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Mouthguard
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Mouthguard
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Mouthguard worn in handball, a contact sport.
An example of a mouthguard used in the treatment of bruxism.

A mouthguard is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, arches, lips and gums. It also prevents the jaws coming together fully, thereby reducing the risk of jaw joint injuries and concussion.[1] A mouthguard is most often used to prevent injury in contact sports, as a treatment for bruxism or TMD, or as part of certain dental procedures, such as tooth bleaching or sleep apnea treatment. Depending on the application, it may also be called a mouth protector, mouth piece, gumshield, gumguard, nightguard, occlusal splint, bite splint, or bite plane. The dentists who specialise in sports dentistry fabricate mouthguards.

Types

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Stock or ready made

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Manufactured in a pre-formed shape in various sizes but with nearly no adjustment to fit the user's mouth. The only adjustment possible is minor trimming with a knife or scissors.

Mouth adapted or "boil and bite"

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A thermoplastic material manufactured in a pre-formed shape in various sizes that can be adapted to fit more closely to an individual's teeth and gums by heating and molding such as boiling then placing in the mouth. Some are now available that incorporate special fins within the fitting zones which increase retention and give an improved fit over traditional boil-and-bite mouth types. Guards are usually made of Ethylene-vinyl acetate, commonly known as EVA. Some of the newer technologies offer an alternative, stronger thermo-polymer that allows for lower molding temperatures, below 140F to prevent burning by scalding hot water. This is the most popular mouthguard used by amateur and semi-professional sportsmen, providing adequate protection but relatively low comfort in comparison to the custom-made guard.[2]

Custom-made

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Vacuum form mouthguard made from an impression using dental alginate.

An impression of the user's teeth is used to create a best-fit mouth protector. The impression may be obtained by using a specially designed impression kit that uses dental putty, or from a dentist who will take an impression in dental alginate material. In the EU, the guard must be sold with a CE mark and the guard must have passed an EC Type-Examination test, performed by an accredited European Notified Body.

  • Vacuum form
    • Custom-made mouth guards using this type of machine produce single layer mouth guards
    • Fit not as good as pressure laminated but offers more protection than boil and bite
  • Pressure laminated
    • Custom-made mouth guards using this type of machine produce multi-layer mouth guards
    • Offers superior fit, comfort and more protection
  • Impressionless
    • Made from a medical-grade thermo polymer, the guards are activated with hot (not boiling) water and create a custom comfort fit, completely unique to the shape of the mouth.
    • 1.6 mm thin, Remoldable, Works with braces, Stays secure in mouth during the entire game or practice
    • Allows athletes to talk, breathe and drink naturally

Dentistry

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Occlusal splint

Occlusal splints (also called bite splints, bite planes, or night guards) are removable dental appliances carefully molded to fit the upper or lower arches of teeth.[3]

They are used to protect tooth and restoration surfaces, manage mandibular (jaw) dysfunction TMD, and stabilize the jaw joints during occlusion or create space prior to restoration procedures. People prone to nocturnal bruxism, or nighttime clenching, as well as morsicatio buccarum may routinely wear occlusal splints at night. However, a meta-analysis of occlusal splints used for this purpose concluded "There is not enough evidence to state that the occlusal splint is effective for treating sleep bruxism. An indication of its use is questionable concerning sleep outcomes, but there may be some benefit with regard to tooth wear."[4]

Occlusal splints are typically made of a heat-cured acrylic resin. Soft acrylic or light cured composite, or vinyl splints may be made more quickly and cheaply, but are not as durable, and are more commonly made for short-term use. Soft splints are also used for children because normal growth changes the fit of hard splints.[5]

They cover all the teeth of the upper or lower arch, but partial coverage is sometimes used. Occlusal splints are usually used on either the upper or the lower teeth, termed maxillary splints or mandibular splints respectively, but sometimes both types are used at the same time. Maxillary splints are more common, although various situations favor mandibular splints.

Stabilizing or Michigan-type occlusal splints are generally flat against the opposing teeth, and help jaw muscle relaxation, while repositioning occlusal splints are used to reposition the jaw to improve occlusion.[6]

Usage

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History

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The exact origins of the mouthguard are unclear. Most evidence indicates that the concept of a mouthguard was initiated in the sport of boxing. Originally, boxers fashioned rudimentary mouthguards out of cotton, tape, sponge, or small pieces of wood. Boxers clenched the material between their teeth. These boxers had a hard time focusing on the fight and clenching their teeth at the same time.[17] Since these devices proved impractical, Woolf Krause, a British dentist, began to fashion mouthpieces for boxers in 1892. Krause placed strips of a natural rubber resin, gutta-percha, over the maxillary incisors of boxers before they entered the ring.[18] Phillip Krause, Woolf Krause’s son, is often credited with the first reusable mouthpiece. Phillip Krause’s invention was highlighted in a 1921 championship fight between Jack Britton and Ted "Kid" Lewis. Lewis was a school friend of Krause and the first professional to utilize the new technology, then called a ‘gum shield.’ During the fight, Britton’s manager successfully argued that the mouthpiece was an illegal advantage. Philip Krause was an amateur boxer himself and undoubtedly used his device before 1921.[19]

There have been other claims to the invention of the mouthguard as well. In the early 1900s, Jacob Marks created a custom-fitted mouthguard in London.[20] An American dentist, Thomas A. Carlos, also developed a mouth guard at approximately the same time as Krause. Carlos claimed that he made his first mouthpiece in 1916 and later suggested his invention to the United States Olympian Dinnie O’Keefe in 1919. Another dentist from Chicago, E. Allen Franke, also claimed to have made many mouth guards for boxers by 1919.[19] The mouthguard’s relevance was again brought to the center of attention in a 1927 boxing match between Jack Sharkey and Mike McTigue. McTigue was winning for most of the fight, but a chipped tooth cut his lip, and he was forced to forfeit the match. From that point on, mouthguards were ruled acceptable and soon became commonplace for all boxers.[21] In 1930, descriptions of mouthguards first appeared in dental literature. Dr. Clearance Mayer, a dentist and boxing inspector for the New York State Athletic Commission, described how custom mouthguards could be manufactured from impressions using wax and rubber. Steel springs were even recommended to reinforce soft materials.[21]

In 1947, a Los Angeles dentist, Rodney O. Lilyquist, made a breakthrough by using transparent acrylic resin to form what he termed an "acrylic splint". Molded to fit unobtrusively over the upper or lower teeth, the acrylic mouthguard was a distinct improvement over the thick mouthguard worn by boxers. It meant that the athlete could talk in a normal manner while the mouthguard was in place. In the January 1948 issue of the Journal of the American Dental Association, the procedure for making and fitting the acrylic mouthguard was described in detail by Dr. Lilyquist.[22] He immediately received nationwide recognition as the father of the modern mouthguard for athletes.[23] The first athlete to wear the acrylic mouthguard was a member of the UCLA basketball team, Dick Perry, who modeled the device at a convention of the Southern California Dental Association. Another early wearer was Frankie Albert, quarterback for the San Francisco 49ers.

American Football mouthguard

In the 1940s and 1950s, dental injuries were responsible for 24-50% of all injuries in American football.[21] In 1952, Life magazine did a report on Notre Dame football players without incisors.[24] The article drew a lot of public attention and led to the inclusion of mouthguards in other contact sports. In the 1950s, the American Dental Association (ADA) began researching mouthguards and soon promoted their benefits to the public.[25] In 1960, the ADA recommended the use of latex mouthguards in all contact sports. By 1962, all high school football players in the United States were required to wear mouthguards. The National Collegiate Athletic Association (NCAA) followed suit in 1973 and made mouthguards mandatory in college football. Since the introduction of the mouthguard, the number of dental injuries has decreased dramatically.[26]

Mouthguards have become a standard in many sports. In addition to football, the NCAA currently requires mouthguards in ice hockey, field hockey, and lacrosse. The ADA shows that mouthguards are extremely effective in preventing facial injury in contact and non-contact sports. The ADA recommends mouthguards be used in 29 sports: acrobatics, basketball, bicycling, boxing, equestrian, football, gymnastics, handball, ice hockey, inline skating, lacrosse, martial arts, racquetball, rugby football, shot putting, skateboarding, skiing, skydiving, soccer, softball, squash, surfing, volleyball, water polo, weightlifting and wrestling.[26] Mouthguard use during Gaelic football games and training is mandatory at all levels.[27]

See also

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References

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Footnotes

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Revisions and contributorsEdit on WikipediaRead on Wikipedia

Mouthguard

View on Grokipedia
from Grokipedia
A mouthguard, also known as a mouth protector, is a removable intraoral appliance designed to cushion the teeth and surrounding orofacial structures against impact, thereby reducing the of , lacerations, fractures, and other injuries during physical activities or medical conditions such as . These devices typically cover the teeth and adjacent soft tissues, absorbing shock and distributing forces to minimize damage to the teeth, , , , and . Mouthguards are most commonly associated with sports protection, where they are recommended for collision and contact sports like football, , hockey, and , as well as non-contact activities involving high-velocity risks such as and . Properly fitted mouthguards can reduce the incidence of sports-related dental injuries by 82% to 93%, with non-users facing significantly higher risks of fractures and injuries. Beyond athletics, mouthguards serve therapeutic purposes in , such as occlusal splints or bite guards for managing (teeth grinding) and (TMJ) disorders, where they prevent wear, alleviate jaw discomfort, and reduce muscle activity without necessarily eliminating the grinding behavior. There are three primary types of mouthguards: (prefabricated and least effective due to poor fit), mouth-formed or boil-and-bite (self-adapted after heating in for moderate protection), and custom-made (dentist-fabricated from impressions for optimal fit, comfort, and efficacy, though more expensive). Custom variants, often made from materials like (EVA), are preferred for high-risk uses and meet standards set by organizations such as the (ADA), which has endorsed their use since 1994.

Overview

Definition and Purpose

A mouthguard is a removable intraoral appliance constructed from soft or semi-rigid materials that covers the , , and gums to absorb and distribute impact forces during physical activities. This design provides a cushioning barrier, minimizing direct trauma to oral structures. The primary purposes of mouthguards include preventing such as fractures and avulsions, where a is completely displaced from its socket. They also protect soft tissues like the , cheeks, and from lacerations and bruising by acting as a buffer against blows. Additionally, mouthguards help reduce the risk of injuries, including fractures and dislocations, by dissipating concussive forces across the . Mouthguards typically fit over the maxillary (upper) or mandibular (lower) arch of teeth, with single-arch designs covering one dental row for targeted protection and dual-arch versions spanning both arches to prevent tooth-to-tooth contact. These configurations ensure secure placement without interfering with breathing or speech during use. Over 5 million teeth are knocked out annually due to sports-related dental injuries, underscoring the critical role of mouthguards .

Benefits and Importance

Mouthguards play a crucial role in preventive oral health by significantly reducing the risk of sports-related injuries. Studies indicate that proper use of mouthguards can lower the incidence of orofacial injuries by approximately 82%, as evidenced by meta-analyses comparing injury rates among users (7.5-7.75%) and non-users (48-60%). This protection extends to damage, including lip lacerations, where mouthguards act as a cushion to absorb and distribute impact forces, preventing cuts and bruising from blows to the face. Additionally, by stabilizing the and dissipating energy from collisions, mouthguards have been associated with reduced risk in some research, with custom-fitted models showing up to 49% lower odds and stock versions up to 69% lower odds compared to no use. Beyond immediate , mouthguards contribute to long-term and economic benefits. They help avert costly dental interventions, such as treatments for avulsed teeth or fractures, which can range from $10,000 to $15,000 in lifetime costs per incident. This reduction in severe injuries also decreases emergency dental visits, promoting overall access to care and lowering healthcare burdens. In dental applications, mouthguards provide secondary relief for conditions like by protecting teeth and supporting (TMJ) health, though custom-made versions offer optimal fit for these benefits. The importance of mouthguards is underscored by their integration into guidelines and societal practices. Organizations like the (ADA) recommend their use in contact sports to minimize oral trauma, while the National Federation of State High School Associations (NFHS) mandates mouthguards in youth leagues for sports such as football, , , and . Furthermore, wearing a mouthguard boosts psychological among athletes, as users report feeling more secure and focused during play, enhancing performance without fear of injury.

Types

Stock Mouthguards

Stock mouthguards are mass-produced prefabricated devices available in standard sizes, such as small, medium, and large, using basic molding processes to create a U-shaped form with a central groove that fits over the teeth without adaptation to individual anatomy. They are widely sold at retail outlets like sporting goods stores and pharmacies, requiring no customization or professional fitting, and are typically constructed from (EVA) for basic shock absorption. These mouthguards must be held in place by clenching the teeth, making them a simple, ready-to-use option for immediate protection. The key advantages of stock mouthguards include their low cost, generally ranging from $10 to $30, which makes them accessible for occasional or introductory use. They offer immediate availability without the need for appointments or processing time, along with easy replacement if damaged, rendering them suitable for beginners engaging in low-impact activities or as a temporary solution until a better-fitting option is obtained. Examples of stock mouthguards include basic foam models and preformed EVA variants from brands like Shock Doctor's entry-level lines, which prioritize affordability over advanced features. Despite their convenience, stock mouthguards have notable disadvantages, primarily stemming from their generic design, which results in poor fit and frequent slippage during activity. This often leads to significant discomfort and low compliance rates among users due to issues like bulkiness and the need for constant repositioning. Their construction provides reduced protection against impacts compared to custom-made alternatives, while also causing greater interference with speech, breathing, and swallowing. When selecting a stock mouthguard, users should choose based on age and approximate width—such as small for children under 12, medium for teens, and large for adults—trying it on to assess basic retention without professional guidance.

Boil-and-Bite Mouthguards

Boil-and-bite mouthguards, also known as mouth-formed or self-adapting mouthguards, consist of pre-formed sheets, typically made from (EVA) copolymers, that soften when immersed in hot water and can be personalized by the user through biting and manual shaping. These devices provide an intermediate option between and custom mouthguards, offering improved retention and comfort over fixed-shape alternatives while remaining accessible for home use. Some boil-and-bite mouthguards carry the ADA Seal of Acceptance, indicating they meet standards for fit, retention, and protection. They are widely available at sporting goods stores and are the most commonly used type among athletes, particularly in contact sports like , rugby, and soccer, where studies indicate they are preferred for their immediacy and affordability. The fitting process for boil-and-bite mouthguards is a straightforward DIY procedure that typically takes 5-10 minutes and involves heating the guard to approximately 170°F (76°C) in hot—but not —water for 15-60 seconds, depending on the manufacturer's instructions. To mold correctly:
  • First, check the initial fit by placing the unheated guard in the and biting down to ensure it covers all upper teeth; trim excess edges with if needed for even length.
  • Boil in a pot and submerge the guard using a for the specified time, avoiding contact with the pot's sides or bottom to prevent uneven heating.
  • Remove the softened guard, let it cool on a clean for about 20 seconds or briefly dip in cold to reduce temperature and avoid burns.
  • Place it in the , center it over the upper teeth, bite down gently but firmly starting with the molars, and use fingers, tongue, and lips to press it against the teeth and gums for a tight seal; suck inward to eliminate air pockets and hold for 30 seconds.
  • Finally, submerge in cold for 30 seconds to set the shape, then test the fit and repeat the process if necessary for adjustments.
These mouthguards generally achieve a thickness of 2-3 mm after molding, providing adequate cushioning for impact absorption while allowing for better retention than stock versions. Priced affordably between $10 and $30, they appeal to intermediate users, such as youth athletes, where boil-and-bite types account for a significant portion of usage due to their ease of personalization without professional assistance. Key advantages include their form-fitted design, which enhances comfort and stability during activity, along with low cost and simple home adaptation that promotes consistent wear. However, drawbacks arise from potential inconsistencies in the molding process; overheating beyond the recommended time or temperature can cause warping, material degradation, or burns to oral tissues, while improper technique may introduce air pockets that compromise protection and fit. They also have a shorter lifespan of 3-6 months with regular use, as the material deteriorates over time and may not endure an entire sports season without replacement. Boil-and-bite mouthguards are available in single-layer variants for basic protection or multi-layer designs that incorporate additional cushioning for enhanced shock absorption, though the latter may increase bulk and fitting complexity. Overall, while they offer superior personalization to stock mouthguards, their precision remains inferior to custom-fitted options supervised by dental professionals.

Custom-Made Mouthguards

Custom-made mouthguards are professionally fabricated appliances tailored to an individual's oral anatomy, utilizing precise dental impressions or digital scans to create a form-fitting device that covers the teeth and surrounding structures. These mouthguards are constructed by layering materials, such as (EVA) sheets, to achieve an optimal occlusal thickness typically ranging from 3 to 5 mm, providing balanced protection without excessive bulk. They are typically designed as single-arch models for the upper teeth, though dual-arch variants covering both arches are available for enhanced stability in specific high-risk or therapeutic applications. Custom mouthguards meeting ADA standards, including the Seal of Acceptance, ensure optimal fit, retention, and shock absorption. The fabrication process begins with capturing an exact image of the patient's , either through traditional stone models poured from physical impressions or via CAD/CAM systems that generate digital 3D models for precise design. These models serve as the foundation for or pressure-lamination techniques, where multiple EVA sheets are heated and vacuum- or pressure-formed over the model to build layered structures that distribute force effectively. This professional oversight, often involving a , ensures the mouthguard adheres closely to the teeth contours, minimizing slippage and maximizing protective efficacy. Compared to other types, custom-made mouthguards offer superior fit and retention, allowing athletes to wear them comfortably for extended periods without interference to speech or breathing, making them particularly suitable for high-risk contact sports. They provide enhanced impact absorption, with studies demonstrating better shock dissipation than stock or boil-and-bite alternatives, such as up to 78% energy absorption in EVA-based designs, thereby reducing the force transmitted to teeth and jaws. For instance, custom designs contribute to lower rates of dental injuries. However, these mouthguards come with notable drawbacks, including a higher ranging from $200 to $800, depending on complexity and materials, as well as the need for an initial dental visit to obtain impressions. The production process typically requires a turnaround time of 1 to 2 weeks, rendering them unavailable for immediate use, which can be a limitation for urgent needs. In and , custom-made mouthguards are widely preferred for their reliability, with athletes showing near-universal adoption rates of 100% in some studies, compared to lower usage in team . indicates they significantly reduce orofacial injury incidence, such as in where mouthguard use is often mandatory and associated with decreased by 47% to 60% relative to non-users. Overall, these devices are credited with preventing a substantial portion of sports-related oral injuries, particularly in high-contact activities.

Materials and Construction

Common Materials

Mouthguards have undergone a significant evolution in materials, transitioning from early rubber used prior to the , which is now obsolete due to its potential to cause allergic reactions, to modern thermoplastics that prioritize safety and performance. This shift was driven by advancements in , enabling materials that are more biocompatible and effective at absorbing impacts without compromising user comfort. The most prevalent material in contemporary mouthguards is (EVA), a valued for its shock-absorbing qualities and widespread adoption in both stock and boil-and-bite varieties. EVA typically exhibits a of 0.93–0.95 g/cm³, providing a lightweight yet resilient structure suitable for oral appliances. Its elasticity, characterized by a ranging from 15 to 80 MPa, allows it to deform under impact while returning to shape, enhancing protection against . EVA softens at temperatures between 80–120°C (176–248°F), facilitating easy molding for custom fits. For custom-made mouthguards, particularly in sports, (EVA) is most commonly used, though acrylic resins can be employed for rigidity and in dental applications or layered designs offering enhanced resistance to wear. These resins provide a harder alternative to EVA, with formulations often softened for better patient tolerance while maintaining structural integrity. Polyolefins and copolymers, such as polystyrene-polyolefin blends, are also utilized, particularly in layered designs to combine softness for comfort with added strength for impact distribution. Material selection emphasizes a balance between softness for wearer comfort and hardness for optimal protection, alongside properties to minimize risks. All modern mouthguard materials must adhere to standards for biocompatibility, ensuring they do not provoke adverse tissue reactions. Recent innovations include the incorporation of additives, such as silver nanoparticles into EVA matrices, to reduce bacterial and promote in 2020s models. As of 2025, emerging materials include biodegradable polymers for and smart integrations with sensors in EVA for real-time impact detection.

Fabrication Methods

Stock mouthguards are mass-produced in factories using injection molding techniques to create uniform, one-size-fits-all shapes that approximate the general contours of the human dentition. This process involves injecting molten thermoplastic material into pre-designed molds under high pressure, allowing for efficient, large-scale replication of standard sizes such as small, medium, and large. The resulting devices provide basic protection but lack individual fit due to their generic form. Boil-and-bite mouthguards are fabricated through the of sheets, which are subsequently cut to standard dimensions and pre-formed into a semi-rigid structure suitable for user . These sheets, often made from materials like (EVA), are processed in industrial extruders to produce consistent thickness, followed by to create a basic arch shape that softens upon heating in boiling water for intraoral molding. This method balances affordability with improved fit over stock options, though relies on user technique. Custom mouthguards employ advanced techniques for superior precision and protection, primarily vacuum-forming and pressure-lamination over dental models. In vacuum-forming, a single sheet of , such as EVA, is heated to approximately 120°C and drawn onto a stone model using negative pressure from a vacuum-forming device, ensuring close adaptation to the individual's occlusion. Pressure-lamination builds multi-layer constructs by stacking 2-4 sheets, heating them to 105-120°C, and applying positive —typically 60-75 psi—via a pressure-forming machine to bond layers uniformly and enhance shock absorption. These methods yield higher precision compared to non-custom approaches, with thickness maintained at 3-4 mm for optimal performance. Emerging digital alternatives, such as , have gained prominence since the early 2020s, utilizing intraoral scans to design and fabricate mouthguards via additive manufacturing techniques like digital light processing (DLP). Resins are layered at resolutions up to 100 μm to produce complex, multi-material structures with integrated hard and soft zones, offering up to 55% greater strain reduction under impact than traditional methods. Fabrication relies on specialized equipment, including stone dental models derived from impressions, heat sources like ovens set to 105-120°C (approximately 221-248°F), and precision trimming tools such as burs for post-forming adjustments. Quality control emphasizes thickness uniformity, with literature recommending consistent 3-4 mm profiles (e.g., 3 mm on labial surfaces, 4 mm on incisal edges) for protective without excessive bulk. Innovations in CAD/CAM integration enable , where digital scans inform designs with features like airflow channels, streamlining production from model creation to final product in under 24 hours via fused deposition modeling or vacuum casting from 3D-printed patterns. This reduces traditional lab timelines significantly while allowing customization beyond conventional limits.

Fitting and Maintenance

Fitting Procedures

Fitting a mouthguard begins with ensuring oral hygiene, such as brushing and flossing the teeth to remove debris that could affect the molding process or comfort. The device is then inserted according to its type, with the goal of achieving full coverage of the upper teeth, secure retention, and no interference with breathing or speech. After insertion, users should verify the fit by closing the mouth gently and checking for even contact across the teeth without gagging or slippage. For stock mouthguards, which are pre-fabricated and available in various sizes, fitting involves selecting the appropriate size by trying on multiple options until one provides adequate coverage without excessive bulk or movement. These are worn directly without adaptation, though they may require keeping the mouth closed to maintain position. Boil-and-bite mouthguards, also known as mouth-formed types, require heating the device in boiling water for about 15-30 seconds as per manufacturer guidelines, followed by cooling it briefly under tap water before placing it in the mouth and biting down firmly to mold it to the teeth using finger and tongue pressure. Custom-made mouthguards are fabricated from dental impressions taken by a professional and typically require no initial user adjustment, though a dentist may perform occlusal equilibration post-delivery to balance contacts and ensure proper jaw alignment. Verification of fit includes confirming that the mouthguard covers all upper teeth and extends slightly over the without sharp edges, provides balanced occlusion for even bite distribution, and allows normal jaw movement. check-ups are recommended periodically, especially for growing children or after dental changes, to assess retention and adjust as needed. Users often experience an adaptation period of 1-2 weeks, during which speech may be temporarily affected due to the device's presence, but consistent wear facilitates normalization. Common errors in fitting include overheating boil-and-bite guards, which can warp the material and lead to poor retention, or insufficient biting pressure, resulting in incomplete molding and gaps that cause slippage. For stock types, selecting an ill-sized option may lead to inadequate coverage or discomfort, while custom guards can suffer from misalignment if impressions are inaccurate. Over-biting during molding can create uneven pressure and potential misalignment. Safety considerations emphasize avoiding use of any ill-fitting mouthguard, as it may increase risks of oral trauma, strain, or even aspiration if it dislodges during activity. materials like EVA enhance conformability during fitting, aiding in a secure yet comfortable seal. If fit issues persist, consultation with a is advised to prevent injury.

Care and Durability

Proper care of a mouthguard is essential to maintain its protective function and prevent bacterial proliferation, such as , which can adhere to its surface if not cleaned regularly. After each use, rinse the mouthguard thoroughly under cool running water to remove , debris, and initial bacterial buildup. For deeper cleaning, gently brush it with a soft using mild soap, non-abrasive , or a solution, ensuring all crevices are addressed to eliminate plaque and prevent odor-causing microbes. Avoid hot water or boiling, as it can warp materials like EVA commonly used in mouthguards. Once cleaned, allow the mouthguard to air dry completely before storage to inhibit moisture-related . Storage practices significantly impact a mouthguard's integrity by protecting it from environmental stressors. Keep the mouthguard in a ventilated, protective case when not in use to promote and reduce accumulation that fosters bacterial . Store it away from direct , sources, or high temperatures, as exposure can cause material degradation, discoloration, or distortion in polymers like EVA. The durability of a mouthguard varies by type and usage patterns, with lifespan influenced by factors such as frequency of wear and intensity of activity. mouthguards typically last 3 to 6 months due to their basic fit and rapid wear from repetitive stress. Boil-and-bite models endure 6 to 12 months, offering moderate resilience, while custom-made versions can persist 1 to 2 years thanks to their tailored construction and higher-quality materials. Intense daily use, such as in contact sports, accelerates material fatigue and , potentially requiring earlier replacement. According to the , mouthguards should be replaced when they show signs of wear, , or loss of fit, regardless of age, to ensure continued . Regular inspection is crucial to identify wear that compromises , with replacement guided by visible or performance decline. Examine the mouthguard periodically for cracks, tears, significant thinning (below 3 mm, reducing shock absorption), persistent odor indicating bacterial residue, or discoloration from protein deposition by enzymes. Mouthguards exhibit resistance to saliva enzymes through routine cleaning but remain vulnerable to mechanical degradation from habits like chewing, necessitating earlier replacement to sustain protection. EVA materials provide moderate durability against such wear when maintained properly.

Applications

Sports and Recreation

Mouthguards play a crucial role in contact sports, where they are designed to absorb impacts from direct blows to the face and jaw, thereby protecting teeth, oral tissues, and potentially reducing force transmission to the brain. In boxing, mouthguards have been mandatory since the 1920s following incidents that highlighted their necessity, and they remain required in professional bouts to prevent dental trauma. Similarly, the National Federation of State High School Associations (NFHS) mandates mouthguard use in football, field hockey, ice hockey, and lacrosse for all participants, and in wrestling for participants with braces, applying to athletes aged 6 to 18 in high school and affiliated youth leagues. As of the 2025 NFHS rules, effective 2026, tooth and mouth protectors in football shall not include attachments that do not serve a protective function. In professional ice hockey, the National Hockey League (NHL) does not require mouthguards, though approximately 90% of players voluntarily use them for added protection. For non-contact sports like basketball, mouthguard use is voluntary but strongly recommended by organizations such as the American Dental Association (ADA) to mitigate risks from falls or collisions. In the National Basketball Association (NBA), many players voluntarily wear mouthguards as a preventive measure against dental injuries, given the game's physicality—including elbows, falls, and collisions—that leads to occasional dental incidents. These devices are particularly effective against orofacial injuries in high-impact scenarios, where blows to the can generate forces exceeding 1,000 Newtons, as seen in punches or tackles. Studies indicate that mouthguard users experience significantly lower rates of dental injuries compared to non-users, with one analysis of players showing injury rates of 0.12 per exposure for users versus 0.67 for non-users. Overall, properly fitted mouthguards can reduce the incidence of sports-related dental fractures and injuries by more than 50% in various athletic contexts. Regarding commotio cerebri, or mild from jaw impacts, mouthguards help by cushioning the and dissipating energy, though evidence on their direct role in prevention remains part of broader research. Enforcement of regulations often includes warnings for initial non-compliance, escalating to fines or penalties in youth leagues under NFHS guidelines. To boost compliance among young athletes, flavored and colored mouthguards—such as those infused with fruit or tastes—are increasingly popular, making the gear more appealing and encouraging consistent wear. Certain mouthguard designs incorporate alignment features, with some studies reporting potential ergogenic benefits like 10-20% increases in bite or improvements in performance during acute testing. However, these claims are debated, as systematic reviews highlight inconsistent and advise against relying on mouthguards solely for performance enhancement. In recreational activities, mouthguards provide essential protection against falls, as in where they safeguard against handlebar impacts or crashes, and where they prevent fractures from ground collisions. Adoption rates in amateur leagues vary by sport, with utilization often around 30-50% in non-mandated activities, driven by growing awareness of injury risks. Professional athletes frequently opt for custom-fitted mouthguards for superior fit in high-impact play, and general suggests they may contribute to a 28% reduction in concussions in sports like by stabilizing the during impacts.

Dental and Medical Uses

Mouthguards, particularly in the form of night guards or occlusal splints, play a key role in managing by preventing excessive tooth wear and alleviating associated . involves involuntary grinding or clenching of teeth, often during sleep, which accelerates enamel erosion beyond the normal physiologic rate of 0.02 to 0.04 mm per year. In severe cases, this can lead to significantly accelerated enamel , contributing to sensitivity, fractures, and restorative needs. Custom-fitted night guards create a barrier between upper and lower teeth, redistributing forces and reducing direct contact that causes attrition. Studies indicate that hard occlusal guards can decrease nocturnal activity in a majority of users, thereby reducing and soreness. Custom night guards are commonly recommended for patients with dental restorations, including crowns on implants, to protect them from bruxism-related damage by distributing excessive occlusal forces and preventing wear or stress on implant-supported prostheses. It is generally safe to wear a custom-made night guard over a dental crown on an implant for occasional use. Clear aligners (such as Invisalign) can also be worn over an implant crown if properly fitted and not exerting excessive or uneven pressure; however, they are not typically designed as night guards, so professional evaluation is essential to confirm fit and safety. Occasional wear reduces potential risks compared to regular nightly use. In temporomandibular disorder (TMD) therapy, stabilization splints—often prescribed as mouthguards—help alleviate by maintaining proper occlusion and redistributing occlusal forces to minimize stress. TMD affects 10% to 15% of adults, with symptoms including myofascial , joint clicking, and limited movement, and splints are a first-line conservative treatment for many cases. These devices position the in a neutral , reducing muscle hyperactivity and . A study on hydrostatic oral splints found 90% of patients reported , most commonly around 60% reduction, with overall in function. Short-term use often yields clinically meaningful relief, though long-term efficacy may require combination with physiotherapy. Studies show significant reduction with splint use in TMD therapy. Beyond dental applications, mouthguards extend to medical uses such as post-surgical protection following orthognathic surgery, where they shield healing tissues from inadvertent trauma during recovery. Oral surgeons commonly prescribe custom mouthguards to patients at risk of occlusal instability or injury after jaw procedures, ensuring stable bite alignment. They also serve in orthodontic retention, particularly as hybrid retainer-night guards that maintain post-braces alignment while protecting against grinding. For epilepsy patients prone to seizures, specialized mouthguards prevent tongue biting and oral trauma by cushioning the bite and stabilizing soft tissues during convulsive episodes. Devices like the Protector Against Tongue Injury (PATI) have demonstrated safety and effectiveness in reducing such injuries without interfering with airway management. Customization enhances mouthguard in medical contexts, such as dual-layer designs for comfort in management, where a soft inner layer conforms to teeth while a hard outer layer provides and mandibular advancement. These oral appliances reposition the to maintain airway patency, with studies showing significant symptom relief in mild to moderate cases. All therapeutic mouthguards require oversight, typically prescribed by dentists following clinical , with regular monitoring to assess and make adjustments. Follow-up visits, often every 6 months, evaluate fit, symptom progression, and device wear, ensuring sustained benefits for conditions like and TMD while preventing complications such as bite changes. This dentist-supervised approach optimizes outcomes and integrates mouthguards into broader treatment plans.

History

Origins and Early Development

The origins of the mouthguard trace back to the late in the sport of , where dentist Woolf Krause developed the first "gum shield" in 1890 to protect fighters from lip lacerations and dental impacts during punches. These primitive devices consisted of strips made from , a natural tree resin, or early forms of , which were hand-molded and required boxers to clench them between their teeth for protection. Prior to Krause's innovation, fighters had improvised with materials like , cotton wool, or tape wrapped around the teeth, but these offered minimal efficacy and often shifted during bouts. Adoption began slowly in the and spread to circuits, with the 1920s marking the first widespread commercial availability and regulatory mandates in the sport. Krause's son, , contributed to early reusable designs using rubber, which debuted in high-profile matches and helped establish mouthguards as standard equipment for wrestlers and boxers by the decade's end. , the approved their use following a controversial heavyweight bout between Mike McTigue and that highlighted the risks of unprotected jaws, leading to formal requirements in ; dentist Clearance Mayer further advanced the field in 1930 by publishing techniques for custom-fitted models using materials. Early mouthguards faced significant challenges, including poor fit that demanded constant clenching, which fatigued the , and an unpleasant from the raw natural materials. Usage was initially confined to elite combat athletes due to the handmade nature and , limiting broader until versions emerged. The global spread accelerated in the 1940s, particularly into , where dental injuries accounted for 24% to 50% of all traumas; basic rubber models were introduced to address this, paving the way for Rodney O. Lilyquist's 1947 acrylic splint design that improved retention and comfort for players.

Modern Evolution and Advancements

Following , the development of mouthguards shifted toward synthetic plastics, with early adoption of materials like acrylic resins in the late 1940s, enabling more durable and formable protective devices compared to earlier rubber or natural substances. By the 1950s, vacuum-forming techniques using plastics such as latex and early vinyl derivatives gained prominence, allowing for better customization and shock absorption in sports like football, as promoted through initial research by the (ADA). The boil-and-bite method, which involves heating a sheet and molding it via bite pressure for a semi-custom fit, emerged as a practical innovation in the late , popularized by brands like Shock Doctor in the 1990s for accessible protection without professional fitting. Key material advancements continued into the 1970s and 1980s, with the widespread adoption of (EVA) copolymers for superior energy absorption and flexibility, reducing injury risk in high-impact activities. Custom lamination techniques, involving layered pressure-formed sheets produced in dental laboratories, became standard in the 1980s and 1990s, enhancing thickness uniformity (typically 3-4 mm) and occlusal force distribution for improved comfort and protection. Regulatory progress supported these innovations; the ADA formally recommended mouthguards for contact sports starting in , expanding endorsements in the 1990s to include 29 activities. Performance-oriented designs proliferated in the , such as Under Armour's models, which claimed enhancements like improved through jaw alignment, though independent studies have questioned these benefits. Since the 2010s, digital technologies have transformed fabrication, with intraoral scanning and enabling precise, multilayer custom mouthguards that optimize fit and reduce production time and costs compared to traditional methods. Recent developments from 2020 to 2025 emphasize and functionality, incorporating like shear-strengthening composites for enhanced impact resistance. Smart integrations in prototypes allow real-time data on force and risk via connected devices, with increasing adoption in sports like rugby under World Rugby protocols as of 2025. Sustainability efforts include recyclable thermoplastics, aligning with greener to minimize environmental impact while maintaining durability. Ongoing research underscores these trends, with a 2024 review in Frontiers in Dental Medicine highlighting how material properties like EVA refinements influence athletic performance, including reduced stress transmission and better occlusion stability. The global mouthguard market was valued at approximately USD 4.0 billion in 2024 and projected to reach USD 4.35 billion in 2025, driven by rising sports participation and technological integration.

References

  1. https://www.ada.org/resources/ada-library/oral-health-topics/athletic-mouth-protectors-mouthguards
  2. https://www.mouthhealthy.org/all-topics-a-z/mouthguards
  3. https://www.ncbi.nlm.nih.gov/books/NBK482466/
  4. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?id=OBR
  5. https://pmc.ncbi.nlm.nih.gov/articles/PMC3939571/
  6. https://jada.ada.org/article/S0002-8177(14)64802-9/fulltext
  7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8890597/
  8. https://pmc.ncbi.nlm.nih.gov/articles/PMC4148563/
  9. https://pmc.ncbi.nlm.nih.gov/articles/PMC11810891/
  10. https://paloaltooralhealth.com/p/Mouth-Guard-p69250.asp
  11. https://healthcenter.uga.edu/keep-your-teeth-wear-the-mouthguard/
  12. https://www.promedica.org/blog/why-athletic-mouth-guards-matter
  13. https://www.gotoapro.org/treatments/mouthguards/
  14. https://www.endeavourhillstotallyteeth.com.au/the-ultimate-guide-to-sports-mouthguards-types-benefits-and-uses/
  15. https://sunbit.com/knowledge-center/dental/dental-tips/sports-dental-injury-prevention-mouthguards/
  16. https://pubmed.ncbi.nlm.nih.gov/31148073/
  17. https://pmc.ncbi.nlm.nih.gov/articles/PMC2987604/
  18. https://www.concussionalliance.org/newsletter/2020/2/6/using-helmets-and-mouthguards-to-reduce-concussion-risk
  19. https://www.txcte.org/sites/default/files/resources/documents/Sports-and-Recreation-Safety.pdf
  20. https://jada.ada.org/article/S0002-8177%2814%2964802-9/fulltext
  21. https://assets.nfhs.org/umbraco/media/1014750/position-statement-and-recommendations-for-mouthguard-use-in-sports-october-2018-final.pdf
  22. https://aaoinfo.org/whats-trending/how-much-should-mouthguards-cost/
  23. https://www.dentistryofwestbend.com/the-best-athletic-mouthguards-in-2021/
  24. https://pmc.ncbi.nlm.nih.gov/articles/PMC11311908/
  25. https://www.sisuguard.com/fitting/classic/
  26. https://www.deltadentalia.com/a-healthy-life/healthy-living/how-to-mold-a-mouthguard/
  27. https://www.lenzdds.com/Mouth-Guards-Leawood-Kansas.asp
  28. https://www.mykoolsmiles.com/dental-abcs/faqs/night-guard-teeth-cost/
  29. https://www.osaa.org/docs/health-safety/nfhsmouthguardpositionstatement.pdf
  30. https://www.axiondentalcare.com/how-long-will-my-mouth-guard-last-get-the-most-use/
  31. https://www.prosthodontics.org/assets/1/7/Mouthguard_Use_in_Sports_Position_Statment.pdf
  32. https://onlinelibrary.wiley.com/doi/10.1111/edt.12925
  33. https://glidewelldental.com/solutions/occlusal-appliances/sports-mouthguards/playsafe-sports-mouthguards
  34. https://famecustommouthguard.com/
  35. https://pmc.ncbi.nlm.nih.gov/articles/PMC11139839/
  36. https://www.youtube.com/watch?v=wbvEH9LA-II
  37. https://www.sciencedirect.com/science/article/abs/pii/S0002817714601513
  38. https://pubmed.ncbi.nlm.nih.gov/38794914/
  39. http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162017000200005
  40. https://www.goodrx.com/conditions/dental-care/night-guard-cost
  41. https://www.meridiendental.com/sportsdentistry.php
  42. https://pmc.ncbi.nlm.nih.gov/articles/PMC11778648/
  43. https://www.aapd.org/research/oral-health-policies--recommendations/prevention-of-sports-related-orofacial-injuries/
  44. https://www.researchgate.net/publication/318446389_The_Role_of_Mouthguards_in_Preventing_and_Reducing_Sports-Related_Trauma
  45. https://www.frontiersin.org/journals/dental-medicine/articles/10.3389/fdmed.2024.1513223/full
  46. https://www.nature.com/articles/s41598-022-08018-1
  47. https://www.intechopen.com/chapters/56614
  48. https://austinpublishinggroup.com/austin-dental-sciences/fulltext/ads-v2-id1009.pdf
  49. https://www.prosthodontics.org/about-acp/position-statement-mouthguard-use-in-sports/
  50. https://pubmed.ncbi.nlm.nih.gov/12894661/
  51. https://www.accessdata.fda.gov/cdrh_docs/pdf18/K181099.pdf
  52. https://pubmed.ncbi.nlm.nih.gov/29375094/
  53. https://www.accio.com/business/mouthguard-trends
  54. https://patents.google.com/patent/US6584978B1/en
  55. https://onlinelibrary.wiley.com/doi/full/10.1111/edt.12809
  56. https://www.greatlakesdentaltech.com/media/resources/HeatingTimes-ThermalformingMaterials_S124.pdf
  57. https://pmc.ncbi.nlm.nih.gov/articles/PMC7811939/
  58. https://pmc.ncbi.nlm.nih.gov/articles/PMC7407806/
  59. https://www.researchgate.net/publication/305373962_Rapid_fabrication_of_functional_mouthguard_using_rapid_tooling_approach
  60. https://www.jstage.jst.go.jp/article/jpr/68/1/68_JPR_D_22_00274/_pdf/-char/en
  61. https://my.clevelandclinic.org/health/treatments/10910-mouthguards
  62. https://dx.doi.org/10.32474/OSMOAJ.2022.05.000221
  63. https://pdfs.semanticscholar.org/2883/92f10f819552ce5eb55b4919aa043ef704b9.pdf
  64. https://onlinelibrary.wiley.com/doi/10.1111/edt.12939
  65. https://www.proteethguard.com/blog/how-to-get-used-to-wearing-a-night-guard/
  66. https://goonguard.com/blogs/news/top-5-mouth-guard-mistakes-football-players-make-and-how-to-avoid-them
  67. https://pmc.ncbi.nlm.nih.gov/articles/PMC9745906/
  68. https://theteethdoctors.com/keeping-your-dental-mouth-guard-clean/
  69. https://pmc.ncbi.nlm.nih.gov/articles/PMC8404567/
  70. https://www.chaskafamilydental.com/knowledge-base/mouth-guards
  71. https://www.valleyhillsdentistry.com/blog/2025/06/how-long-do-mouth-guards-last-before-they-need-to-be-replaced
  72. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/practice/dental-standards/aip-review/99_aip_review_april_2025.pdf
  73. https://mydentalhome.com/blog/protecting-their-teeth-do-all-nba-players-wear-mouthguards/
  74. https://pmc.ncbi.nlm.nih.gov/articles/PMC10176392/
  75. https://www.researchgate.net/publication/276440927_Tooth_surface_loss_revisited_Classification_etiology_and_management
  76. https://decisionsindentistry.com/article/occlusal-guards-are-the-unsung-heroes-of-muscle-deprogramming-in-the-short-term/
  77. https://www.mayoclinic.org/diseases-conditions/bruxism/diagnosis-treatment/drc-20356100
  78. https://www.aafp.org/pubs/afp/issues/2015/0315/p378.html
  79. https://www.nature.com/articles/s41405-022-00096-7
  80. https://www.oralsurgeryofutah.com/2018/12/06/did-your-oral-surgeon-recommend-a-mouthguard/
  81. https://chomperlabs.com/products/the-retainer-night-guard-for-night-time-teeth-grinding-and-retention
  82. https://www.thejpd.org/article/s0022-3913%2800%2970005-9/fulltext
  83. https://www.epilepsygroup.com/notes6-35-331/safety-in-epilepsy-and-seizures-have-you-ever-bitten-yo.htm
  84. https://jsdentallab.com/blogs/news/dual-laminate-night-guard
  85. https://www.veenstradental.com/blog/night-guard-usage-supporting-data-on-tooth-damage-reduction-from-bruxism
  86. https://www.dcmouthguards.com/blogs/news/what-is-the-best-mouth-guard-for-mma
  87. https://pocketdentistry.com/of-athletic-dental-injuries-the-mouthguard/
  88. https://pubmed.ncbi.nlm.nih.gov/17241103/
  89. https://www.tandfonline.com/doi/full/10.1080/19424396.2025.2477096
  90. https://blog.sisuguard.com/tbt-history-of-mouthguards
  91. https://www.shockdoctor.com/blogs/posts/mouth-guard-technology-evolved-ages
  92. https://decisionsindentistry.com/article/physics-of-protection-athletic-mouthguards/
  93. https://pmc.ncbi.nlm.nih.gov/articles/PMC6323172/
  94. https://pubmed.ncbi.nlm.nih.gov/34886486/
  95. https://preventbiometrics.com/
  96. https://www.linkedin.com/pulse/global-thermoformed-preformed-mouthguard-market-jjrxf
  97. https://www.imarcgroup.com/sports-mouthguard-market
  98. https://www.skyquestt.com/report/sports-mouthguard-market
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