Academy for Sports Dentistry Position Statement on the use of Mouthguards and other Oral Appliances for the Prevention of Concussion and Enhancement of Strength and Performance
The Academy for Sports Dentistry has not yet (2011) identified any sound, independently peer-reviewed, published scientific research which either supports or refutes the wearing of any type of mouthguard or oral appliance for concussion prevention, or athletic performance and strength enhancement. The Academy for Sports Dentistry supports continued and future scientific dialogue and research which has been substantiated by sound, peer reviewed independent scientific data published in credible journals.
Approved January 27, 2011
A Properly Fitted Mouthguard
An athletic mouthguard is a resilient device or appliance placed inside the mouth to reduce injuries particularly to the teeth and surrounding structures.
For optimal safety and well-being of athletes competing in the 21st Century, the Academy for Sports Dentistry has adopted the position that the single word “mouthguard” must be replaced by the term “a properly fitted mouthguard”.
In contact sports, it is critical that the mouthguard provides protection from direct and indirect impact. It must fit accurately, stay in position during impact, and redistribute the impact’s energy. The criteria for the fabrication or adaptation of a properly fitted mouthguard must include the following considerations:
- Pertinent Medical History
- Dental Status that considers: Dental Caries, Periodontal Status, Developmental Occlusion, Orthodontic or Prosthodontic Appliances, Congenital/Pathological Conditions, Jaw Relationships
- Demographic Factors
- Type of Sport Played
The fitting of a mouthguard is best accomplished under the supervision or direction of a dentist. The athlete and/or parents should always be advised of the special design for the “properly fitted mouthguard” and the end product should have the following properties and considerations:
- It should be fabricated to adequately cover and protect both the teeth in the arch, and the surrounding tissues.
- It should be fabricated on a stone model taken from an impression of the athlete.
- Adequate thickness in all areas to provide for the reduction of impact forces. In particular, a minimum of 3mm thickness in the occlusal/labial area.
- It should have a seated equilibrated occlusion that is balanced for even occlusal contact. This helps to provide for the ideal absorption of impact energy.
- A fit that is retentive and not dislodged on impact.
- Speech considerations equal to the demands of the playing status of the athlete.
- A material that meets FDA approval.
- The properly fitted mouthguard should be routinely and professionally examined for fit and function. Frequency of routine inspection is dependent on factors such as the athlete’s age, the demand of the sport that the athlete is engaged in, and the willingness for the athlete to properly care for the appliance. The frequency of the inspection should be determined by the dental professional for each individual situation and athlete.
Approved by the Academy for Sports Dentistry Board of Directors 04/05/2010
Not all mouthguards are equal. There are 3 different types of mouthguards. The first type is the stock mouthguard. Those type of mouthguards comes pre-formed and is very uncomfortable. The second type is the boil and bite mouthguard. Those type of mouthguards tend to be thin, cumbersome to work with, and is loose fitting. They do offer protection so it is better to have these mouthguards rather than stock mouthguards. The third type of mouthguards are custom mouthguards. These are mouthguards are fitted either by a dentist or by using self impression kits. Custom fitted mouthguards are the best type of mouthguards that anyone can get and it ensures you that you are getting the most protection.
According to Dr. Ray Padilla, an active member in the Academy for Sports Dentistry, the lifetime dental rehabilitation costs can approach several thousand dollars per tooth for the child or athlete who looses a tooth or teeth in a sporting injury. The total rehabilitation costs for a single tooth knocked-out are more than 20 times the preventative cost for a professional grade custom mouthguard. Prevention of oral injuries can save you thousands.
According to the American Dental Association, more than 200,000 oral injuries are prevented annually in this country by sports mouthguards. It is estimated by National Youth Sports Foundation that more than 5 million teeth will be knocked out in sporting activities this year. These oral traumas will happen to children, high school and college level athletes. In fact, dental injuries are the most common type of orofacial injury sustained during participation in sports.
Due to the behavior of material used in manufacturing our mouth guard, it is best not use our mouth guard with braces. There is a high likelihood that brackets will break due to the tight fitting results. It is best to consult a custom mouth guard manufacturer that specializes in mouth guard for braces.
After braces usually an individual is fitted with hawley retainers. The metal wire in the front of the retainer is hazardous and could cause severe damage if you use our mouth guard with retainers, or any mouth guard for that matter. A mouth guard, when properly fitted is secure. Any mouth guard that is loose is not advised to wear. If you have any questions regarding fit, please contact us.
Consult your local dentist if you have any concerns.
Those who have worn our guards know the difference. We spend more time in manufacturing our mouthguards than anyone else (graphics excluded). There is no fancy coating, added futuristic plastic, or any other type of marketing related fluff with our mouthguards. Our thickness control is unmatched in the industry. Because of our manufacturing process, you can be sure that you are getting the highest quality mouthguard in the industry that backed by a dental warranty. Our customer service is superior to others and we treat each customer as if they are the only customer.
Mandibular – Lower Jaw
Orthopedic – Musculoskeletal System
Repositioning – Movement from original position
Appliance – Device or tool
When a mouthguard is in place, regardless of whether it is a boil and bite or a custom mouthguard, there will be a repositioning of the lower jaw created by the device or appliance placed in the mouth. This term has been loosely used by all sorts of mouthguard companies. The term may even have been trademarked. The mouthguard industry are marketed in several categories: boil and bite mouthguards, vacuum formed custom mouthguards, thermoformed custom mouthguards, performance mouthguards, and concussion prevention mouthguards. In all these categories, all companies are jumping on the bandwagon of MORA, vying for more market share.
Our stance is simple, we protect your teeth. We create the highest quality mouthguards with our patented manufacturing process. We do this by using the best equipment, understanding dental anatomy, attention to detail, and practical usage of products made. We are the only manufacturer that utilizes the custom mouthguards what we produce.
There is no dispute that wearing a mouthguard is better than not wearing one. A properly fitted mouthguard gives the best protection that an individual can have. It has been documented and you may have even read in literature that wearing a custom mouthguard moves the jaw downward and forward creates joint space in the TMJ. In theory (not been medically proven), regardless of any technology patents filed, this space may reduce concussive forces to the temporal area. We are not disputing this theory, but claiming that a patented technology is superior than others, that may be a stretch. We would gladly arrange a test case, if approached, and provide our custom mouthguards as control subjects against any other manufacturer making these claims.
I am sure there are other unproven advantages of wearing a custom mouthguard, but bottom line, wear a mouthguard because it will save you money by protecting your teeth.
We have been making mouthguards for years. There is no compelling reason to switch materials though we always are on the look out for breakthroughs in this industry. EVA is the defacto standard in making mouthguards. Even studies can be confusing. You get one study that shows that there is no clear difference and a year later another study shows one product is superior. Before releasing studies, one must pay attention to details, whether they are believable or not. If a study is released in the same state as where the manufacturer of the product is headquartered, is it believable? Tweak the environment another way and maybe we can get a result that another product is better. The PDF Versions of the studies are stored in our database just incase these websites magically disappear one day. In any case, maybe the answer is out there. Just google it and maybe you will find it.
We have been asked about this many times before and we could possibly spend an eternity discussing this topic. Bottom line is that until someone does any test with the mouthguard already manufactured, any other tests that have been performed is just a hypothesis. Even with that in mind, if you show us studies that show one is superior to another, we can show you a different study with different variables that show different results. Below is a similar study much like the above link in impact rating showing that Polyshok is superior:
There is no known published article where they have performed any tests after the mouthguard has already been manufactured. Even the surface area being tested only gives best representation of the type of impact and simulation is only an estimate. With that being said, the below is a link to energy absorption of mouthguard materials: