Sports-Related Dental Injuries and Sports Dentistry
Mouthguards

When athletes are surveyed as to why they don’t wear mouthguards, results indicate participants believe their mouthguards will affect their breathing. However, Rapisura, et al. tested two types of mouthguards with female athletes and found there was no effect on aerobic performance with their subjects with either the custom or prefabricated mouthguards they tested.³⁴

When considering recommendations, an ideal mouthguard should follow the following recommendations outlined by the Academy for Sports Dentistry (ASD):

The fitting of a mouthguard is best accomplished under the supervision or direction of a dentist. The athletes and caregivers should be educated on the special design of a “properly fitted mouthguard” with following properties and considerations:

• It should be fabricated to adequately cover and protect all teeth in the arch, including the surrounding tissues.
• It should be fabricated from a custom impression of the athlete’s arch.
• Adequate thickness in all areas is important to provide for the reduction of impact forces. In particular, a minimum of 3 mm thickness in the occlusal/labial area.
• It should have a seated equilibrated occlusion that is balanced for even occlusal contact. This provides for a balanced absorption of impact energy.
• A fitted mouthguard that is retentive and not dislodged on impact.
• Speech considerations.
• A material that meets FDA approval.³⁸

The properly fitted mouthguard should be routinely and professionally examined for fit and function. Frequency of routine inspection is dependent on factors such as the athlete’s age and the willingness for the athlete to properly care for the appliance. The frequency of the inspection should be determined by the dental professional for each individual situation and athlete.

Mouthguards typically are made of thermoplastic copolymer and designed to fit over occlusal and facial surfaces of the maxillary teeth and gingival tissues.³⁶ The American Society for Testing and Materials (ASTM) and the manufacturers of mouthguards have classified the mouthguards into three types:

• Stock Mouthguards
• Mouth-formed Protectors or Boil-and-Bite Mouthguards
• Custom-made Mouthguards