Sports mouthguards are proven devices that reduce both the probability of and damage to orofacial tissues. While commonly used, clinicians may be unaware of the different sports mouthguard materials, proposed fabrication techniques, design recommendations, and newer digital fabrication methods.13
The Glossary of Prosthodontic Terms defines a mouthguard as a removable occlusal device that is useful in reducing mouth injuries and protecting the teeth and surrounding structures from injury. The American National Standards Institute/American Dental Association (ADA) Standards on Dental Care Products (ANSI/ADA SCDP) Specification No. 99 (2013) delineates the following types of mouthguards (Figure 2):
Type 1. Stock: Usually an over the counter, U-shaped device containing a central groove that surrounds but does not conform to an individual's dentition. They contain no retentive features and are held in place by clenching the teeth. Studies suggest that Stock mouthguards offer fewer protective abilities, and arch form differences between different populations may also render them to be less effective. Stock mouthguards are also available and often handed out as bimaxillary devices.
Type 2. Mouth-formed: Include the “boil and bite” thermoplastic materials, that after heat softening, are placed intraorally to allow some adaptation to an individual's intraoral features. While providing improved retention and fit compared with the Stock mouthguards, some Type 2 mouthguards have been reported to demonstrate poor fit and stability, they may interfere with ventilation, and they may lose thickness during molding, which may provide less protection.
Type 3. Custom: Dentally fitted mouthguards, that provide increased protection as they are fabricated on a stone model replicating the patient's dentition and soft tissues. Improved trauma protection is provided as the Type 3 mouthguards properly covers the full dentition and soft tissues with adequate thickness and proper extensions into the vestibular areas. Furthermore, customized protection for patients with fixed orthodontic appliances is possible, and the optimal fit of the Type 3 mouthguards provides improved stability with less impairment to the user's physiologic functions. There are also ways to make custom fitted mouthguards more protective in certain areas, so they can be tailored to an athlete’s individual needs.
Figure 2. Types of Mouthguards
Source: IADT ToothSOS app