Mouthwear

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 The ASTM (American Society for Testing and Materials) defined athletic mouthguard as a resilient device or appliance placed inside the mouth (or inside and outside) to reduce mouth injuries particularly to the teeth and surrounding structures.

The IASD (International Academy for Sports Dentistry)  statement on “A Properly Fitted Mouthguard ”. In this statement, the IASD adopted the ASTM operational definition for a mouthguard. The IASD statement goes further to state that the single word "mouthguard" must be replaced by the terminology “properly fitted mouthguard”.

Mechanisms of protection:

Hickey et al., 1967, conducted a study on an intact male cadaver to determine the effect of mouthguards on pressure changes and bone deformation within the skull after a blow to the chin. Results indicated that both intracranial pressure and bone deformation were reduced when mouthguards were in place; thus, a new importance was given to this mean of protection in contact sports beyond that of preventing injury to the oral tissues.

Moreover, De Wet, 1981, found that almost one of ten unprotected boys was concussed, and this at primary school level. He also reported that one boy even had two episodes of concussion without attracting special attention.

Josell and Abrames, 1982, reported that by separating the soft tissue and the teeth, the mouthguard might prevent laceration and bruising of the lips and cheeks during impact. Also, they stated that mouthguards would cushion and distribute the impact during a direct frontal blow, which might otherwise cause fracture or dislocation of anterior teeth. Mouthguards may prevent the teeth in opposing arch from traumatic contact, which could fracture the teeth or damage their supporting structures. They also reported that mouthguards might help prevent 43 concussions, cerebral hemorrhage, and possibly death, by separating the jaws, thus preventing the condyles from being displaced up and backward against the wall of the glenoid fossa.

Oikarenin et al., 1993, compared the guarding capacities of mouthguards and concluded that intra-oral mouthguards not only protect the teeth, but they also prevent soft tissue lacerations as direct contact with the oral mucosa and teeth is prevented and that the intracranial pressure in indirect trauma is reduced.

Mueller et al., 1996, found that several mechanisms contributed to the decreased incidence of oral trauma with mouthguard use: First, Mouthguards separated the teeth from the soft tissues, thereby preventing lacerations and bruising during impact. Second, they cushioned opposing teeth and structures. Third, they cushioned and distributed the impact and prevent superior and posterior displacement of the condyles.They concluded that these might help in the prevention of concussions, cerebral hemorrhage, neck injuries, and possible death.

Barth et al., 2000, studied management of sports related concussions and found that properly fitted mouthguards produced a separation between the head of the condyle and the base of the skull and this increased distance would be necessary to reduce acceleration, reducing the force of impact during a blow and thus reducing the impact of those forces on the brain and reducing trauma. Additionally, the cushionquality of the mouthguard itself allows for an easing or reducing of the acceleration of the blow, similar to the padding in a boxer’s gloves or protective headgear. This dampening effect should also reduce the ultimate force brought to bear on the brain.