Mouthguard Use in Sport

Position Statement – Mouthguard Use in Sport

Dental trauma sustained as a result of sports participation can be prevented and minimised by wearing a properly fitting and custom made mouthguard. It is recommended that all school age children and players participating in sport, where dental trauma may occur, wear a mouthguard in order to prevent traumatic dental injuries resulting in extensive restorative dental treatment.

The Faculty of Sport and Exercise Medicine, in conjunction with the Faculty of Dental Surgery at the Royal College of Surgeons of England, has produced this guide on the use of mouthguards for sport and exercise medicine practitioners, health professionals, sports participants, schools and parents.

Mouthguard use in sport:

1. Dental injuries are common in both contact and non-contact sports and traumatic dental injuries occur most commonly between the ages of 7-14 years in developing immature dentitions. The majority of injuries are to the maxillary central incisor teeth.  Arrested tooth root development and pathology may result in the need for, root canal treatment (RCT) or early extraction and tooth loss at a young age.

2. Males are twice as likely as females to sustain dental trauma and more likely to experience more than one episode. If a second injury occurs, in a previously traumatised immature dentition, cervical tooth fracture is common and this will decrease the tooth lifespan. Dental trauma sustained in childhood may bring life-long restorative dental treatment need and monitoring.

3. A well fitting and retentive mouthguard offers oral soft tissue and dentition protection from impacts sustained through sports participation. It significantly reduces the risk of injury to the dentition, soft tissues, the temporomandibular joint (TMJ) and intraoral bony structures. It is imperative that the correct advice is given to the sportsperson, dependent on their stage of dental development and dental status. All children of school age must wear a mouthguard for contact sports.

4. Three types of mouthguard are available; stock, boil and bite and custom fitted. A custom fitted mouthguard offers maximum protection and is the recommended option for all sports participants where dental trauma may occur:

Stock Mouthguards can be used without modification. They are usually held in place by clenching the teeth together.

Boil and Bite Mouthguards are moulded after immersion in hot water and adapted by the wearer using their finger, tongue and biting pressure and offer a better fit than a stock mouthguard. An impression can be posted to a mouthguard supplier to be fabricated, which will give better retention and comfort above the standard, over the counter, boil and bite mouthguards. This is not ideal, as it relies on the sportsperson to take an accurate uniform dental impression of themselves. Stock and Boil and Bite mouthguards offer the lowest level of protection and may be bulky, of uneven uniform thickness and poorly retained in the mouth.

Custom Fitted Mouthguards offer the best protection and should be fabricated only after a full mouth dental health assessment, and any outstanding dental treatment is completed. The custom fitted mouthguard is made using an accurate impression of the sportsperson’s dentition and surrounding oral structures taken by a dental professional. It ensures maximum protection, comfort, optimal uniform thickness, retention and minimises breathing and gagging problems. It can be tailor made to the individuals request and sport. Optimal maxillomandibular occlusal relations (upper and lower teeth contacts) are also obtained. A Dental Professional can also allow space within a custom fitted mouthguard for development of the dentition in the young sportsperson.

5. Well fitting and optimally retentive mouthguard wearers have significantly lower rates of severe dental injuries and complex dental treatment need over non wearers who sustain dental trauma.

6. Regular mouthguard cleaning and checks are recommended. An older mouthguard may become worn, thin and ill fitting. A consultation with a dental professional should be undertaken if in any doubt regarding an existing mouthguard’s status.

7. Children or adults undergoing orthodontic treatment must wear a mouthguard for protection of themselves and their opponents when participating in contact sports. Custom fitted mouth guards are recommended for orthodontic patients. Pre-fabricated mouthguards are available which can be worn over an Orthodontic appliance but are less satisfactory.

8. At present there is no robust evidence to support mouthguard use in concussion prevention, research in this area is ongoing.

9. The Faculty of Sport and Exercise Medicine UK is supportive of the use of mouthguards in sport participation at all levels, however it is difficult to mandate the use of mouthguards where there is no British Standard. A British Standard for mouthguards would give quality assurance on the potential protection provided with a focus on fit, retention and shock absorbency.

©Faculty of Sport and Exercise Medicine UK – Mouthguard Use in Sport April 2016, to be reviewed April 2019.

Author: Mr Lyndon Meehan BDS, BSc, MJDF RCS (Eng), PG Dip Endo

References:

  1. Knapik J, Marshall S, Lee R, Darakjy S, Jones S, Mitchener T, Delacruz G, Jones B (2007) Sports Medicine 37(2) 117-144 Mouth guards in Sport Activities: History Physical Properties and Injury Prevention Effectiveness
  2. Levin L, Zadik Y (2012) Dental Traumatology (28) 49-54 Education on and prevention of dental trauma: it’s time to act
  3. Patrick D, Van Noort R, Found M (2005) British journal of sports medicine (39) 278-281 Scale of protection and various types of sports mouth guard

Terms of Use

Position statements published by the FSEM (UK) are quick reference or information documents for the Sport and Exercise Medicine and healthcare community. They can include up to ten short points of clinical relevance and are designed to be useful short reference documents.

The FSEM (UK) will publish updates to its official position statements as and when new information is available. The current versions will appear on the website, including the date published, and will supersede and replace prior versions. FSEM UK does not circulate or endorse out of date versions of its position statements.

Our position statements are freely available to the medical and healthcare profession and are subject to copyright, if you plan to use or share them, please ensure you include an up to date version of the statement and credit the Faculty of Sport and Exercise Medicine UK.