Skip to main content

Factors Affecting Sports-Related Orofacial Injuries and the Importance of Mouthguards

Abstract

Sports dentistry is one of the most recent and upcoming fields in dentistry. It includes mainly the prevention and management of sports-related orofacial injuries and associated oral diseases or traumas. The dentist can play a critical role in informing athletes, coaches, and patients and their parents about the importance of prevention, treatment, and diagnosis for orofacial injuries in sports. The most significant aspect in preventing sports-related orofacial injuries is wearing basic protective devices such as properly fitting helmets, face masks, and/or mouthguards. A properly fitted mouthguard prevents violent contact between the upper and lower dentition. According to the American Society for Testing and Materials, there are three types of mouthguards: custom-fabricated mouthguards, mouth-formed guards, and stock mouthguards. Essential properties of the various materials used in the manufacture of mouthguards include water absorption, density, and thickness as well as temperature transmission, energy absorption, and drawing strength (tensile strength) of custom-made mouthguards. Currently, a variety of materials is being used for mouthguards, most commonly polyvinyl acetate-polyethylene copolymer or ethylene vinyl acetate copolymer and polyvinyl chloride. Mouthguard use is significant for athletes, since dentists play an important role in the design and application of these in clinical practice. The purpose of this article is to review the importance of mouthguard use, the incidence and location of orofacial sports injuries, the risk factors for such injuries, and the types of mouthguards and their roles in the prevention of sports-related orofacial injuries.

This is a preview of subscription content, access via your institution.

References

  1. Kracher CM, Smith WS. Sports-related dental injuries and sports dentistry. http://www.dentalcare.com/en-US/dental-education/continuing-education/ce127/ce127.aspx?moduleName_coursecontent&PartID=1&Section1D=-1. Accessed 13 Aug 2013.

  2. Saini R. Sports dentistry. Natl J Maxillofac Surg. 2011;2:129–31.

    PubMed Central  PubMed  Article  Google Scholar 

  3. Rodd HD, Chesham DJ. Sports-related oral injury and mouthguard use among Sheffield school children. Community Dent Health. 1997;14:25–30.

    CAS  PubMed  Google Scholar 

  4. Smith WS, Kracher CM. Sports-related dental injuries and sports dentistry. Dent Assist. 1998;67:102–16.

    Google Scholar 

  5. Davis GT, Knott SC. Dental trauma in Australia. Aust Dent J. 1984;29:217–21.

    CAS  PubMed  Article  Google Scholar 

  6. Skaare AB, Jacobsen I. Dental injuries in Norwegians aged 7–18. Dent Traumatol. 2003;19:67–71.

    PubMed  Article  Google Scholar 

  7. Macko DJ, Gfrasso JE, Powell EA, et al. A study of fractures teeth in a school population. J Dent Child. 1979;46:130–3.

    CAS  Google Scholar 

  8. Burden DJ. An investigation of the association between overjet size, lip coverage, and traumatic injury to maxillary incisors. Eur J Orthod. 1995;17:513–7.

    CAS  PubMed  Article  Google Scholar 

  9. Hamilton FA, Hill FJ, Holloway PJ. An investigation of dentoalveolar trauma and its treatment in an adolescent population. Part 1: the prevalence and incidence of injuries and the extent and adequacy of treatment received. Br Dent J. 1997;182:91–5.

    CAS  PubMed  Article  Google Scholar 

  10. Kargul B, Caglar E, Tanboga I. Dental trauma in Turkish children, Istanbul. Dent Traumatol. 2003;19:72–5.

    PubMed  Article  Google Scholar 

  11. Andreasen JO, Andreasen FM. Textbook and color atlas of traumatic injuries to the teeth. 4th ed. Oxford: Blackwell Publishing; 2007. p. 220–2.

  12. Braham RL, Roberts MW, Morris ME. Management of dental trauma in children and adolescents. J Traumatol. 1977;17:857–65.

    CAS  Google Scholar 

  13. Chapman PJ. Prevention of orofacial injuries in children and young adolescents. Aust Med Sport. 1986;18:3–6.

    Google Scholar 

  14. American Academy of Pediatric Dentistry. Policy on prevention of sports-related orofacial injuries. http://www.aapd.org/media/Policies_Guidelines/P_Sports.pdf. Accessed 23 Aug 2013.

  15. Caglar E, Kargul B, Tanboga I. Dental trauma and mouthguard usage among ice hockey players in Turkey premier league. Dent Traumatol. 2005;21:29–31.

    PubMed  Article  Google Scholar 

  16. Caglar E, Kuscu OO, Kiranatlioglu G, Sandalli N. Do American football players in Turkey protect themselves from dental or orofacial trauma? Dent Traumatol. 2009;25:115–7.

    PubMed  Article  Google Scholar 

  17. Gassner R, Tuli T, Hachl O, et al. Craniomaxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg. 2003;31:51–61.

    PubMed  Article  Google Scholar 

  18. Newsome PR, Tran DC, Cooke MS. The role of the mouthguard in the prevention of sports-related dental injuries: a review. Int J Pediatr Dent. 2001;11:396–404.

    CAS  Article  Google Scholar 

  19. Petersson EE, Andersson L, Sörensen S. Traumatic oral vs non-oral injuries. Swed Dent J. 1997;21:55–68.

    CAS  PubMed  Google Scholar 

  20. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg. 1972;1:235–9.

    CAS  PubMed  Article  Google Scholar 

  21. Soporowski NJ, Tesini DA, Weiss AI. Survey of orofacial sports-related injuries. J Mass Dent Soc. 1994;43:16–20.

    CAS  PubMed  Google Scholar 

  22. Tysvaer AT. Head and neck injuries in soccer. Impact of minor trauma. Sports Med. 1992;14:200–13.

    CAS  PubMed  Article  Google Scholar 

  23. Bruzzone E, Cocito L, Pisani R. Intracranial delayed epidural hematoma in a soccer player. A case report. Am J Sports Med. 2000;28:901–3.

    CAS  PubMed  Google Scholar 

  24. Yeşil Duymuş Z, Gungor H. Use of mouthguard rates among university athletes during sport activities in Erzurum, Turkey. Dent Traumatol. 2009;25:318–22.

  25. Batista AM, Ferreira Fde O, Marques LS, et al. Risk factors associated with facial fractures. Braz Oral Res. 2012;26:119–25.

    Google Scholar 

  26. Pinkham JR, Kohn DW. Epidemiology and prediction of sport-related traumatic injuries. Dent Clin North Am. 1991;35:609–25.

    CAS  PubMed  Google Scholar 

  27. Glassman M. The first line of defense. N Y State Dent J. 1995;61:48–50.

    CAS  PubMed  Google Scholar 

  28. Rothman D. Pediatric orofacial injuries. J Clin Dent Assoc. 1996;24:37–49.

    CAS  Google Scholar 

  29. Kumamoto DP, Maeda Y. A literature review of sports-related orofacial trauma. Gen Dent. 2004;52:270–80.

    PubMed  Google Scholar 

  30. Järvinen S. Traumatic injuries to upper permanent incisors related to age and incisal overjet: a retrospective study. Acta Odontolol Scand. 1979;37:335–8.

    Article  Google Scholar 

  31. Bauss O, Rohling J, Schwestka-Polly R. Prevalence of traumatic injuries to the permanent incisors in candidates for orthodontic treatment. Dent Traumatol. 2004;20:61–6.

    PubMed  Article  Google Scholar 

  32. Lee-Knight CT, Harrison EL, Price CJ. Dental injuries at the 1989 Canada games: an epidemiological study. J Can Dent Assoc. 1992;58:810–5.

    CAS  PubMed  Google Scholar 

  33. Kumamoto DP. Sports dentistry. Conpendium. 1993;14:492–8.

    CAS  Google Scholar 

  34. Flanders RBM. The incidence of orofacial injuries in sports: a pilot study in Illinois. J Am Dent Assoc. 2005;126:491–6.

    Article  Google Scholar 

  35. Glendor U. Aetiology and risk factors related to traumatic dental injuries: a review of the literature. Dental Traumatol. 2009;25:19–31.

    Article  Google Scholar 

  36. Hoffmann J, Alfter G, Rudolph NK, et al. Experimental comparative study of various mouthguards. Endod Dent Traumatol. 1999;15:157–63.

    CAS  PubMed  Article  Google Scholar 

  37. Winters JE Sr. Commentary: role of properly fitted mouthguards in prevention of sport-related concussion. J Athl Train. 2001;36:339–41.

    PubMed Central  PubMed  Google Scholar 

  38. Biasca N, Wirth S, Tegner Y. The avoidability of head and neck injuries in ice hockey: a historical review. Br J Sports Med. 2002;36:410–27.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  39. Josell SD, Abrams RG. Traumatic injuries to the dentition and its supporting structures. Pediatr Clin North Am. 1982;29:717–43.

    CAS  PubMed  Google Scholar 

  40. Labella CR, Smith BW, Sigurdsson A. Effect of mouthguards on dental injuries and concussions in college basketball. Med Sci Sports Exerc. 2002;34:41–4.

    PubMed  Article  Google Scholar 

  41. Wisniewski JF, Guskiewicz K, Trope M, et al. Incidence of cerebral concussions associated with type of mouthguard used in college football. Dent Traumatol. 2004;20:143–9.

    PubMed  Article  Google Scholar 

  42. Knapik JJ, Marshall SW, Lee RB, et al. Mouthguards in sport activities: history, physical properties and injury prevention effectiveness. Sports Med. 2007;37:117–44.

    PubMed  Article  Google Scholar 

  43. Ranalli DN. Prevention of sports-related traumatic dental injuries. Dent Clin North Am. 2000;44:35–51.

    CAS  PubMed  Google Scholar 

  44. Oikarinen KS, Salonen MAM, Korhonen J. Comparison 238 of the guarding capacities of mouth protectors. Endod Dent Traumatol. 1993;9:115–9.

    CAS  PubMed  Article  Google Scholar 

  45. Johnsen DC, Winters JE. Prevention of intraoral trauma in sports. Dent Clin North Am. 1991;35:657–66.

    CAS  PubMed  Google Scholar 

  46. American Society for Testing and Materials. Standard practice for care and use of athletic mouth protectors. Philadelphia: American Society for Testing and Materials; 2006. ASTM F697-00.

  47. Patrick DG, van Noort R, Found MS. Scale of protection and the various types of sports mouthguard. Br J Sports Med. 2005;39:278–81.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  48. McCarthy MF. Sports and mouth protection. Gen Dent. 1990;38:343–6.

    CAS  PubMed  Google Scholar 

  49. Ranalli DN. Prevention of craniofacial injuries in football. Dent Clin North Am. 1991;35:627–45.

    CAS  PubMed  Google Scholar 

  50. Academy for Sports Dentistry. Position statement: mouthguard mandates. http://www.academyforsportsdentistry.org/Organization/PositionStatement/tabid/58/Default.aspx. Accessed 23 Jun 2010.

  51. Badel T, Jerolimov V, Pandurić J, et al. Custom-made mouthguards and prevention of orofacial injuries in sports. Acta Med Croatica. 2007;61:9–14.

    PubMed  Google Scholar 

  52. Auroy P, Duchatelard P, Zmantar NE, et al. Hardness and shock absorption of silicone rubber for mouth guards. J Prosthet Dent. 1996;75:463–71.

    CAS  PubMed  Article  Google Scholar 

  53. Scott J, Burke FJT, Watts DC. A review of dental injuries and the use of mouthguards in contact team sports. Br Dent J. 1994;176:310–4.

    CAS  PubMed  Article  Google Scholar 

Download references

Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no potential conflicts of interest that are directly relevant to the contents of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elif Bahar Tuna.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tuna, E.B., Ozel, E. Factors Affecting Sports-Related Orofacial Injuries and the Importance of Mouthguards. Sports Med 44, 777–783 (2014). https://doi.org/10.1007/s40279-014-0167-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40279-014-0167-9

Keywords

  • Sport Injury
  • Contact Sport
  • National Collegiate Athletic Association
  • Maxillary Incisor
  • Dental Trauma