Mouthguard

A mouthguard is a protective device for the

A thermoplastic material manufactured in a pre-formed shape in various sizes that can be adapted to fit more closely to an individual's teeth and gums by heating and molding such as boiling then placing in the mouth. Some are now available that incorporate special fins within the fitting zones which increase retention and give an improved fit over traditional boil-and-bite mouth types. Guards are usually made of Ethylene-vinyl acetate, commonly known as EVA. Some of the newer technologies offer an alternative, stronger thermo-polymer that allows for lower molding temperatures, below 140F to prevent burning by scalding hot water. This is the most popular mouthguard used by amateur and semi-professional sportsmen, providing adequate protection but relatively low comfort in comparison to the custom-made guard.^[2]

Custom-made

An impression of the user's teeth is used to create a best-fit mouth protector. The impression may be obtained by using a specially designed impression kit that uses dental putty, or from a dentist who will take an impression in dental

• Vacuum form
  • Custom-made mouth guards using this type of machine produce single layer mouth guards
  • Fit not as good as pressure laminated but offers more protection than boil and bite
• Pressure laminated
  • Custom-made mouth guards using this type of machine produce multi-layer mouth guards
  • Offers superior fit, comfort and more protection
• Impressionless
  • Made from a medical-grade thermo polymer, the guards are activated with hot (not boiling) water and create a custom comfort fit, completely unique to the shape of the mouth.
  • 1.6 mm thin, Remoldable, Works with braces, Stays secure in mouth during the entire game or practice
  • Allows athletes to talk, breathe and drink naturally

Dentistry

Occlusal splints (also called bite splints, bite planes, or night guards) are removable dental appliances carefully molded to fit the upper or lower arches of teeth.^[3]

They are used to protect tooth and restoration surfaces, manage mandibular (jaw) dysfunction

Occlusal splints are typically made of a heat-cured acrylic resin. Soft acrylic or light cured composite, or vinyl splints may be made more quickly and cheaply, but are not as durable, and are more commonly made for short-term use. Soft splints are also used for children because normal growth changes the fit of hard splints.[5]

They cover all the teeth of the upper or lower arch, but partial coverage is sometimes used. Occlusal splints are usually used on either the upper or the lower teeth, termed maxillary splints or mandibular splints respectively, but sometimes both types are used at the same time. Maxillary splints are more common, although various situations favor mandibular splints.

Stabilizing or Michigan-type occlusal splints are generally flat against the opposing teeth, and help jaw muscle relaxation, while repositioning occlusal splints are used to reposition the jaw to improve occlusion.^[6]

Usage

• Dental trauma
  • Mouthguards are used in sports where deliberate or accidental impacts to the face and jaw may cause harm. Such impacts may occur in many sports including
    compliance of individuals for the regular using of mouthguard during activities.^[10] Moreover, even with regular use, effectiveness in prevention on dental trauma is not complete, and injuries can still occur even when mouthguards are used as users are not always aware of the best makes or size, which inevitably result in a poor fit.^[11]
• Oral medicine
  • Mouthguards may be used as
    temporomandibular joint disorder^[12]
  • To prevent tooth attrition in bruxism^[12]
  • To deliver topical medication (e.g.,
    corticosteroids) for chronic gingival diseases such as mucous membrane pemphigoid.^{[medical citation needed}
    ]
  • As a therapeutic device in the treatment of morsicatio buccarum.^[13]
• Dental aesthetics
  • During
    tooth bleaching^{[medical citation needed}
    ]
  • As a night protector of thin porcelain bridges^[medical citation needed]
• Orthodontics
  • Transparent or clear aligner, which is basically an
    acrylic thermoplastic splints, used to correct a series of different malocclusions. Not all malocclusions can be corrected with transparent aligners, only mild and moderate malocclusions. They can be used alone or in combination with brackets.^[14]
    There are many brands.
  • Two types of mouthguards, the mandibular advancement device (MAD)^[15] and the tongue stabilizing device (TSD), are used for treating sleep apnea and snoring^[16]

History

The exact origins of the mouthguard are unclear. Most evidence indicates that the concept of a mouthguard was initiated in the sport of

There have been other claims to the invention of the mouthguard as well. In the early 1900s, Jacob Marks created a custom-fitted mouthguard in London.^[20] An American dentist, Thomas A. Carlos, also developed a mouth guard at approximately the same time as Krause. Carlos claimed that he made his first mouthpiece in 1916 and later suggested his invention to the United States Olympian Dinnie O’Keefe in 1919. Another dentist from Chicago, E. Allen Franke, also claimed to have made many mouth guards for boxers by 1919.^[19] The mouthguard’s relevance was again brought to the center of attention in a 1927 boxing match between Jack Sharkey and Mike McTigue. McTigue was winning for most of the fight, but a chipped tooth cut his lip, and he was forced to forfeit the match. From that point on, mouthguards were ruled acceptable and soon became commonplace for all boxers.^[21] In 1930, descriptions of mouthguards first appeared in dental literature. Dr. Clearance Mayer, a dentist and boxing inspector for the New York State Athletic Commission, described how custom mouthguards could be manufactured from impressions using wax and rubber. Steel springs were even recommended to reinforce soft materials.^[21]

In 1947, a Los Angeles dentist, Rodney O. Lilyquist, made a breakthrough by using transparent acrylic resin to form what he termed an "acrylic splint". Molded to fit unobtrusively over the upper or lower teeth, the acrylic mouthguard was a distinct improvement over the thick mouthguard worn by boxers. It meant that the athlete could talk in a normal manner while the mouthguard was in place. In the January 1948 issue of the Journal of the American Dental Association, the procedure for making and fitting the acrylic mouthguard was described in detail by Dr. Lilyquist.^[22] He immediately received nationwide recognition as the father of the modern mouthguard for athletes.^[23] The first athlete to wear the acrylic mouthguard was a member of the UCLA basketball team, Dick Perry, who modeled the device at a convention of the Southern California Dental Association. Another early wearer was Frankie Albert, quarterback for the San Francisco 49ers.

In the 1940s and 1950s, dental injuries were responsible for 24-50% of all injuries in American football.^[21] In 1952, Life magazine did a report on Notre Dame football players without incisors.^[24] The article drew a lot of public attention and led to the inclusion of mouthguards in other contact sports. In the 1950s, the American Dental Association (ADA) began researching mouthguards and soon promoted their benefits to the public.^[25] In 1960, the ADA recommended the use of latex mouthguards in all contact sports. By 1962, all high school football players in the United States were required to wear mouthguards. The National Collegiate Athletic Association (NCAA) followed suit in 1973 and made mouthguards mandatory in college football. Since the introduction of the mouthguard, the number of dental injuries has decreased dramatically.^[26]

Mouthguards have become a standard in many sports. In addition to football, the NCAA currently requires mouthguards in

• Bruxism
• Dental trauma

References

• Tribst, J. P. M., de Oliveira Dal Piva, A. M., Borges, A. L. S., & Bottino, M. A. (2018). Influence of custom‐made and stock mouthguard thickness on biomechanical response to a simulated impact. Dental Traumatology, 34(6), 429-437.
• "Tooth surface loss; Part 3: Occlusion and splint therapy" British Dental Journal, Vol. 186, No. 5, 1999-03-13, via nature.com. Retrieved on 2007-08-18.
• Widmalm, Sven E. "Bite Splints in General Dental Practice", (Website, lectures from author's homepage), University of Michigan, 2003-11-14. Retrieved on 2007-08-19.
• Widmalm, Sven E. "Use and Abuse of Bite Splints", (Website, lectures from author's homepage), University of Michigan, 2004-10-27. Retrieved on 2007-08-19.

Footnotes

Wikimedia Commons has media related to Mouthguard.

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