Factors associated with mouthguard use and discontinuation among rugby players in Malaysia

Changes in oral functions and speech when using custom-fitted mouthguards: An uncontrolled before-and-after study

BACKGROUND/AIM

Mouthguards are crucial for protecting athletes against orofacial injuries, yet concerns persist regarding their potential impact on oral functions. This study aimed to investigate the effects of sports mouthguards on oral functions and speech over time.

MATERIAL AND METHODS

Thirty national rugby players received custom-fitted mouthguards. Questionnaire responses and speech recordings were collected before mouthguard use and at various intervals after using mouthguards: immediately, 1 week, 2 month, and 6 months. Spectrographic analysis was performed to measure voice onset time (VOT) for /p, b, t, d/ phonemes. Questionnaire responses were assessed with Friedman's test, while VOT changes were examined using one-way repeated measure analysis of variance.

RESULTS

Compliance with mouthguard use improved during training and competitions, with consistent wear reported during matches. Over time, speaking difficulties and lisping decreased significantly (p < .001). The perception of nausea improved (p < .001), stabilizing after 1 month (p = .414). Sensations of bulkiness declined (p < .001). Mouth dryness reduced steadily, with no occurrences reported by all players by the end of the study. None of the participants reported bad breath, ulcers, or redness in the mouth. VOT changed immediately after wearing mouthguards (p < .001), gradually regressing toward the baseline, although not completely reaching it. Players held a favorable view of mouthguard use, with comfort and support for mandatory use increasing over time.

CONCLUSIONS

Custom-fitted mouthguards do not lead to significant long-term disruptions in oral functions. Athletes generally adapt to mouthguard use, reporting improved comfort and greater support for their use.

Mouthguards Based on the Shear-Stiffening Effect: Excellent Shock Absorption Ability with Softness Perception

Mouthguards are used to prevent craniomaxillofacial injuries when collisions happen during contact and high-speed sports. However, poor compliance with mouthguard wear in athletes is attributed to discomfort because of its thickness and hardness. These drawbacks significantly restrict their protective performance for oral tissues and applications during contact sports; as a result, the incidence of craniomaxillofacial injuries increases. In this study, non-Newton material is introduced into mouthguard material and then a mouthguard with shear-stiffening behavior is fabricated, which is named the shear-stiffening mouthguard (SSM). Compared with commercial mouthguard materials (Erkoflex and Erkoloc-pro), SSMs show remarkable enhancement of shock absorption ability with an approximately 60% reduction in peak force relative to commercial materials and approximately 3-fold extensive buffer time. Moreover, Young's modulus of SSMs (average 0.48 MPa) is extremely lower compared to commercial materials (22.88 MPa for Erkoflex and 26.71 MPa for Erkoloc-pro). This manifests that SSMs have not only excellent shock absorption ability but also softness perception. Moreover, SSMs show biocompatibility in vitro. In conclusion, this work provides a platform to develop a new type of thin and soft mouthguard with a shear-stiffening effect and broadens the horizon in protecting oral tissues with shear-stiffening materials.

The use of mouthguards and related factors among basketball players in Indonesia

BACKGROUND

Basketball is a sport with a higher injury rate. Regardless, few basketball players use mouthguards, which predisposes them to injuries. The use of mouthguards (UoM) could be related to several factors. This study aims to identify factors associated with UoM and to construct a model from the factors among basketball players in Indonesia.

METHODS

Through convenience sampling, a total of 286 among basketball players in Indonesia was included in this cross-sectional study. These participants filled out online a modified questionnaires regarding demographic and several factors related to UoM. The data was analyzed using chi-square test, independent-sample t-test, binary logistic regression, and structural equation modeling (SEM).

RESULTS

There were 286 players. 127 of them were males and 159 were females. Of them, 86 (30.1%) used mouthguards. Age, duration (in year), and weekly practicing basketball (in hour) were all significantly different between mouthguards users and non-users with (p = 0.005, p = 0.036 and p = 0.035), respectively. The UoM was significantly associated with level of awareness, injury experience, social support, and oral health professional (OHP) support with (p = 0.002, p < 0.001, p < 0.001 and p < 0.001), respectively. This result was also supported by a variety of variables' ORs, which range from 1.28 to 5.97. The coefficient of determination (R2) was 0.27.

CONCLUSIONS

The UoM among basketball players in Indonesia was related to several factors, including the level of knowledge, level of awareness, duration of basketball career, injury experiences, social support, and oral health professionals' support which was constructed to propose a model. The model could explain 27% of the relationship between variables and UoM among Indonesian basketball players. This model will be useful for more comprehensive initiatives to promote oral health. It might be applicable for other countries as well as other sports communities / physical activities.

Improving the Wearing Rate of Mouthguards in the Youth Rugby Category Affects the Total Future Mouthguard Wearing Rate

The aim of this study is to consider the hypothesis that wearing mouthguards (MGs) from a young age helps to shape players’ habit of continuing to wear MGs as adults. In addition, we consider the mandatory rule of wearing mouthguards in the youth category on the future wearing rates of mouthguards. Eighty-five Japanese male amateur rugby players were included in this study. We examined the relationship between the wearing rates of mouthguards when participants were high school students and as adults (in 2018) using a questionnaire. Collected data were classified into categories (age, mouthguard type, and applied mandatory rule or not), and their relationships were analyzed. The wearing rate of mouthguards in high school was significantly related to the wearing rate of mouthguards in adulthood (χ2 = 12.1, p < 0.01). The mandatory rule to wear mouthguards at high school was related to the wearing rates of mouthguards as adults, but not significantly (χ2 = 3.42, p = 0.06). Participants’ mouthguard wearing rates as adults were affected by their high school wearing rates. The mandatory rule of wearing mouthguards in the youth category may be somewhat effective for improving mouthguard wearing rates; however, it is more important to provide knowledge about their importance.

Physiological Effects of Wearing Athletic Mouth Pieces While Performing Various Exercises

The purpose of this study is to evaluate physiological responses associated with exercise using two different mouthpieces compared with not using a mouthpiece. Improved performance while using the PX3 Bite Regulator (PX3) may significantly reduce the risk of concussions by allowing an athlete to better prepare, react, absorb, and/or avoid impact completely compared with the restricted breathing or mandibular instability that occurs when using mouthguards. Twenty-three subjects completed a battery of five physiological tests; the 1.5-mile run, sit and reach, anaerobic endurance, leg press, and bench press. Each test battery was completed under three conditions: wearing a PX3, wearing a mouthguard, or no mouthpiece respectfully. The PX3 resulted in significantly faster 1.5-mile run times (667.4 ± 9.4 vs. 684.9 ± 9.2 vs. 679 ± 7.9 s, p ≤ 0.05) and significantly longer anaerobic endurance runs (311 ± 23 vs. 283 ± 18 vs. 286 ± 18yds, p ≤ 0.05) compared with the mouthguard and no mouthpiece. The leg press lifts (51.8 ± 4.1 vs. 46.0 ± 4.3, p ≤ 0.05) while wearing the PX3 were significantly greater than when wearing a mouthguard. There were improvements, but no significant differences for sit and reach (16.8 ± 0.8 vs. 15.9 ± 0.8 vs. 16.4 ± 0.8 in., p = 0.73) and bench press (17.7 ± 1.8 vs. 17.2 ± 1.6 vs. 17.2 ± 1.7 lifts, p = 0.94). The increased performance with the PX3 could be a result of better jaw alignment and/or decreased resistance to airflow.

The Role of Mouthguards in Preventing and Reducing Sports-related Trauma

a mouthguard, also known as a gumshield, mouth protector or sports guard is an appliance that covers the teeth and surrounding mucosa with the aim of preventing or reducing trauma to the teeth, gingival tissue, lips and jaws. The device is usually worn on the maxillary arch and works by separating the maxillary and mandibular dentition, protecting the teeth from the surrounding soft tissue, absorbing or redistributing shock and/or stabilising the mandible during traumatic jaw closure. They may also play a role in preventing and reducing concussion by absorbing impact forces that would otherwise be transmitted through the base of the skull to the brain, although the evidence for this is less conclusive. A mouthguard will usually fall into one of three categories: stock mouthguards (which are made ready to use and are believed to give the least protection), the mouth-formed or 'boil and bite' type (which are heated in hot water, placed in the mouth and moulded to the teeth) and custom-made mouthguards (which are usually made on a stone model of the maxillary teeth and surrounding tissue and are thought to give the most protection). These devices can be made from various materials but ethylene-vinyl acetate is by far the most popular material, probably because of the ease with which it can be used for the production of custom-made mouthguards. This paper gives a review of the role of mouthguards in preventing and reducing sports-related trauma and examines the materials that are used to fabricate them.

Association of dental trauma experience and first-aid knowledge among rugby players in Malaysia

OBJECTIVES

To assess and compare the knowledge of rugby players regarding first-aid measures for dental injuries.

METHODS

A cross-sectional study was conducted at rugby tournaments in 2009 and 2010 on players aged 16 and over. Convenient sampling was performed. A total of 456 self-administered questionnaires were returned. Data collected were analysed using SPSS 21. Descriptive analysis was undertaken for the demographic data. The subjects were classified according to their experience of sustaining each type of injury. Cross-tabulation and chi-square tests were carried out to compare the responses. When the expected cell count was less than five, Fisher's exact test was used. The level of significance was set at P < 0.05.

RESULTS

The prevalence of self-reported dental injuries was as follows: tooth fracture (19.3%), luxation (6.6%) and avulsion (1.1%). Significant differences were found, whereby 52.2% of those who had no history of tooth fracture were more likely to seek immediate treatment (P < 0.001), whereas 42% of those who previously experienced tooth fracture claimed that they would only visit a dentist if they experienced pain (P = 0.001). Management of luxation and avulsion did not differ significantly between the groups. However, about half of those who did not have a history of tooth avulsion admitted to not knowing the correct answer, while three of five casualties would keep the tooth iced.

CONCLUSIONS

Knowledge of the management of tooth fracture and storage medium differs between previous casualties and non-casualties. Overall, knowledge of dental trauma management was insufficient, suggesting the need to educate and train the players.

Sports dentistry: A review

Dental trauma in sports is the major linking channel between sports and dentistry. Sports dentistry is the prevention of oral/facial athletic injuries and related oral diseases and manifestations. In children, sports activities were found to be responsible for 13% of overall oral trauma. It is emphasized that there is a great need for "Team Dentist" from high schools to professional teams. In this review, we discuss the relationship between sports and dentistry, and the importance of educating parents, teachers, and children in prevention of injuries related to the sports.