Skip to main content

Advertisement

SpringerLink
Log in

An analysis of athletes' knowledge, acceptance and usability toward custom-made mouthguards: uncontrolled before–after study

  • Original Article
  • Published:
Sport Sciences for Health Aims and scope Submit manuscript

Abstract

Background

Dentofacial trauma in sports is considered a major public oral health problem. Despite the recommendation to use mouthguards in several sports, their use routinely for training and competition is still very low.

Aims

An uncontrolled before–after interventional study was performed to evaluate athletes’: (1) knowledge about mouthguard (2) acceptance evaluating before vs after use custom-made mouthguard, and (3) usability comparing boil-and-bite vs custom-made mouthguard.

Methods

Sixty amateur athletes participated in the study. A custom-made mouthguard was produced for each athlete. All athletes answered two questionnaires: (1) knowledge about mouthguards and (2) visual analogue scale (VAS) regarding the parameters: comfort, fit, stability, tiredness, thirsty, dry mouth, nausea, communication, ability to drink, breath, altered taste, and protection. VAS was applied at three different moments: (1) about boil-and-bite mouthguard (questionnaire applied only to athletes who had already used this dispositive), (2) before the delivery of the custom-made mouthguard, (3) after a familiarization period of 30 days using custom-made mouthguard. For statistical analyses, Wilcoxon test was used with a level of significance set at 5% (p < 0.05).

Results

Forty-four athletes knew or had seen a mouthguard and twenty athletes already used the boil-and-bite mouthguard. Acceptance increased in all parameters analyzed after the use of custom-made mouthguards when compared to before using them. Communication had the worst results considering all parameters assessed. However, communication evaluation increased significantly with the use of custom-made mouthguard (3.64 ± 2.99: boil-and-bite; 8.93 ± 1.54: custom-made).

Conclusions

Although most athletes knew the mouthguards, most of them did not use this device routinely during training and competitions. The acceptance regarding the use of mouthguard was great. All parameters analyzed showed better usability with the custom-made mouthguard in comparison to boil-and-bite mouthguard.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Robbins J, Gangnon RE, Theis SM, Kays SA, Hewitt AL, Hind JA (2005) The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc 53(9):1483–1489. https://doi.org/10.1111/j.1532-5415.2005.53467.x

    Article  PubMed  Google Scholar 

  2. Clark HM (2008) The role of strength training in speech sound disorders. Semin Speech Lang 29:276–283. https://doi.org/10.1055/s-0028-1103391

    Article  PubMed  Google Scholar 

  3. Freiwald HC, Schwarzbach NP, Wolowski A (2020) Effects of competitive sports on temporomandibular dysfunction: a literature review. Clin Oral Investig 25:55–65. https://doi.org/10.1007/s00784-020-03742-2

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sannajust JP, Thiery C, Poumarat G, Vanneuville G, Barthélémy I, Mondie JM (2002) Forces occlusales maximales isométriques et sport. Etude préliminaire [Maximal isometric bite force and sports. Preliminary study]. Rev Stomatol Chir Maxillofac 103(3):141–147 (French)

  5. Gassner R, Bösch R, Tuli T, Emshoff R (1999) Prevalence of dental trauma in 6000 patients with facial injuries: implications for prevention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:27–33. https://doi.org/10.1016/s1079-2104(99)70290-8

    Article  CAS  PubMed  Google Scholar 

  6. ADA Council on Access, Prevention and Interprofessional Relations, ADA Council on Scientific Affairs (2006) Using mouthguards to reduce the incidence and severity of sports-related oral injuries. J Am Dent Assoc 137:1712–1720. https://doi.org/10.14219/jada.archive.2006.0118

  7. Polmann H, Melo G, Conti Réus J, Domingos FL, de Souza BDM, Padilha AC et al (2019) Prevalence of dentofacial injuries among combat sports practitioners: a systematic review and meta-analysis. Dent Traumatol 36:124–140. https://doi.org/10.1590/0102-311X00015920

    Article  PubMed  Google Scholar 

  8. Werlich MO, Honnef LR, Bett JVS, Domingos FL, Pauletto P, de Souza BDM, Duque TM, Hallal ANC, Canto GDL (2020) Prevalence of dentofacial injuries in contact sports players: a systematic review and meta-analysis. Dent Traumatol 36(5):477–488. https://doi.org/10.1111/edt.12556

  9. Tuna EB (2014) Factors affecting sports-related orofacial injuries and the importance of mouthguards. Sports Med 44:777–783. https://doi.org/10.1007/s40279-014-0167-9

    Article  PubMed  Google Scholar 

  10. Biagi R, Cardarelli F, Butti A, Salvato A (2010) Sports-related dental injuries: knowledge of first aid and mouthguard use in a sample of Italian children and youngsters. Eur J Paediatr Dent 11:66–70

    CAS  PubMed  Google Scholar 

  11. Vucic S, Drost RW, Van Wijk AJ, Wesselink PR, Wolvius EB (2016) Patterns of orodental injury and mouthguard use in Dutch field hockey. Sports Med 50:661–668. https://doi.org/10.1136/bjsports-2015-095677

    Article  Google Scholar 

  12. Kvittem B, Hardie NA, Roettger M, Conry J (1998) Incidence of orofacial injuries in high school sports. J Public Health Dent 58(4):288–293. https://doi.org/10.1111/j.1752-7325.1998.tb03011.x

    Article  CAS  PubMed  Google Scholar 

  13. Knapik JJ, Marshall SW, Lee RB, Darakjy DD, Jones SB, Mitchener TA, de la Cruz GG, Jones BH (2007) Mouthguards in sport activities: history, physical properties and injury prevention effectiveness. Sports Med 37(2):117–144

    Article  PubMed  Google Scholar 

  14. Ferrari CH, Ferreira De Medeiros JM (2002) Dental trauma and level of information: mouthguard use in different contact sports. Dent Traumatol 18:144–147. https://doi.org/10.1034/j.1600-9657.2002.00017.x

    Article  PubMed  Google Scholar 

  15. Correa MB, Schuch HS, Collares K, Hallal PC, Demarco FF (2010) Survey on the occurrence of dental trauma and preventive strategies among Brazilian professional soccer players. J Appl Oral Sci 18:572–576. https://doi.org/10.1590/s1678-77572010000600007

    Article  PubMed  PubMed Central  Google Scholar 

  16. Dursun E, Ilarslan YD, Ozgul O, Donmez G (2015) Prevalence of dental trauma and mouthguard awareness among weekend warrior soccer players. J Oral Sci 57:191–194. https://doi.org/10.2334/josnusd.57.191

    Article  CAS  PubMed  Google Scholar 

  17. Farrington T, Coward T, Onambele-Pearson G, Taylor RL, Earl P, Winwood K (2016) An investigation into the relationship between thickness variations and manufacturing techniques of mouthguards. Dent Traumatol 32:14–21. https://doi.org/10.1111/edt.12192

    Article  PubMed  Google Scholar 

  18. Gawlak D, Mańka-Malara K, Mierzwińska-Nastalska E, Gieleta R, Kamiński T, Łuniewska M (2017) A comparison of impact force reduction by polymer materials used for mouthguard fabrication. Acta Bioeng Biomech 19:89–95

    PubMed  Google Scholar 

  19. Lloyd JD, Nakamura WS, Maeda Y et al (2017) Mouthguards and their use in sports: report of the 1st International Sports Dentistry Workshop. Dent Traumatol 33:421–426. https://doi.org/10.1111/edt.12375

    Article  PubMed  Google Scholar 

  20. Parker K, Marlow B, Patel N, Gill DS (2017) A review of mouthguards: effectiveness, types, characteristics and indications for use. Br Dent J 222:629–633. https://doi.org/10.1038/sj.bdj.2017.365

    Article  CAS  PubMed  Google Scholar 

  21. Gawlak D, Mańka-Malara K, Kamiński T, Łuniewska M, Mierzwińska-Nastalska E (2016) Comparative evaluation of custom and standard boil-and-bite (self-adapted) mouthguards and their effect on the functioning of the oral cavity. Dent Traumatol 32:416–420. https://doi.org/10.1111/edt.12269

    Article  PubMed  Google Scholar 

  22. Badel T, Jerolimov V, Pandurić J (2007) Dental/orofacial trauma in contact sports and intraoral mouthguard programmes. Kinesiology 39(1):97–105

    Google Scholar 

  23. Kujala UM, Taimela S, Antti-Poika I, Orava S, Tuominen R, Myllynen P (1995) Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data. BMJ 311(7018):1465–1468

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Newsome PRH, Tran DC, Cooke MS (2001) The role of the mouthguard in the prevention of sports-related dental injuries: a review. Int J Pediatr Dent 11(6):396–404

    Article  CAS  Google Scholar 

  25. Ranalli DN (2002) Sports dentistry and dental traumatology. Dent Traumatol 18(5):231–236

    Article  PubMed  Google Scholar 

  26. Kumamoto DV, Maeda Y (2004) A literature review of sport-related orofacial trauma. Gen Dent 52(3):270–281

    PubMed  Google Scholar 

  27. Deyoung AK, Robinson E, Godwin WC (1994). Comparing comfort and wearability: custom-made vs. selfadapted mouthguards. J Am Dent Assoc 125(8):1112–1118

  28. Lang B, Pohl Y, Filippi A (2002) Knowledge and prevention of dental trauma in team handball in Switzerland and Germany. Dent Traumatol 18:329–334. https://doi.org/10.1034/j.1600-9657.2002.00123.x

    Article  PubMed  Google Scholar 

  29. Schildknecht S, Krastl G, Kühl S, Filippi A (2012) Dental injury and its prevention in Swiss rugby. Dent Traumatol 28:465–469. https://doi.org/10.1111/j.1600-9657.2012.01115.x

    Article  PubMed  Google Scholar 

  30. Zamora-Olave C, Willaert E, Montero-Blesa A, Riera-Punet N, Martinez-Gomis J (2018) Risk of orofacial injuries and mouthguard use in water polo players. Dental Traumatol 34:406–412. https://doi.org/10.1111/edt.12434

    Article  Google Scholar 

  31. Ifkovits T, Kühl S, Connert T, KrastlDagassan-BerndtFilippi GDA (2015) Prevention of dental accidents in Swiss boxing clubs. Swiss Dent J 125:1322–1335

    PubMed  Google Scholar 

  32. Gawlak D, Mierzwinska-Nastalska E, Manka-Malara K, Kaminski T (2014) Comparison of usability properties of custom-made and standard self-adapted mouthguards. Dent Traumatol 30:306–311. https://doi.org/10.1111/edt.12085

    Article  PubMed  Google Scholar 

  33. Sepet E, Aren G, DoganOnur O et al (2014) Knowledge of sports participants about dental emergency procedures and the use of mouthguards. Dent Traumatol 30:391–395. https://doi.org/10.1111/edt.12105

    Article  PubMed  Google Scholar 

  34. Vucic S, Drost RW, Ongkosuwito EM, Wolvius EB (2016) Dentofacial trauma and players’ attitude towards mouthguard use in field hockey: a systematic review and meta-analysis. Br J Sports Med 50:298–304. https://doi.org/10.1136/bjsports-2015-094896

  35. Escosteguy CC (1999) Methodological and statistical topics in randomized controlled clinical trials. Arq Bras Cardiol 72(2):139–143. https://doi.org/10.1590/S0066-782X1999000200002

  36. Sedgwick P (2014) Before and after study designs. BMJ 349:g5074. https://doi.org/10.1136/bmj.g5074

    Article  PubMed  Google Scholar 

  37. Gawlak D, Mierzwińska-Nastalska E, Mańka-Malara K, Kamiński T (2015) Assessment of custom and standard, self-adapted mouthguards in terms of comfort and users subjective impressions of their protective function. Dental Traumatol 31:113–117. https://doi.org/10.1111/edt.12132

    Article  Google Scholar 

  38. Collares K, Correa MB, da Silva ICM, Hallal PC, Demarco FF (2014) Effect of wearing mouthguards on the physical performance of soccer and futsal players: a randomized cross-over study. Dent Traumatol 30(1):55–59. https://doi.org/10.1111/edt.12040

    Article  PubMed  Google Scholar 

  39. Çetinbas T, Sönmez H (2006) Mouthguard utilization rates during sport activities in Ankara, Turkey. Dent Traumatol 22:127–132. https://doi.org/10.1111/j.1600-9657.2006.00397.x

    Article  PubMed  Google Scholar 

  40. Johnsen DC, Winters JE (1991) Prevention of intraoral trauma in sports. Dent Clin North Am 35(4):657–666

    Article  CAS  PubMed  Google Scholar 

  41. Johnston T, Messer LB (1996) An in vitro study of the efficacy of mouthguard protection for dentoalveolar injuries in deciduous and mixed dentitions. Endod Dent Traumatol 12:277–285. https://doi.org/10.1111/j.1600-9657.1996.tb00527.x

    Article  CAS  PubMed  Google Scholar 

  42. Hoffmann J, Alfter G, Rudolph NK, Goz G (1999) Experimental comparative study of various mouthguards. Endod Dent Traumatol 15(4):157–163

    Article  CAS  PubMed  Google Scholar 

  43. Park JB, Shaull KL, Overton B, Donly KJ (1994) Improving mouthguards. J Prosthet Dent 72(4):373–380

    Article  CAS  PubMed  Google Scholar 

  44. Guérard S, Barou JL, Petit J, Poisson P (2017) Characterization of mouthguards: impact performance. Dent Traumatol 33:281–287. https://doi.org/10.1111/edt.12329

    Article  CAS  PubMed  Google Scholar 

  45. Ranalli DN (2002) Sports dentistry and dental traumatol. Dent Traumatol 18(5):231–236

    Article  PubMed  Google Scholar 

  46. Westerman B, Stringfellow PM, Eccleston JA, Harbrow DJ (2002) Effect of ethylene vinylacetate (EVA) closed-cell foam and its effect on transmitted forces in mouthguard material. Br J Sports Med 36(3):205–208

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Zadik Y, Jeffet U, Levin L (2010) Prevention of dental trauma in a high-risk military population: the discrepancy between knowledge and willingness to comply. Mil Med 175:1000–1003. https://doi.org/10.7205/milmed-d-10-00150

    Article  PubMed  Google Scholar 

  48. Gardiner DM, Ranalli DN (2000) Attitudinal factors influencing mouthguard utilization. Dent Clin North Am 44:53–65

    Article  CAS  PubMed  Google Scholar 

  49. Eroğlu E, Diljin KA, Lütfi BM (2006) Elite tae kwon do athletes’ satisfaction with custom-made mouthguards. Dent Traumatol 22:193–197. https://doi.org/10.1111/j.1600-9657.2006.00385.x

    Article  PubMed  Google Scholar 

  50. Hersberger S, Krastl G, Kühl S, Filippi A (2012) Dental injuries in water polo, a survey of players in Switzerland. Dent Traumatol 28:287–290. https://doi.org/10.1111/j.1600-9657.2011.01083.x

    Article  PubMed  Google Scholar 

  51. Maestrello C, Mourino AP, Farrington FH (1999) Dentists’ atitudes towards mouthguard protection. Pediatr Dent 21(6):340–346

    CAS  PubMed  Google Scholar 

  52. Berg R, Berkey, DB Tang, JMW, Altman DS, Londeree KA (1998) Knowledge and attitudes of Arizona high-school coaches regarding orofacial injuries and mouthguard use among athletes. J Am Dent Assoc 129:1425–1432. https://doi.org/10.14219/jada.archive.1998.0077

  53. von Arx T, Flury R, Tschan J, Buergin W, Geiser T (2008) Exercise capacity in athletes with mouthguards. Int J Sports Med 29:435–438. https://doi.org/10.1055/s-2007-965341

    Article  Google Scholar 

  54. De Young AK, Robinson E, Godwin WC (1994) Comparing comfort and wearability: custom-made vs. self-adapted mouthguards. J Am Dent Assoc 125:1112–1118. https://doi.org/10.14219/jada.archive.1194.0121

  55. Duddy FA, Weissman J, Lee RA, Paranjpe A, Johnson JD, Cohenca N (2012) Influence of different types of mouthguards on strength and performance of collegiate athletes: a controlled-randomized trial. Dental Traumatol 28:263–267. https://doi.org/10.1111/j.1600-9657.2011.01106.x

    Article  Google Scholar 

  56. Duarte-Pereira DM, Del Rey-Santamaria M, Javierre-Garcés C, Barbany-Cairó J, Paredes-Garcia J, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C (2008) Wearability and physiological effects of custom-fitted vs self-adapted mouthguards. Dent Traumatol 24:439–442. https://doi.org/10.1111/j.1600-9657.2008.00595.x

    Article  PubMed  Google Scholar 

  57. Ferreira GB, Guimarães LS, Fernandes CP, Dias RB, Coto NP, Antunes LAA, Antunes LS (2019) Is there enough evidence that mouthguards do not affect athletic performance? A systematic literature review. Int Dent J 69:25–34. https://doi.org/10.1111/idj.12406

    Article  PubMed  Google Scholar 

  58. Björn L, Yango P, Andreas F (2002) Knowledge and prevention of dental trauma in team handball in Switzerland and Germany. Dent Traumatol 18:329–334

    Article  Google Scholar 

  59. Fernandes LM, Neto JC, Lima FRT, Magno MB, Santiago BM, Cavalcanti YW, de Almeida LFD (2019) The use of mouthguards and prevalence of dento-alveolar trauma among athletes. A systematic review and meta-analysis. Dent Traumatol 35:54–72. https://doi.org/10.1111/edt.12441

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We are indebted to the study participants. This study was supported by individual scholarships (FAPERJ – Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (#E-26/010.002195/2019), CAPES – Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico, FOPESQ/UFF).

Author information

Author notes

  1. Sandra Regina Santos Meyfarth and Katherine Azevedo Batistela Rodrigues contributed equally to this article.

Authors and Affiliations

  1. Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil

    Sandra Regina Santos Meyfarth, Rodrigo Von Held, Lívia Azeredo Alves Antunes & Leonardo Santos Antunes

  2. Postgraduate Program in Dentistry of Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, RJ, Brazil

    Katherine Azevedo Batistela Rodrigues, Lívia Azeredo Alves Antunes & Leonardo Santos Antunes

  3. Graduation Student, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil

    Philippe Sarkis & Luiz Edmundo Costa Gouvea Junior

  4. Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil

    Lívia Azeredo Alves Antunes & Leonardo Santos Antunes

Authors
  1. Sandra Regina Santos Meyfarth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katherine Azevedo Batistela Rodrigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rodrigo Von Held
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Philippe Sarkis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luiz Edmundo Costa Gouvea Junior
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lívia Azeredo Alves Antunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Leonardo Santos Antunes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandra Regina Santos Meyfarth.

Ethics declarations

Ethical approval

The study was approved by the local Ethics and Research Committee (# 2175625) by resolution 466/12 of the National Health Commission.

Conflict of interest

All the authors declare no conflict of interest.

Human and animal rights

Not applicable.

Informed consent

Appropriate written informed consent term was obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Meyfarth, S.R.S., Rodrigues, K.A.B., Von Held, R. et al. An analysis of athletes' knowledge, acceptance and usability toward custom-made mouthguards: uncontrolled before–after study. Sport Sci Health 19, 267–275 (2023). https://doi.org/10.1007/s11332-022-00919-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11332-022-00919-y

Keywords

Search

Navigation