Are mouthguards the best way of protection against sports injuries?
By Angeliki Tzortzakaki
Undoubtedly, sports contribute significantly to both the physical and mental well-being of individuals. They enhance health and overall quality of life. However, despite these tremendous benefits, sports also have downsides—chief among them, injuries, particularly in the orofacial region. To help prevent such head-related injuries, special protective sports mouthguards have been developed.
About Sports-Related Injuries
Incidents of orofacial injuries related to sports are on the rise. These injuries typically involve dental tissues, soft tissues (such as lips, gums, and tongue), and the bones of the jaw and temporomandibular joint (TMJ). Dental tissue injuries are the most common and make up the largest proportion. The frequency and type of injuries vary depending on the sport, which in turn determines the necessity for a mouthguard.¹ ²
Contact sports, combat sports, and sports that involve special equipment (e.g., sticks) increase the likelihood of injury. Common examples include boxing, rugby, wrestling, martial arts, and basketball. These injuries occur more often in boys due to higher participation rates in these activities and are particularly common in children and adolescents. In fact, 90% of dental trauma due to sports occurs before the age of 19, with incidence rates decreasing after the age of 20. Professional athletes tend to be injured more frequently than amateurs due to the intensity and stress of training and competition.
Additionally, anatomical factors such as protruding upper front teeth or poor lip closure can increase the risk of sports-related injuries.
About Mouthguards
To prevent orofacial injuries in sports, protective mouthguards were developed. Their production began in the 19th century by dentist Woolf Krause, originally intended to protect the soft tissues of the head for boxing athletes.¹ These are removable, flexible devices primarily designed to absorb and evenly distribute impact forces, thus protecting dental, soft, and skeletal tissues from trauma.²
There are three types of sports mouthguards:
Stock Mouthguards – Pre-formed and ready to use, but they cannot be adjusted.
Boil-and-Bite Mouthguards – Made from thermoplastic material that is softened in hot water and shaped to the teeth by biting.
Custom-Made Sports Mouthguards (CSMs) – Individually fabricated for each athlete based on precise specifications.
Of these, the custom-made mouthguard is preferred due to its superior fit and protection. Unlike the other types, it offers better retention, more effective force distribution, and does not hinder speech, breathing, or athletic performance.
Mouthguards are designed to be durable, resistant to deformation, and non-obstructive to essential functions like breathing and speaking. Importantly, they are also constructed so as not to impair performance—some studies even suggest they may enhance it slightly, though opinions vary. While evidence is inconclusive regarding their effectiveness in preventing brain injuries such as concussions, they may offer some degree of protection.
There are specific guidelines and standards for the design and delivery of custom-made mouthguards. Initially, a dental impression is taken and sent to a dental technician for fabrication. The material used—typically a polymer like EVA—must be odorless, tasteless, and approved by regulatory bodies.
Cleaning is done by the dentist using ultrasonic devices and disinfectants. Athletes can maintain hygiene using a soft toothbrush and neutral soap or specialized cleaning tablets.
Conclusion
Orofacial injuries in sports are common and are increasing with the popularity of contact sports. The use of a mouthguard is a vital preventive measure and should be encouraged.
References
Mordini et al. Sport and Dental Traumatology: Surgical Solutions and Prevention. Dent. J. 2021, 9, 33.
Avgerinos et al. Position Statement and Recommendations for Custom-Made Sport Mouthguards. Dent Traumatol. 2024 Nov 22.