ADA News

Reston, Va.—Drs. Emilio Canal, Michael Messina and colleagues believe they have the U.S. men's team ready for World Cup competition in South Africa, "totally dentally ready."

Starter: Dr. Emilio Canal Jr. poses last month with Tim Howard, starting goalkeeper for the US Soccer World Cup team when Mr. Howard’s mouthguard was fitted. Photos courtesy Dr. Emilio Canal Jr.

"There are no underlying dental issues they're taking with them," the "soccer docs" told the ADA News. "As far as we're concerned, they're cleared and ready to go," say the dentists whose general practice in this Washington, DC suburban area is a dental home and/or way station to an international soccer community, players and coaches alike, youth to professional.

We'll call them "soccer docs," which is not a term they used during an interview, just on the basis of their involvement since 1996 with U.S. men's and women's teams, Major League Soccer including the local MLS franchise DC United, professional women's, Olympics and youth teams, the United States Soccer Federation, the Federation Internationale de Football Association (FIFA), the Academy for Sports Dentistry for which Dr. Canal is serving his second presidency, and their networking for local dental support at U.S. men's training camps. Oh, did we mention mouthguards?

"Our involvement is to provide coverage for all the home games (during qualifying competition) and also to do the pre-tournament evaluations when the tournaments are out of the country," the "soccer docs" said in an interview at their office not far from Dulles International Airport where the occasional player or coach deplanes for a trip to the dentist. "For the World Cup squad we do clinical examinations, radiographic examinations and impressions for mouthguards.

"The mouthguards that we provide are the pressure and heat-laminated mouthguards," Dr. Canal said. Who makes them, we asked. "We make them in our office. We could send them out to a laboratory as well to be made. There are many laboratories out there that provide them and they do an excellent job with it. But we've been making them for 20 years. We choose to make them ourselves. And that includes all the U.S. men's and women's World Cup teams, Olympics teams and all the youth world cups (for players under 20 grouped by age). We pretty much cover all the teams in U.S. soccer (national as opposed to local, regional or state teams)."

The U.S. men's team trainers have mouthguards for each player although there's no certainty that many will use them. But that's another story. However, at least one U.S. player was seen on national television using a mouthguard during the team's May 29 "friendly" match with Turkey. The Reston dentists also prepared an emergency kit for the team's athletic trainers with temporary filling material, an adhesive for recementing a crown, floss, a mirror, an explorer, a mixing pad and a save-a-tooth kit.

So your practice has been doing the World Cup (for how long) we started to ask as Dr. Canal responded mid-question, "Four World Cups and it's been great fun. We've met a lot of interesting people." Actually, they've been involved in five World Cups now although Dr. Canal correctly says four when speaking of their involvement with the U.S. men's team.

Mouthguard prep: U.S. Soccer World Cup team members (from left) Jonathan Bornstein, Robbie Findley and  Brad Guzan do the paperwork while Drs. Eric Cantor, Philadelphia, and Emilio Canal Jr., Reston, Va., engage in conversation. Photos courtesy Dr. Emilio Canal Jr.

Dr. Messina picks up the story of how-we-got-started-in-soccer with the 1994 World Cup in the United States, their first. But that was a venue assignment in a host nation rather than dental service with the national team. "We were in charge of all the teams that went through RFK (DC stadium host for some of the matches). From there we met a lot of the folks who went to work for DC United, so they brought us along, said we need a dentist. When Bruce Arena (current MLS and former U.S. men’s coach) got the Olympic team in 1996, he brought us along ..." and the story leads to their fifth World Cup.

During the 2010 team's formative years, one competitor flew from England to Dulles, arriving with an abscessed tooth just days before the team’s final qualifying match. "He was in a lot of pain. So we saw him that day and treated the tooth and did a root canal for him and he was able to play," said Dr. Canal.

"Ultimately our goal being dentists is to make sure that doesn't happen," Dr. Messina added. "Is it possible 100 percent of the time? No, because sometimes a tooth that's going to abscess will abscess. Sometimes there are no signs. The main thing is we don’t want to send players over there that we know radiographically are going to all of a sudden become an emergency and have to be treated over there."

When the men's team trained recently in Philadelphia, Drs. Canal and Messina through the Academy for Sports Dentistry called on Dr. Ralph Zonies (Zonies and Hulgado Dental Associates) in nearby Cherry Hill, N.J., "to let us use his office and he was kind enough to open his office and bring in his staff. That's most of our role these days, to coordinate coverage depending on what city they're in, not necessarily to be at every game." For more on the academy see www.academyforsportsdentistry.org. The ASD annual symposium is June 24-26 in the Washington, D.C., metro area.

Did you find dental problems with the 23 players going to South Africa? "We did find a couple—we're not saying any names—some problems of small decay that we didn't feel would impact over the next couple of months, that should be addressed in the next six months but nothing that would interfere with play," said Dr. Canal, their responses coming across as a soccer give-and-go, each contributing to the flow of conversation. "We didn’t find any abscessed teeth. There were some missing teeth issues but nothing that would keep them from getting through the first two months."

Did you provide any treatment? "No. In the last World Cup (2006), a couple players needed root canals before they left, some fillings as well."

What's gotten better, the dental condition of the players, the treatment or both, we asked. "I think the fact that U.S. soccer has made dentistry a big part of the whole medical program is that these kids are getting evaluated and they're knowing that they are going to be evaluated so they're taking care of themselves so that when they're coming through the training session they don't have to lose training time because they want to show well for the coaches. So I feel like they're getting that taken care of, whereas before they would show up, they would have problems and also be missing a day or two because they're getting treated."

The U.S. men's team is scheduled for first round World Cup matches with England June 12, Slovenia June 18 and Algeria June 23. FIFA convenes a World Cup every four years and this year's competition runs from June 11-July 11.

Neither Drs. Canal or Messina will be in South Africa. FIFA requires host country dentists on site at all venues in much the same way these "soccer docs" entered the game in 1994.

For patients, the ADA offers information on mouthguards on ADA.org. After a Chicago Blackhawks player lost seven teeth in the National Hockey League playoffs, the Association offered advice in a press release also posted on ADA.org.