Tony Finn – Dental Prosthetist

190 High Street, Hastings, 3915

Ph:5979 3007

Mob:0400 051 512

Dear Parent/Guardian,

Mouthguards have come a long way since the mass produced ones available at Chemists and Sports stores. In fact within the Dental Profession it is a well known that these “shop bought” or “boil & bite” mouthguards are dangerous. They fit poorly and may be harmful. Recent media attention has highlighted the shortcomings and dangers of “stock” mouthguards and this publicity should move authorities toward the banning of these products.

A mouthguard is a cheap price to pay compared to the cost of a crown or a bridge. The average price of a single tooth crown at a dentist is $1600.00

Statistics

Only two in five children aged five to 17-years-old wear a mouthguard during matches and just one in five during training, according to the Australian Dental Association.

Did you know that 50% of traumatic dental traumas are caused by sporting injuries? You can prevent these severe injuries from occurring by wearing a mouthguard while playing sports. A mouthguard should be worn for all contact sports including, but not limited to: Football, Soccer, Hockey, Netball, Basketball, Squash and Boxing.

Private Health

Some private health funds cover 70 - 100% of the cost of a mouthguard. So a custom fitted mouthguard can quite often cost less than a shop/chemist bought one.Item codes are on reverse side of form

The Diamond Custom Pressure Laminated Mouthguard is a totally different concept in protection. It’s a Custom-fitted Pressure formed Laminated Mouthguard.

A mouthguard can do more than protect your teeth from chipping or being knocked out.

A Diamond  Custom Pressure Laminated Mouthguard will:-

* Reduce risk of concussion.

* Reduce risk of jaw, neck and spinal injuries.

* Reduce risk of mouth, lip and tongue damage.

* Offer higher levels of comfort, breathing and speech.

* Reduces the effect of gagging.

*Player’s confidence is greatly enhanced.

An DIAMOND Custom Pressure Laminated Mouthguard is a small investment to cover a potentially large risk.

All mouthguards come with your name imprinted inside it, and a hard plastic box to store it in

For any questions relating to mouthguards, Please contact Tony directly on 0400 051 512

PTO

CLUB NAME------------

PLAYER’S NAME------NICKNAME for inside M/G ------

ADDRESS------

PHONENUMBER------

Impressions will be taken at on If you can’t make these nights, please contact Tony to arrange a suitable alternate night at his clinic in Hastings.

MOUTHGUARD TYPE------COST------

MOUTHGUARD COLOUR/S------

BOX COLOUR------

PARENT/GUARDIANS Signature------(if under 18 years ofage)

Please note: Official receipts will be issued on collection of mouthguard if required.

DO you require a receipt YesNo

Do you have Private Health Insurance with extras YesNo

Payment is required at the time of impression being taken, either by CASH, CREDIT CARD, or Private Health Fund

For private health insurance with extras quoteitem numbers:- P014 (Consultation) & P151(Mouthguard). Provider number 4456591Y to your fund. This will give you an idea as too how much they will cover.

I will also have a mobile Hicaps terminal present however not all Funds will allow payments through mobile terminals

Colour and type of mouthguard can be discussed on the day of impression being taken.

“NOTE” Siblings are also welcome on the day, please copy this form and fill in the details

PLEASE NOTE: If your child has Braces, The Impression will need to done at the Hastings Clinic as it is a bit more technical to do