Current Concepts in Preventive Dentistry
The Ideal Mouthguard

When considering recommendations, an ideal mouthguard:

• protects the teeth, soft tissue, bone structure, and temporomandibular joints
• diminishes the incidence of concussions and neck injuries
• exhibits protective properties that include high electric absorption and electric distribution throughout the expansion
• provides a high degree of comfort and fit to the maxillary arch
• remains securely and safely in place during action
• allows speaking and does not limit breathing
• is durable, resilient, tear resistant, odorless, and tasteless

The American Society for Testing and Materials and the manufacturers of mouthguards have classified the mouthguards into three types:

• Stock Mouthguards
  Stock mouthguards may be purchased from a sporting goods store or pharmacy. They are made of rubber, polyvinyl chloride, or a polyvinyl acetate copolymer. The advantage is that this mouthguard is relatively inexpensive, but the disadvantages far outweigh the advantages. They are available only in limited sizes, do not fit very well, inhibit speech and breathing, and require the jaws to be closed to hold the mouthguard in place. Because the stock mouthguards do not fit well, the player may not wear the mouthguard due to discomfort and irritation. The Academy of Sports Dentistry has stated that the stock mouthguard is unacceptable as an orofacial protective device.
• Mouth-formed Protectors
  There are two types of mouth-formed protectors: the shell-liner and the thermoplastic mouthguard. The shell-liner type is made of a preformed shell with a liner of plastic acrylic or silicone rubber. The lining material is placed in the player’s mouth, molds to the teeth and then is allowed to set. The preformed thermoplastic lining (also known as “boil and bite”) is immersed in boiling water for 10 to 45 seconds, transferred to cold water and then adapted to the teeth. This mouthguard seems to be the most popular of the three types and is used by more than 90% of the athletic population (Figure 23).

• Custom-Made Mouth Protectors
  This is the preferred mouthguard of the three types and the most expensive to the athlete. But isn’t it worth the cost to protect an athlete’s teeth from injury? Most parents will spend quite a bit of money on athletic clothing and shoes but might not think about protecting their child’s teeth. This mouthguard is made of thermoplastic polymer and fabricated over a model of the athlete’s dentition (Figure 24). The mouthguard is made by the dental office and fits exactly to the athlete’s mouth. The advantages include: fit, ease of speech, comfort, and retention. By wearing a protective mouthguard, the incidence of a concussion by a blow to the jaw is significantly reduced because the condyle is separated from the base of the skull by placing the mandible in a forward position.