‘Injury prevention versus performance’: has the time come to mandate the use of mouthguards in all contact sports?

Abstract

Mouthguard use continues to be a hotly debated issue in the domain of contact sports. Regulations from sports governing bodies on wearing mouthguards and attitudes towards their use from athletes vary significantly across ‘at-risk sports’. We explore how recent advances in sports dentistry have led to the widespread availability of new customisable mouthguards and whether their use may impact athletic performance, reduce orofacial trauma or sport related concussion. We also discuss whether ‘no mouthguard, no play’ policies designed to mandate their use may help to promote a culture of safe participation in contact sport.

Effect of different custom-made mouthguard palatal extensions on the stress-state of dentoalveolar: a 3D-FEA

“…[20] Dental trauma can have many negative consequences, including pain, psychological shadows, high treatment costs and even damage to the appearance. [3,19,21] Ultimately, how to prevent dental trauma is more important than treating teeth.…”

“…[1,2] People playing sports, especially teenagers, have a high probability of sustaining dentofacial injuries in intense confrontational or contact sports. [1][2][3] About 30% of teenagers participating in sports experience dentofacial injuries of varying degrees, which often lead to dental trauma, jaw fractures, temporomandibular joint injuries and even concussions. [1][2][3] In May 2015, the American Academy of Sports Dentistry, the American Academy of Pediatric Dentistry, the American Academy of Oral and Maxillofacial Surgery, the American Academy of Orthodontics and the American Academy of Dental Medicine jointly recommended that all children and adults should wear comfortable, appropriate mouthguards.…”

“…device used to reduce damage to the orofacial anatomy in certain circumstances, especially the teeth and surrounding tissues, effectively avoiding or reducing damage to oral soft and hard tissue by covering the teeth and gingival tissues. [3,4] However, the actual use of MGs is a concern. A survey by Grewal et al [5] indicated that among one-third of schoolchildren participating in contact sport activities, only 3% always used MGs.…”

Investigating the effect of mouth guard use on aerobic performance in amateur boxers

“…Individual sports must decide if the reduction in OFT, outweighs any modest impact on performance or discomfort for athletes. It has been proposed that in under 16's sport the continued safe participation of athletes, outweighs any small reduction in performance observed and other sports should consider mandating for their use at a national or organization level (Ahmed & Fine, 2021). Amateur and professional boxing has shown that comprehensive medical guidance can help to promote the mandatory use of mouthguards, and that this is not a barrier to athletes wanting to participants at all levels of competition.…”

Impact response of different materials for sports mouthguards

“…However, most patients who used these mouthguards reported forgetfulness as the most frequent reason for not always using them due to the discomfort created. On the other hand, some athletes do not use mouthguards because they consider that it affects performance and promotes some discomfort [9], but Ferreira et al [10] clarify that mouthguards do not impair the athlete's performance. According to American Dentistry Association Council (see https://www.ada.org/en/member-center/oral-healthtopics/mouthguards), a mouthguard should not only protect teeth and surrounding structures but also prevent ingestion or inhalation in case of loss or fractured teeth.…”