Custom-made mouthguards had no detrimental effect on athletic strength and performance

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The use of mouthguards are important for the prevention of dental and maxillofacial injuries when participating in contact support. Mouthguards buffer the impacts or blows that might otherwise cause moderate to severe dental and maxillofacial injuries. Mouthguards were recommended by the American Dental Association in 1950. However, while they have been shown to reduce injury there is a reluctance among some  to wear them, with discomfort, breathing and speech difficulties, and interference in athletic performance being commonly cited.  Therefore the aim of this trial was to evaluate and compare the effect of two different types of mouthguards on the athletic performance and strength of collegiate athletes.

A small group of athletes aged 19 to 23 years  (n=18)  were randomised to  three groups and performed the same sequence of exercises designed to test strength and performance on three consecutive Mondays, wearing wither a custom-made mouthguard , an over-the-counter boil-and-bite mouthguard or no mouthguard.  Following the tests, each athlete completed a brief anonymous survey aimed at evaluating the athletes’ overall satisfaction with each type of mouthguard.

They found that  custom-made  mouthguards

  • had no detrimental effect on athletic strength and performance
  • were reported by the athletes as being comfortable and not causing difficulty in breathing.

In contrast, boil-and-bite mouthguards did not perform as well and were reported as being uncomfortable and causing breathing difficulties.

They concluded

Based on the results of this study, the use of custom-made mouthguards should be encouraged in contact sports as a protective measure, without concern for any negative effect on the athletic performance of the athletes.

Duddy FA, Weissman J, Lee RA Sr, Paranjpe A, Johnson JD, Cohenca N. Influence of different types of mouthguards on strength and performance of collegiate athletes: a controlled-randomized trial. Dent Traumatol. 2012 Jan 25. doi: 10.1111/j.1600-9657.2011.01106.x. [Epub ahead of print] PubMed PMID: 22272945.


This is only a small study but it addresses an interesting issue  as a recent study in Italian rugby players ( Boffano et al ) found that,

 Only 53.85% of the subjects reported wearing their mouthguard all the time both during training and games. The most commonly reported problem associated with using a mouthguard was the discomfort on speech, followed by difficulty in closing lips, adversely affected breathing, adversely affected swallowing and slipping sensation.

encouraging more athletes participating in contact sport to regularly wear their mouthguards is therefore likely to have a positive effect on oral injuries.

Boffano P, Boffano M, Gallesio C, Roccia F, Cignetti R, Piana R. Rugby athletes’ awareness and compliance in the use of mouthguards in the North West of Italy. Dent Traumatol. 2011 Oct 4. doi: 10.1111/j.1600-9657.2011.01067.x. [Epub ahead of print] PubMed PMID: 21967600.


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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