The Safety Equipment Athletes Often Neglect? Mouthguards

Women players more likely to protect their teeth, a Tufts School of Dental Medicine study shows

Two female lacrosse players running downfield. Mouthguard use by athletes isn’t as high as it should be, though women players more likely to protect their teeth, a Tufts Dental study shows.

When a ball or puck is flying towards an athlete’s face, a mouthguard can be all that stands between him or her and some serious dental trauma. Yet, a survey of Tufts athletes conducted by researchers at the School of Dental Medicine shows the use of mouthguards is inconsistent, although women athletes appear to be far more likely to wear them than men.

And—get ready for a bit of the “ick” factor—neither gender reported cleaning their mouthguards as often as they should. In fact, more than half said they never cleaned them at all, although dirty mouth guards can harbor bacteria and fungi.

According to the Office of the Surgeon General, a little more than a third of all mouth injuries are related to athletics. Research supports the idea that mouthguards reduce the prevalence of injuries in contact sports. The NCAA mandates mouthguards for football, lacrosse, and field hockey.

Players on the field or the court, however, often leave the locker room without protection for their teeth, gums, and jaws. Shavani Saith, D19, lead author on the research, which she presented at the International Association for Dental Research’s annual meeting in June, spent her youth playing ice hockey, including four years as an undergraduate at the University of Michigan.

Although the NCAA required mouthguards for ice hockey players at the time—it now recommends, but does not require, mouthguards for the sport—the rule was not always followed. “Most of the time, the mouthguard was out of the mouth,” she said. “Knowing what I know now, I definitely would have worn it more often.”

The researchers, including principal investigator Britta Magnuson, D08, assistant professor of diagnostic sciences, and Sarah Pagni, assistant professor of public health and community service at the dental school, examined responses from 167 members of Tufts football, softball, field hockey, men’s ice hockey, and men’s and women’s lacrosse and basketball teams about their mouthguard use in practices, scrimmages, and games.

The results varied not only by gender but by team, with men’s and women’s basketball players placing the least importance on using a mouthguard, and men’s and women’s lacrosse, field hockey, and football placing the most importance.

Athletic mouthguards fall into three categories: pre-formed ones, which cannot be customized and offer the least protection, the “boil-and-bite” type, which can be adjusted for individual mouths, and those custom-made by a dentist, which offer the best fit and protection, said Magnuson. The majority of Jumbos in the study used the boil-and-bite variety.

The most surprising result, said Pagni, was the gender divide. Just about two-thirds of male athletes from all sports said they always used mouth guards, while 90 percent of the women said they always did. “We didn’t go into it thinking we’d find that,” Magnuson said—and without more investigation, they can’t draw any conclusions about why this is so. The main reasons cited for not using mouthguards were discomfort and difficulty in communicating with teammates during play. Others claimed mouthguards hindered their athletic performance, either because the devices made it difficult to breath, or broke their concentration.

For both men and women, less than 1 percent of the athletes said they always cleaned their mouth-guard, with 43 percent saying they cleaned them sometimes, and a whopping 55.7 percent saying they never cleaned them.

“They definitely hold bacteria and fungi,” said Magnuson. The best way to clean a commercial mouth guard is using an anti-microbial rinse, or brushing with toothpaste; for a custom-made guard, ask the dentist, since brushing with toothpaste can be too abrasive for some of them. “At least wash it off,” Magnuson said.

Helene Ragovin can be reached at

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