Mouthguards

NICOLA BALDWIN, NATALIE FITZGERALD, ALINA ATILANO AYALA

Mouthguards

Type of oral splints fabricated to protect the oral cavity from injuries

Protects:

Incisors specifically from frontal blows

Maxillary teeth from mandibular should a blow to jaw occur

Soft tissues

Lips

Cheeks

Tongue

(Duarte-Pereira et al., 2007)

Boil and Bite Mouthguard

Can be purcashed over the counter

Not made from impressions of clients dentiton

Made from thermoplastic material

Most popular type of mouthguard

Used by >90% of athletes

(Winters & Demont, 2014). (Tuna & Ozel, 2014).

Custom Made Mouthguard

Made by dental professional

Maxillary and mandibular impression taken

Wax bite registration taken

Stone models are made

Mouthguard made in dental lab

Vacuum former is used to mold multiple layers of EVA material resulting

in a custom fit

Expensive option

Requires in office visit

(Gawlak, et al, 2016).

Custom Made Mouthguard

PICO
P
Craniofacial injuries related to sports and comfort

I
Custom mouthguards

C
Boil and bite mouthguard

O
Custom made mouthguards more effective and comfortable for athlete

PICO Question

With relation to craniofacial injuries and comfort for the athele, are
custom made mouthguards superior than boil and bite mouthguards in
terms of protection and comfort for athlete?

Boil and Bite VS Custom Made

We believe that custom made mouthguards offer superior protection

and comfort compared to boil and bite type.

Evidence Against

Custom made mouthguards:

Induce gag reflex

Have no advantage over boil and bite with regards to protection from
cerebral concussion

Become loose over time

Thin and perforate as they are worn down

(Gawlak, et al, 2016).

Evidence Against

Boil and bite mouthguards:

More easily accessible

Offer cheaper alternative

(Tuna & Ozel, et al, 2014). (Pressure laminated mouthguards, 2011).

Evidence For

Custom made mouthguard:

Offer athlete a better fit and adaptation to dentition

Higher lever of function and protection due to its smaller dimensions

Less speech difficulties

Led to less clenching and oral dryness

Higher level of fit and comfort

Reduces incidence of mild traumatic brain injury and concussion when worn
properly and with a proper fit

(Gawlak, et al, 2014). (Gawlak, et al, 2016). (Gawlak, et al, 2013). (Winters DDS & DeMont PhD, CAT(C), ATC, 2014). (Winters DDS & DeMont PhD, CAT(C), ATC, 2014).

Evidence For

Standard (boil and bite) mouthguards:

Led to more mucosal irritation and was more uncomfortable to the athlete

Caused breathing difficulties

Caused speaking difficulties, damage to mucosa and TMJ problems.

Very loose retention

Prone to deformation and damage

Difficult to adjust to oral cavity

Uncomfortable fit

Produce bad taste in oral cavity

(Gawlak, et al, 2014). (Gawlak, et al, 2016). (Gawlak, et al, 2013). (Winters DDS & DeMont PhD, CAT(C), ATC, 2014). (Winters DDS & DeMont PhD, CAT(C), ATC, 2014).

Role of the Dental Hygienist

Be aware if clients participate in any sports that put them at risk

Educate the client

Provide options

Advocate for best option for client

References
DenTek Maximum Protection Dental Guard Kit, 3 pc. (n.d.). Retrieved July 19, 2016, from http://www.walmart.com/ip/DenTek-Maximum-Protection-Dental-Guard-Kit-3-pc/22142283

Duarte-Pereira, D., del Rey-Santamaria, M., Javierre-Garcs, C., Barbany-Cair, J., Paredes-Garcia, J., & Valmaseda-Castelln, E. et al. (2008). Wearability and physiological effects of custom-fitted vs self-adapted mouthguards. Dental Traumatology, 24(4), 439-442.
http://dx.doi.org/10.1111/j.1600-9657.2008.00595.x

Gawlak, D., Maka-Malara, K., Kamiski, T., uniewska, M., & Mierzwiska-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 Traumatology
Dental Traumatology. doi:10.1111/edt.12269

Gawlak, D., Mierzwiska-Nastalska, E., Maka-Malara, K., & Kamiski, T. (2014). Assessment of custom and standard, self-adapted mouthguards in terms of comfort and users subjective impressions of their protective function. Dent Traumatol, 31(2), 113-117.
http://dx.doi.org/10.1111/edt.12132

Gawlak, D., Mierzwiska-Nastalska, E., Maka-Malara, K., & Kamiski, T. (2013). Comparison of usability properties of custom-made and standard self-adapted mouthguards. Dent Traumatol,30(4), 306-311. http://dx.doi.org/10.1111/edt.12085

Humphrey, D. (2015). Mouthguards. Lecture, Durham College.

Pressure laminated mouthguards: Role in prevention/reduction of injuries to athletes mouth and brain in contact sports. (2011). Can J Dental Hygiene, 45(1), 9-10.

Tuna, E. B., & Ozel, E. (2014). Factors Affecting Sports-Related Orofacial Injuries and the Importance of Mouthguards. Sports Med Sports Medicine, 44(6), 777-783. doi:10.1007/s40279-014-0167-9

Winters DDS, J. & DeMont PhD, CAT(C), ATC, R. (2014). Role of mouthguards in reducing mild traumatic brain injury/concussion incidence in high school football athletes. General Dentistry, 1-5.