Ergonomic Sports Mouthguards: A Narrative Literature Review and Future Perspectives

Abstract

Sports activities can increase participants’ risk of orofacial trauma. Therefore, it is crucial to have a comprehensive understanding of various types of sports mouthguards. This study aims to present a narrative literature review on ergonomic mouthguards, including their indications for use, classifications, materials, manufacturing methods, and the current status of additive manufacturing in their production. Research of the existing literature was performed in the Google Scholar, MEDLINE/PubMed, Web of Science, and ScienceDirect databases to identify the currently available publications on the topic of sports mouthguards from January 1951 to August 2023. The terms used were “sports mouthguard”, “mouthguards and orofacial traumas”, and “mouthguards and additive manufacturing”. A total of 920 articles were found, and 39 articles were selected and included in this review. While consensus exists regarding the significance of using sports mouthguards with optimal attributes, there is a need for standardization in the methodology for manufacturing custom-made mouthguards. These can be fashioned with conventional ethylene vinyl acetate (EVA) copolymer reinforcements. Such standardization would ensure uniform stress distribution and guarantee ample protection for oral tissues, allowing for universal reproducibility among dental practitioners. Additive manufacturing stands as an innovative method for fabricating mouthguards, displaying promising benefits. However, the materials and methodologies employed in this workflow still require refinement and characterization for a safe clinical integration.

Comfort and wearability properties of custom‐made and boil‐and‐bite mouthguards among basketball players: A randomized parallel arm clinical trial

“…In terms of public health, orofacial injuries stemming from sports activities are a significant concern, carrying a 6‐fold higher risk of trauma compared to other critical events such as traffic accidents and acts of violence 10 . Previous systematic reviews and meta‐analyses have shown that orofacial injuries are most prevalent in contact sports such as wrestling, rugby, basketball, handball, field hockey, and soccer 4,5,10–12 . The most common causes of dentofacial injuries include falls during attempts to block opponents, collisions with other players, or contact with objects like balls or sticks on hard surfaces 4,5,13,14 …”

“…Its primary advantage lies in its affordability, and athletes attempt to maintain its position in the mouth by applying occlusal pressure, which, however, disrupts speech and breathing and may instill a false sense of protection 21 . The B&B MG, a self‐malleable mouthguard, is favored by athletes for its intermediate price point between stock and custom mouthguards 12,22 . It is constructed from thermoplastic material designed to soften and become malleable when exposed to hot water.…”

“…It is constructed from thermoplastic material designed to soften and become malleable when exposed to hot water. Subsequently, athletes adapt it to their jaw by biting, sucking, and manually pressing around the cheek and mouth 12,23 . However, performing these adaptation movements without professional dental assistance can result in an ill‐fitting mouthguard, potentially compromising protection in specific areas 12,24 .…”

“…Subsequently, athletes adapt it to their jaw by biting, sucking, and manually pressing around the cheek and mouth 12,23 . However, performing these adaptation movements without professional dental assistance can result in an ill‐fitting mouthguard, potentially compromising protection in specific areas 12,24 . Additionally, an athlete's uncontrolled biting force can lead to excessive thinning (70%–99%) of the mouthguard, which diminishes its protective capacity 12,22 .…”

“…However, performing these adaptation movements without professional dental assistance can result in an ill‐fitting mouthguard, potentially compromising protection in specific areas 12,24 . Additionally, an athlete's uncontrolled biting force can lead to excessive thinning (70%–99%) of the mouthguard, which diminishes its protective capacity 12,22 . Custom‐made (CM) MGs are crafted by molding thermoplastic material using vacuum or pressure forming techniques on a plaster model derived from an athlete's oral impressions and the process is often supervised by a dentist 22,25 .…”