Summary
The mouthguard is a resilient device or appliance which is placed inside the mouth to protect against injuries to the teeth, lacerations to the mouth and fractures and dislocations of the jaw. There is clear support in the scientific literature for the use of mouthguards in contact sports such as rugby. Moreover, there is evidence that mouthguards are effective in protecting against concussion and injuries to the cervical spine.
There is a high level of acceptance of mouthguards by players and an increasing number are regularly wearing mouthguards. This is especially true among the elite players, but acceptance and wearing rates are moderately high among club players as well. There is strong support among players and researchers for mouthguard wearing to be made compulsory. It is generally recommended that: (i) mouthguards be worn during both practice sessions and games; (ii) the habit of wearing a mouthguard begins at an early age; (iii) mouthguards be regularly replaced while children are still growing; and (iv) adult players replace their mouthguards at least every 2 years.
The selection of a mouthguard will depend on a number of factors including the age of the individual, effectiveness and cost. The type I (stock), or ‘off-the-shelf’, mouthguards are considered inferior when compared with the other available types, and their use is discouraged. Type II (mouth-formed) mouthguards come in 2 forms, the shell-liner version and the popular thermoplastic ‘boil and bite’ version. While the effectiveness of the shell-liner mouthguard was examined in one experimental study, no such research has been reported for the thermoplastic mouthguard. Type III (custom-fabricated) mouthguards are recommended for players playing in the more vulnerable positions and in the higher grades. Most experimental studies in which the effectiveness of mouthguards has been demonstrated have involved type III mouthguards.
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References
American Society for Testing and Materials. Standard practice for care and use of mouthguards (F697-80). Reapproved 1992. Philadelphia (PA): American Society for Testing and Materials, 1992
Clegg JH. Mouth protection for the rugby football player. Br Dent J 1969; 127: 341–3
Fricker JP. Mouthguards. Aust J Sports Med Exerc Sci 1983; 15: 22–3
Bureau of Health Education and Audiovisual Services. Mouth protectors and sports team dentists. J Am Dent Assoc 1984; 109: 84–7
Edwards JL. Dento-facial injuries in rugby. N Z J Sports Med 1984; 12 (4): 97–9
Kerr IJ. Mouthguards for the prevention of injuries in contact sports. Sports Med 1986; 3: 415–27
Chapman PJ. Mouthguards and the role of sporting team dentists. Aust Dent J 1989; 34: 36–43
Johnsen DC, Winters JE. Prevention of intraoral trauma in sports. Dent Clin North Am 1991; 35: 657–66
Jagger RJ, Milward PJ. The bimaxillary mouthguard. Br Dent J 1995; 178 (1): 31–2
Kay EJ, Kakarla P, MacLeod DAD, et al. Oro-facial and dental injuries in club rugby union players. Br J Sports Med 1990; 24 (4): 271–3
Stenger JM, Lawson EA, Wright JM, et al. Mouthguards: protection against shock to head, neck and teeth. J Am Dent Assoc 1964; 69: 273–81
Chapman PJ. Concussion in contact sports and importance of mouthguards in protection. Aust J Sci Med Sport 1985 Mar; 17 (1): 23–7
McCown IA. Boxing injuries. Am J Surg 1959; 98: 509–16
Chapman PJ. Orofacial injuries and the use of mouthguards by the 1984 Great Britain Rugby League touring team. Br J Sports Med 1985; 19: 34–6
Chapman PJ. Orofacial injuries and international rugby players attitudes to mouthguards. Br J Sports Med 1990; 24 (3): 156–8
Hickey JC, Morris AL, Carlson LD, et al. The relation of mouth protectors to cranial pressure and deformation. J Am Dent Assoc 1967; 74: 735–40
Nicholas NK. Mouth protection for children. N Z Dent J 1982; 78: 62–4
Chapman PJ. The bimaxillary mouthguard: increased protection against orofacial and head injuries in sport. Aust J Sci Med Sport 1985; 17 (4): 25–9
Park JB, Shaull KL, Overton, B, et al. Improving mouthguards. J Prosthet Dent 1994; 72: 373–80
Going RE, Loehman RE, Chan MS. Mouthguard materials: their physical and mechanical properties. J Am Dent Assoc 1974; 89: 132–8
Morton JG, Burton JF. An evaluation of the effectiveness of mouthguards in high school rugby players. N Z Dent J 1979; 75: 151–3
Chapman PJ. Prevention of orofacial sporting injuries in children and young adolescents. Aust J Sci Med Sport 1986; 18 (2): 3–6
Jennings DC. Injuries sustained by users and non-users of gum shields in local rugby union. Br J Sports Med 1990; 24 (3): 159–65
Stokes AN, Chapman PJ. Mouthguards, dental trauma and the 1990 All Blacks. N Z J Sports Med 1991; 19: 66–7
Upson N. Dental injuries and the attitudes of rugby players to mouthguards. Br J Sports Med 1982; 16 (4): 241–4
Hawke JE, Nicholas NK. Dental injuries in rugby football. N Z Dent J 1969; 65: 173–5
Chapman PJ. The prevalence of orofacial injuries and use of mouthguards in Rugby Union. Aust Dent J 1985; 30: 364–7
Chapman PJ. Attitudes to mouthguards and prevalence of orofacial injuries in International rugby: a study of the 1990 Wallabies. Aust J Sci Med Sport 1991; 23 (4): 115–7
Chapman PJ, Nasser BP. Attitudes to mouthguards and prevalence of orofacial injuries in four teams competing at the Second Rugby World Cup. Br J Sports Med 1993; 27 (3): 197–9
McNutt T, Shannon Jr SW, Wright JT, et al. Oral trauma in adolescent athletes: a study of mouth protectors. Pediatr Dent 1989; 11 (3): 209–13
Chapman PJ. The prevalence of orofacial injuries and use of mouthguards in Rugby League. Aust J Sci Med Sport 1985; 17 (3): 15–8
Dorney B. Mouthguard protection in sports injury: case report. Aust Dent J 1994; 39 (6): 372
Moon DG, Mitchell DF. An evaluation of a commercial protective mouthpiece for football players. J Am Dent Assoc 1961; 62: 568–71
de Wet FA, Badenhorst M, Rossouw LM. Mouthguards for rugby players at primary school level. J Dent Assoc S Afr 1981; 36 (4): 249–53
Blignaut JB, Carsten IL, Lombard CJ. Injuries sustained in rugby by wearers and non-wearers of mouthguards. Br J Sports Med 1987; 21 (2): 5–7
Gerrard DF, Waller AE, Bird YN. The New Zealand Rugby Injury and Performance Project II. Previous injury experience of a rugby playing cohort. Br J Sports Med 1994; 28: 229–33
Francis KT, Brasher J. Physiological effects of wearing mouthguards. Br J Sports Med 1991; 25 (4): 227–31
Brebner RTS, Marshall DW. Mouthguards: a community project in Hawkes Bay. N Z Dent J 1977 Apr; 78: 61–3
Adams B. A mouthguard project in Christchurch. N Z Dent J 1978; 74: 90–1
Heintz WD. Mouth protectors: a progress report. J Am Dent Assoc 1968; 77: 632–6
Heintz WD. The case for mandatory mouth protectors. Physician Sports Med 1975; 3: 61–3
National Health and Medical Research Council. Football injuries of the head and neck. Canberra: Government Publishing Service, Commonwealth of Australia, 1994
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Chalmers, D.J. Mouthguards. Sports Med. 25, 339–349 (1998). https://doi.org/10.2165/00007256-199825050-00006
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DOI: https://doi.org/10.2165/00007256-199825050-00006