Review helps clinicians choose mouth guards for athletes

Anisha Hall Hoppe, Dental Tribune International

Thu. 2. November 2023

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São José Dos Campos, Brazil: Orofacial trauma is common in sport, making protective mouth guards essential, and indeed mouth guards have been sold for sports use for over 100 years. A study published in a special issue of Applied Sciences provides a useful overarching review of mouth guard classifications, materials, manufacturing methods and reinforcement techniques involved in fabrication. The overview highlights the significance of standardised manufacturing methods, the need for reinforced materials and the potential of 3D-printing technology to enhance the safety and performance of athletes.

Mouth guards are categorised into three types: stock (prefabricated), boil and bite (mouth-formed), and custom-made (thermoformed), and the American Dental Association provides differing recommendations for mouth guard use based on the different sports in which they are worn.

Mouth-formed mouth guards are made from thermoplastic materials and softened in boiling water and then moulded to fit the athlete’s mouth. However, this process can result in misfits and varying thicknesses, potentially compromising protection, especially for posterior teeth.

Ergonomic custom-made mouth guards, however, offer precise fit and ergonomic shapes, providing benefits such as improved speech and comfort. They are moulded on plaster models, derived from oral impressions, by heating thermoplastic materials, typically ethylene vinyl acetate (EVA). Custom-made mouth guards are considered the most effective and comfortable choice, offering superior protection against injuries during sports. The use of reinforcement by means of air cavities or materials such as Sorbothane, sponge, and acrylic and nylon fibre in order to enhance the impact-absorbing capacity of mouth guards has been explored.

Additive manufacturing methods can be employed in producing mouth guards to overcome some of the limitations of conventional methods. Although 3D-printed mouth guards have shown surface uniformity and consistent thickness, they do not yet surpass the mechanical performance of traditional EVA mouth guards, requiring further refinement and characterisation. The need for further research to evaluate different polymers and establish safe clinical implementation is highlighted in the review. However, 3D-printed mouth guards offer advantages in terms of occlusal balance, providing a symmetrical bilateral occlusion in centric occlusion.

The review also emphasises the importance of exploring new materials and fabrication methodologies for improving stress absorption capacity, reinforcing mouth guards and enhancing athletes’ comfort. Overall, standardisation and innovation in mouth guard manufacturing are crucial to ensure optimal protection for athletes.

The study, titled “Ergonomic sports mouthguards: A narrative literature review and future perspectives”, was published on 16 October 2023 in Applied Sciences.