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Lam Tran

Carly Meriwether
A. General Data
1. Description of Site
Texas Karate Academy is a dojo located in Beaumont, Texas.
The dojo is a 5,000 square feet state of the art facility with 3
separate training rooms for different classes. Their programs
are designed to educate the students of the dojo in the art of
Karate, Kickboxing, Muay Thai, Wrestling, and Brazilian JiuJitsu. The academy was established in 1998, and they now
have over 30 years of experience with 5 certified professional
instructors. They are a private facility for members of all ages
who wish to enjoy professional training. The academy offers
programs to their students and members at various levels of
expertise ranging from new to elite competitor. Members pay
monthly fees to have access to the dojo and participate in
training sessions. The academy is located at 7310 Hwy 105
Beaumont, Texas 77713(1,2).
2. Description of Client Population and Target Group
There are many students and members receiving training at
the Texas Karate Academy. The dojo caters to children from
ages 4-7 and 8-12 with their respective programs, the
instructors not only train their student members physically,
but mentally as well with their school work. The dojo also
trains members who want to be in shape, lead an active
lifestyle, or training to competitively fight. The academy staffs
have five certified professional instructors, including the Chief
Instructor and owner of the Texas Karate Academy who has
over 18 years himself of experience in Martial Arts. The
remaining staffs include the Senior instructor, a Master
instructor, and two Junior instructors. The Chief Instructor is a
4th degree Black Belt and oversees the dojo and teaches
advance classes for competitive members as well as kids. The
Senior instructor is a 3rd degree Black Belt, and helps the Chief
with the training programs. The Master instructor has a 4th

degree Black Belt BJJ and specializes in Brazilian Jiu-Jitsu and

Judo martial art style. The two Junior instructors each have
their respective Black Belt and teach the childrens martial
arts after-school programs. The academy also has two
receptionists that make appointments and general office
3. Description of Services Provided
The Chief instructor who runs the academy designs his
training regiments and implements the programs. The
instructors coordinate the activities and programs for their
members at the Texas Karate Academy. The members of the
academy sign up for the various styles and training programs
depending on their skill level and knowledge. The academy
has a busy day to day schedule with classes and programs
and is looking towards expanding to a possible second
4. Other Pertinent Data
The water fluoridation level at this location is 0.80 PPM(3).

B. Information Related to Dental Health

There are no dental health services provided at Texas Karate
Academy. Although Texas Karate Academy requires their members to
wear mouthguards while sparring, it is not mandatory to have
mouthguards during normal practice. The academy offers members
various mouthguards for purchase. Their onsite store carry generic
universal mouthguards and the boil-and-bite guard that can form fit an
individuals teeth. There are no previous dental programs at this
facility; therefore, the staffs are unaware and have minimal knowledge
of dental health.
C. Dental Health Status
According to a prevalence study by the Centers for Disease
Control, 73.3% of 3rd Grade students in the state of Texas has
cavities, 42.7% of 3rd Grade students with untreated tooth decay,
and 34.4% of 3rd Grade students has dental sealants on at least

one permanent molar tooth in 2007 to 2008(4,5). Almost all children

nationwide will experience gingivitis affecting generally equal
between the sexes, but they are at a low risk for severe periodontal
disease(6). A prevalence survey from the National Health and
Nutrition Examination Survey report 35% of adults have well-aligned
bite, while 20% of the population have deviations from the ideal
bite(7). The American Cancer Society estimated about 39,500
individual will be diagnosed with oral cancer and 7,500 of these
individual will die of these cancers for 2015. The chance of children
with cancer are rare but can occur, the average age of the
population diagnosed is 62(8). In 2008, 59.8% of Texans visited the
dentist and 60.2% of Texans had their teeth cleaned by a dental


Goal The goal of this project is to provide a mouthguard program for the
children tournament team at the Texas Karate Academy.
1. Increase the dental health knowledge of the tournament team by 15%.
2. Increase the utilization of oral protective equipment by 100%.
3. Increase the dental health knowledge of the tournament team's
parents by 20%.
4. Provide oral protective equipment for tournament team participants.
5. Provide a flyer to use regarding oral protective equipment.

There are many factors that can affect the oral health of adolescents,
contact sports is one of them. Mouthguards play a very important role in
primary prevention when it comes to dental health for these adolescents
partaking in contact sports. Wearing a mouthguard can prevent chipped or
broken teeth, fractured crowns or bridgework, lip and cheek injuries, root
damage to the teeth, fractured jaws, and concussions. Athletes are 60 times
more likely to suffer harm to the teeth if theyre not wearing a
mouthguard(10).The American Dental Association projects that one third of
dental injuries are sports related(11). Wearing a protected mouthguard

device while participating in sports can prevent more than 200,000 dental
injuries a year(11,12).
Even with all the dental injuries and risks that are involved, a high
percentage of children do not use mouthguards while playing organized
sports because it is not mandatory(13). Children also complain the use of
mouthguards being uncomfortable and often will not fit properly. An
effective mouthguard should be comfortable and offers good protection to
the wearer, and be able resist wear and tear while not affecting normal
breathing and speech(14). There are three types of mouthguards available to
athletes(10). Stock mouthguards are comfortable and are relatively
inexpensive, however they cannot be molded to fit like the more costly boiland-bite version which forms around the user's mouth. The most expensive
mouthguard can be made by a dentist to fit a user's mouth personally and
offers the best fit and projection. If custom-fit mouthguards is a cost issue,
using stock mouthguards are better than not wearing any.
We chose this project because we know the importance of educating
the younger population about oral health and the importance of wearing a
mouthguard. Mouthguards can be one of the least expensive pieces of
protective equipment available, yet the least used. By making the program's
participants their own custom-fit mouthguards, we hope to decrease their
chances of dental injuries and less dental concerns later in life . We know
that by educating our target group at an early age, we can instill good habits
and increase the awareness of the importance of oral protection.

The program plan is aimed at educating the members of Texas Karate
Academy about the importance of utilizing mouthguards. The program will
also provide custom fit mouthguards to the children of the academy. The
program will consist of multiple education sessions involving brushing, dental
health knowledge, importance of using mouthguards, how to attain good
habit, mouthguard activities, and how to care for the mouthguards. Each
session will take place on a weekly basis over the course of a month at Texas
Karate Academy. These sessions will be developed as planned:
1. Session 1 (Members and Staff)
a. The importance of mouthguards. (time needed 30 minutes)

General introduction about the purpose of the program and

give relevant information as to why it relates to the oral
health of the members of the academy.
Introduce the program and the objective.
Provide facts and data about oral injuries in contact
Discuss the importance of a mouthguard program
for members and staff.
Provide pamphlet to members and staff.
Explain the programs goal.
Inquire about participation from members.
Provide consent forms to parents for underage
2. Session 2 (Members)
a. Taking impressions and pouring. (time needed 1 hour)
The dental impressions will be taken on participating
members under the supervision of a DDS. The DDS will assist
in making the mouth guards at an office.
Introduce the members to the participating DDS.
Provide toothbrushes, toothpaste, and mouthwash to
Explain and instruct proper brushing technique to
members in order to remove excess debris for accurate
Explain procedures that will take place.
Answer any possible questions.
Take the impressions on members with assistants.
Instruct members to use mouthwash post
Mouth guard will be finished at a location of the
DDSs discretion.
3. Session 3 (Members and Staff)
a. Caring for mouth guard. (time needed 30 minutes)
Members will receive their respective mouth guards. Members
and the staff will learn how to take proper care of

Deliver the mouth guards to members.

Discuss the importance of cleaning mouthguards.
Explain the proper ways to care for mouthguards.
Provide illustrated instruction to members and staff.
Inquire staff to display the flyer for future members.
Provide a questionnaire to members and staff of the
academy to request feedback.
Constraints and Alternative Strategies
1. Constraint: There may be a lack of interest during the program.
Alternative: Keep presentation clear, use illustrations to make more
interesting, ask questions to be involved.
2. Constraint: There may be lack of participation from members.
Alternative: Inquire the academy to display fliers about the
importance of using mouthguard while sparring.
3. Constraint: The parents of the underage children may not give
Alternative: Discuss with the parents in person about the
importance of wearing mouthguards during contact sports.
4. Constraint: The participants and parents may not remember about
the program.
Alternative: Provide reminders and flyers.
1. Personnel: Program planners, DDS (for second session only),
assistants (for second session only)
2. Supplies:
Alginate (for 10)
Disposable trays (10 size small)
Stone (for 10)
Stone Grinder
Suction Machine
Mouthguard material sheets (10)
Plastic bags labeled with name (10)
Paper towels (to transport impressions)
Toothbrush (70)
Toothpaste (70)
Mouthrinse (70)

3. Evaluation materials:
Questionnaires (Program Evaluation)
4. Supplements:
A pamphlet will be provided by program planner.
Program plan written outline Provided by program planner.

The estimated cost for the dental health program is as listed:
1. Alginate
2. Disposable trays
3. Stone
4. Grinder
5. Suction Machine
6. Mouthguard sheets
7. Plastic bags
8. Power towels
9. Toothbrush
10. Toothpaste
11. Mouthrinse
12. Gloves
13. Pamphlet

Donated by DDS
Donated by
Donated by DDS
Donated by LIT
Donated by
Donated by
Donated by
Donated by
Donated by


All resources will be obtained prior to each session. There will be 4
sessions spanning a 4 week period.
Session 1

Wednesday - March 25, 2015

Session 2

Wednesday - April 1, 2015

Session 3

Wednesday April 8, 2015


A. Process Evaluation
1. A weekly review of information which was presented previously
will be conducted to ensure objectives are met.
2. A weekly inspection will be conducted to assess the degree of
utilization of mouthguards.
3. A weekly questionnaire session will be conducted to ensure
optimal retention of information.
4. Evaluate the number of mouthguards needed to be made using
an informed consent.
5. The success and individual comprehension of each presentation
will be assessed through a question and answer sessions during
every visit and upon the completion of the program.
B. Product Evaluation
1. A pretest and post-test will be administered to the participants to
compare their level of knowledge in the importance of
mouthguard as it relates to primary prevention in dental health.
2. The success of the program will be evaluated by a questionnaire
from the participants and staffs upon the conclusion of the

(1) Texas Karate Academy, (2015) Retrieved from, www.Tkausa.com
(2) M. Berryhill, (personal interview, March 2, 2015)
(3) Centers for Disease Control and Prevention, (2013) Jefferson County,
Retrieved from,http://apps.nccd.cdc.gov/mwf/PWSDetailV.asp?
(4) Centers for Disease Control and Prevention, (2011) Oral Health
Resources, Caries Experience, Retrieved from
(5) Centers for Disease Control and Prevention, (2011) Oral Health
Resources, Dental Sealants, Retrieved from

(6) Clinical Key (2012) Gingivitis, Retrieved From

(7) Proffit W. R. & Fields H. W. & Moray L. J. (1998) US National Library of
Medicine Issue, Prevalence of malocclusion and orthodontic treatment need
in the United States: estimates from the NHANES III survey. 13 (Vo 2. Pg 97106) Retrieved From http://www.ncbi.nlm.nih.gov/pubmed/9743642
(8) American Cancer Society (2014) Oral Cavity and Oropharyngeal Cancer,
What are the key statistics about oral cavity and oropharyngeal cancers?
Retrieved From
(9) Vy H. Nguyen, DDS, MPH (June 16, 2009). State Oral Health Profile .
[ONLINE] Available at: http://apps.nccd.cdc.gov/nohss/ByState.asp?
(10) Mouthguards. [ONLINE] Available at: http://www.ada.org/en/HomeMouthHealthy/az-topics/m/mouthguards.
(11) Dr. Abbey Lamanna (August 27, 2013). Alarming Statistics About
Mouthguard Usage. [ONLINE] Available at: http://blog.lakeshorefamilydentistry.com/alarming-statistics-about-mouthguard-usage/.
(12) (2009). Important Reasons for Mouth Guards. [ONLINE] Available at:
(13) (April 2, 2012). Play it Safe: Prevent Childhood Injuries on the Field with
Simple Sports Safety Precautions. [ONLINE] Available at:
(14) (July 23, 2011). Study Finds Too Few Kids Wearing Mouthguards.
[ONLINE] Available at:
(15) Family Gentle Dental Care, (February 6, 2008) Mouthguards. [ONLINE]
Available at:


Introductory statement:
This lesson plan is intended for the Texas Karate Academy children
tournament team ages 5-18. The program will provide mouthguards for the
children and increase their dental health knowledge. This lesson should take
three 30 minute sessions.

1. Cognitive
a. The children will be able to describe a mouthguard and explain the
importance of a mouth guards. (Blooms Taxonomy - comprehensive)
b. The children will be able to indicate the correct procedures to store
an avulsed tooth. (Booms

Taxonomy - comprehensive)

2. Psychomotor
a. The children will be able to demonstrate the proper way to care for
their mouthguards.

(Blooms Taxonomy - knowledge & application)

3. Affective
a. The children will decide to wear their mouthguard when engaging in
activities at the dojo.

(Blooms Taxonomy-application)

Content outline:
a. Explain to the children what oral protective equipment is.

b. Describe and provide facts about oral injuries in contact sport that
can be sustain from not wearing mouthguards.
c. Discuss the importance and purposes of using a mouthguard and
discuss how it relates to their dental health.
d. Provide the children their personalized mouthguard.
e. Demonstrate the proper way to wear a mouthguard.
f. Discuss the proper procedures to take in case a tooth is knocked
g. Demonstrate the proper technique to care for mouthguards.

Lesson Plan 1 - Importance of mouthguards.

Initiatory Activities:
We will introduce ourselves as Dental Hygiene students at LIT and why
we are there and our intentions. We will explain the project's goal and
objectives to the academy members and the children's parents. A general
introduction of the topic will be discussed and reasons as to why the topic
relates to the oral health of the members of the academy. Carly will briefly
explain about her daughter participating in softball and the importance of
her using all protective gears, especially for the mouth. The story will gives
us common ground and acts as an ice breaker to allow us to discuss the
importance of the tournament team wearing mouth guards. We will explain
to the members that we will fabricate personalized mouthguards for the
children of the tournament team as part of the program's objectives.
Informed consent will be sent out to children who are not of age. We will
provide facts and pictures of what can happen when an individual get hit in
the mouth while not wearing a mouth guard. We will ask the children how
many of them already wear mouth guards to calculate if using mouthguard is
already mandatory. We would start by showing different kind of mouthguards
that are available(store bought, boil and bite, and a personalized
mouthguard from a dentist). We would compare the different types so that

they were aware of the difference. We will explain to the children that a
mouth guard is a flexible appliance made out of plastic that is worn to
protect the teeth from sport related injuries. We will discuss the importance
of wearing a mouthguards. Mouthguards can protect your teeth from sport
related trauma such as lacerations to the lip, cheek and chin, fractures of
facial bones, permanent injury to the jaw joint, broken teeth, teeth being
knocked out, and neck injuries from the lower jaw getting jammed into upper
jaw. Mouthguard also prevents laceration and bruising of the lips and cheeks,
especially when you have braces. This is all very important because you only
have two sets of teeth; a set of baby teeth and a set of adult teeth. A lost
tooth has to be replaced and it can be very expensive; the best prevention is
to wear mouth guards. If you do happen to have a tooth get knocked out
during sport activities, it is very important store the tooth in milk. Milk is the
best way to store and preserve an avulsed tooth. An avulsed tooth can be
replanted within a time frame of 15 minutes. The healing time will vary
according to the factors that affect the tooth. Less than 15 minutes provides
greatest chance of survival. We will provide pictures of sport related injuries
to persuade the children to realize how injuries like these can happen. We
will also relate to the children about growing up with missing teeth, and help
them realize that wearing a mouthguard will prevent such events to occur.
We will give the children and their parents a pre-test to give us the
knowledge of what learning level they are on. The test's grade will provide an
idea of the amount of information, details, and time we will need for this

Lesson Plan 2 - Taking and pouring impressions.

Developmental Activities:
Part 1

We will make custom fitted mouth guards for all the participants on the
team thanks to Dr. Williams and three fellow classmates for donating their
time and materials. First we will review and cover the information that has
presented the previous week:

Program's goal and objectives

What are mouthguards
Oral injuries during contact sports
Importance of utilizing a mouthguard
Reasons to protect and keep all tooth when growing up
We will collect the signed informed consent from participating children

to determine the number of mouthguards we need to make. We will take

impressions for mouth guards after the lesson so they can be ready since
they take about an hour. The first step in fabricating a mouthguard is taking
impression of the individuals teeth with a dental material called alginate.
The children will brush and rinse to remove any plaque and residues with the
toothbrushes that we will provide. We will each take turn mixing the
impression paste and forming the children's teeth impressions. Each of the
children's impressions are wrapped in a wet paper towel then stored in a
plastic bag (to avoid shrinking) with their respected name. Once each childs
impressions are formed, they will be instructed to brush and remove any
remaining materials from their mouth. We will also provide alcohol-free
fluoride rinse to the children to swish post-impression. The impressions will
then be poured with dental stones (calcium hydrate, a variation of plaster of
paris) at Dr. Williams office immediately after the final impression is taken.
We will have the help of three assistants to speed up the pouring process.
After the stone model hardened, the name of each child will be written on
their stone model with a permanent marker for accuracy. The stone model
will then be stored and transferred to Lamar Institute of Technology to be
trim and grind to ensure each mouthguards will be formed correctly.
Part 2

Once the stone model has hardened, we will use a stone grinder at
Lamar Institute of Technology to sand each model to a smooth finish to
remove the base and any defects that would otherwise obstruct the
mouthguard material to form. We will use a special suction machine to mold
and form a gel-plastic material to make the final mouthguard. The machines
have a heating element that will melt the mouthguard sheets then use a
vacuum suction to form over the stone model.
After the stone model is prepped and smoothened and all the supplies
are gathered, we will begin the final step in forming the mouthguards. We
will begin by placing the material for the mouth guard under the heating
element at the top of the machine. The heating element will slowly heat the
material until it melt and gets pliable. The material is then lowered onto the
cast and a vacuum draws out the air and molds the material to the cast. The
material is the pried of the cast, trimmed and polished. We will place each of
the children's mouthguard into a bag with miscellaneous items like
toothbrushes, floss, toothpastes ect. Once the mouth guards are finished
and delivered, we will show the children the proper way to wear them to
ensure the mouth guards are beneficial.

Lesson Plan 3 - Caring for mouthguard.

Culminating Activities:
We will hand each children their mouthguards at the academy. We will
review why it is important to utilize oral protective equipment when
engaging in contact sports and activities and introduce new topics to the

Program's goal and objectives

What are mouthguards
Importance of utilizing a mouthguard
What injuries we can get if we dont wear them

How to care for mouthguards

How mouthguards should properly fit in the mouth
We will relate to the children that it will be beneficial to keep good care

of their teeth so they can smile when they take their graduation portrait.
After the review of information, we will discuss proper home care for their
mouthguards. The children's tournament team will be shown how to properly
care for a mouth guard and we will have them demonstrate after our lesson.
We will observe as they practice cleaning their mouthguard on a table to
ensure that they understand.
We will have a premade made cast model that has had a mouth guard
previously fitted to it to demonstrate how the mouth guard should fit. We
will have the children try their new mouthguards to make sure they are
correctly fit and worn.
The children will learn how to wear and take proper care of their
mouthguards with these tips:

Moisten the mouthguard with cold water before and after use.
Never use hot water on your mouthguard as it will miss shape it.
Dont chew on your mouthguard as it will miss shape it.
Wear your mouth guard at all times during sports.
Clean your mouth guard by washing it with soap and warm water.
Mouthguard can be also be cleaned with nonabrasive toothpaste and

soft toothbrush.
Dont bend mouth guard when storing it.
Dont wear or handle anyone elses ever.
Avoid storing in high temperatures such as a hot car or placing it in

direct sunlight.
Do not microwave.
Store your mouth guard in a hard plastic case to protect its shape and

Soak your mouth guard in an antimicrobial mouthwash to keep it fresh
when not in use.

It is time to see your dentist if your mouthguard develops tears, holes,

or becomes loose. This condition could cause mouth sores to develop

and apply uneven pressure to teeth and jaw joints.

Be sure to bring your mouthguard with you to each dental visit to have

its fit checked, especially before each playing season.

Mouthguards should be replaced every year to ensure the best fit and

Your mouthguard should also be replaced once a year depending on
the childs growth.
The children will choose to wear the mouth guards during all their

extracurricular activities now that their awareness has been raised. Because
the children are armed with the correct information early enough to start
them on good habits, they are better about keeping their teeth safe and will
be less likely to have dental concerns later in life.
We will answer any question should they come up. We will give the
children and their parents the post-test to measure any positive increase in
the information we have presented to them. Combining the post-test's
results with information from our own direct observation will allow us
evaluate and compare how much information the children were able to
gained from this program's presentations. We will also administer an
evaluation questionnaire to participants to measure our program's

Materials and Resources

We will use our patient education flip-book that we originally had
prepared for our reading materials, the book contains colorful and
educational pictures to make the activities worthwhile. We will present a
book that contains facts and pictures of oral sports related injuries to the
children. We will also include an illustrated handout sheet that will

demonstrate to the children the proper ways to care and store their
mouthguards. A plastic teeth model will be utilize to teach the children how
to brush which was provided to us by Colgate. The children will also receive
toothbrushes from us, complimentary of Colgate. We will employ a cast
model with a previously made mouthguard to show the children the correct
way their mouthguard should fit.
We will take each child's impression and present our lesson plans as
part of our program at the Texas Karate Academy located in Beaumont,
Texas. The pouring process of the cast-model will also take place at Dr.
William's office located in Beaumont, Texas. We will utilize Lamar Institute of
Technology's laboratory room for the final step, which includes grinding each
cast-model to a smooth finish and forming the final mouthguards using a
specialize machine.
When it is necessary to students to make contact with personnel to
secure materials or to obtain information, you should:

Leave a message explaining your purpose.

Leave a message that includes your credential.
Leave a message stating the organization that you are affiliated with.
Formally request an audience by phone or in person.

Evaluation Procedures
We will make each child their own personalized mouthguard. Having
the children actively engaged in the program's mouthguard activities will
serve to effectively encourage good habits. We hope to empower each child
to make their own decision to increase the utilization of mouthguards. The
children will learn how to properly brush their teeth, cleaning and storing
mouthguards, sports related oral injuries, and ways to prevent injuries. The
children will also be taught proper procedures on how to store an avulsed

tooth from trauma. Instilling good habit while the children are young will
decrease the chances of oral implications later on in life. To determine the
knowledge the children have gained, we will employ a pre/post-test. The
same test will be given at the start of the program and at the program's
conclusion. The difference of the two test's score will allow us to determine
the knowledge gained and the program's effectiveness. If the post-test
scores higher and the children choosing to wear their mouthguard of their
own will, then we will have successfully made a positive impact on each child

Pre/Post- Test
1. How many sets of teeth do you have?
a. 1
b. 2
c. 4
d. 6
2. Do you have more than one set of permanent teeth?
a. Yes
b. no
3. What percent of dental injuries are sports related?
a. 0%
b. 13-39%
c. 99%
4. What do you store a tooth in that has been knocked out?
a. Tap water
b. Milk
c. Soda
d. Saliva
5. After a tooth has been avulsed due to trauma, a time frame of 15
minutes provides the greatest chance of survival.
a. True
b. False
6. What are mouthguards made out of?
a. Metal
b. Wood
c. Plastic
d. Glass
7. How often should you replace your mouth guard?
a. Once a year
b. Every 2 months
c. After every game
d. Never
8. It is safer to wear a mouth guard during sparing.
a. True
b. False
9. What is the purpose of a mouthguard?
a. It is a decoration
b. To protect your teeth
c. Mouthguard has no purpose
10.What should be used to wash a mouthguard?
a. Mud
b. Soap and water
c. Soda
d. Saliva