pathology and dental medicine at Oklahoma State University, tracked the mouthguards of 62 Division I football players over the course of an entire season. The findings were not pretty: Glass discovered a collection of bacteria, yeasts and fungi in the mouthguards, all of which can lead to different diseases and infections, including meningitis, urinary tract infections, peritonitis, periodontal disease, wound infections and exercise-induced asthma.
“Frankly, that doesn’t surprise me at all,” says Dr. Paul Mikhli, a dentist in Beachwood, Ohio, who counts several professional football and baseball players as patients. “A lot of it depends on what you do with your mouthguard. It’s kind of like sticking your pen in your mouth. You wouldn’t do that if you knew all the crap that gets on your pen, would you?”
“No pun intended,” Mikhli adds with a laugh.
The good news, he notes, is that the mouth happens to be among the most resilient places in the body. It’s accustomed to playing defense.
“It collects the most bacteria,” Mikhli says, “and it also heals quicker than anywhere else.”
But that doesn’t mean it’s impenetrable.
“Think about it for a minute: How many times do you touch your face, rub your nose, or pick something out of your teeth?” Mikhli says. “Stuff gets all around in there. It just does. Especially when you’re not thinking about it, and during a game, it’s the last thing on the players’ minds. If that stuff is getting on your mouthguard consistently … you just never know how you got this cold or that virus.”
One obvious way to combat all of that: Clean them. Routinely. Mikhli suggests chlorhexidine, a mouthwash-type solution. The Colts provide the players with a rinse, though that doesn’t necessarily mean they use it (or even know about it). Asked about this, Hines seemed to shrug. “I know we get our helmets cleaned,” he said, “so I hope they clean the mouthguards, too.”
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In fact, listed in the league’s new COVID-19 protocols for the 2021 season, “mouthguards must be sanitized post-practice or game with either UV light treatment or acceptable solution.”
Like a lot of players, Hines has his mouthguard strapped to his face mask, reducing the chance of it coming in contact with the field during a game. A self-described germaphobe, he changes his frequently — “every two weeks,” he vows — and has since his college days at North Carolina State. He started swapping them out after noticing grass in his mouthpiece after every game.
Nyheim Hines tries to keep his mouthpiece fresh throughout the season. (Trevor Ruszkowski / USA Today)He says he goes through as many as 10 in a season. Campbell slides in a new one every week. Blackmon doesn’t wear one during practices and insists on using a new one for every game. “They’re gross, I know that,” acknowledges the second-year safety, who’s on injured reserve. “But I’m playing with a mouthpiece no matter what. I’m here to play football. If I get sick, I just hope I’m all right.”
Rookie defensive end Kwity Paye, who wore a mouthpiece throughout his time in college, says he was fitted for one before training camp started but never actually got one from the training staff.
“So I just don’t wear one anymore,” he says. “I’ve been good without it.”
Tight end Mo Alie-Cox, who sports the most blinged-out mouthguard of any Colt, has a rule: If his hits the ground, he won’t put it back in his mouth.
“I try to be cognizant of where mine is at all times,” he says. “Those things can get disgusting.”
For those who don’t replace them frequently, Mikhli likens it to “not changing your underwear for a month.”
Soaking the mouthguards in a solution between uses can reduce the “microbial load,” Glass noted in his study, as well as the chances of “oral and systemic diseases.” His recommendation: daily sanitization, and swapping them out every two weeks or when they become “sharp and/or jagged.”
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What Mikhli doesn’t want to happen is for players to hear how dirty they get, then leave them in their locker. The positives that come with wearing one far outweigh the associated risks, especially if they’re cleaned regularly. A third of all oral injuries are sports-related, he said, and mouthguards remain the best defense.
“They are so important,” Mikhli says. “They act as a cushion to prevent concussions. They stop your bottom jaw from knocking into your top teeth.”
The NFL announced this fall a partnership with four universities — Alabama, North Carolina, Washington and Wisconsin — to further study ways in which mouthguards can reduce head injuries in the sport. The league will collect kinematic data from players at all four schools, tracking new high-tech mouthguard sensors for impact speed, direction, force, location and severity. The data, the league says, will help it better predict injury, inform potential rule changes and improve player safety.
Furthermore, Mikhli notes, some studies have shown that athletes can actually produce more force when their mouthguard is in. “When you clench down, you activate your jaw muscles, which can produce more energy,” he says, adding that a few of his patients who happen to be MLB pitchers have asked him whether wearing one on the mound could actually help them throw faster. He sometimes wears his at the gym when he’s lifting weights.
Hines says that when he’s fielding a punt, or about to crash into an opposing linebacker, he notices that he clenches down on his mouthguard even harder.
“Every time I’m at top speed, I guarantee you I’m biting down as hard as I can,” he says. “It’s kind of like war. For three hours every Sunday, we’re willing to put our life on the line to play football. We’re OK with the risks.
“I could just go without the animal feces. That’s disgusting, man.”
(Top photo of Mo Alie-Cox: Mark Konezny / USA Today)
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