Mouthguards

Injuries

The risk of injury is greater in collision sports than in contact sports. Oral cavity trauma is not life threatening, but associated maxillofacial injuries and fractures can compromise the airway. Soft tissue injuries include cuts and lacerations of the lip and tongue. Swelling of gums and other oral parts is also associated with collision sport trauma. Almost 80% of dental injuries are to maxillary teeth, the most frequent injury being crown fractures of the central incisor teeth, usually affecting a single tooth. Chipping, cracking, fracturing, or displacement of teeth is possible, as well as teeth being knocked out by falls or collisions with another player or object. Tooth injury varies in degree and type with age. In children, the primary teeth are commonly displaced, whereas in adults, the permanent teeth are often fractured. In children, injury usually results in primary teeth failing to continue eruption or in color changes, infection, abscess, loss of space in the dental arch, ankylosis, injury to the permanent teeth, and/or abnormal exfoliation. In the case of permanent teeth, the injury can result in discoloration, infection, abscess, loss of space in the dental arch, ankylosis, reabsorption of root structure, and/or abnormal tooth development.

Causes

The common cause of oral injury is severe impact to the mouth and teeth. This can be the result of a fall, collision with a fellow player, or collision with sports equipment and hard objects (stick or ball). The damage can be sufficient to cause lacerations of the lip and disruption of the enamel and/or dentin of a tooth.

Prevention

Mouthguards reduce the risk of broken or lost teeth and other jaw and mouth injuries during contact sports by cushioning a blow to the face that otherwise might result in an oral injury. A mouthguard decreases the intensity of force to the mouth during a powerful collision, which can cause injury to the lips, cheek lining, tongue, alveolar arches, and teeth. A misdirected elbow in a one-on-one basketball game or a fall from a bicycle (noncontact) can result in chipped or broken teeth, nerve damage to a tooth, or even tooth loss. A mouth protector can reduce the risk of such injuries as well as protect the soft tissues of the tongue, lips, and cheek lining. Mouthguards have also been shown to reduce the risk of mandibular fracture and brain injury.

Types

Three types of mouthguards are available.

Over the Counter. These mouthguards, which are readily available at most sporting goods stores, are inexpensive but come only in limited sizes (small, medium, large). They are ready-made and require no preparation; simply remove from the cover and put in the mouth. Over-the-counter mouthguards are often bulky and lack any retention; they need to be held in place by constantly biting down. The bulky mouthguard may interfere with breathing and talking, making them the least comfortable type. The athlete usually tries to alter or even cut this mouth shield in order to make it more comfortable. This decreases the protectiveness of the mouthguard. The lack of retention and protection makes these mouthguards the least recommended.

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