Mouthguards during orthodontic treatment: Perspectives of orthodontists and a survey of orthodontic patients playing school-sponsored basketball and football

Abstract

The objectives were to: 1) identify the beliefs and practices of orthodontists about mouthguard use in orthodontic patients, and 2) survey orthodontic patients currently playing school-sponsored basketball and/or football about mouthguards. Fifteen orthodontists were interviewed about mouthguard use in their patients. Patients (11–18 years old) playing organized school basketball (N=53) and/or football (N=22) from 13 of those 15 orthodontic practices participated in an online survey about mouthguards. Approximately half of the orthodontists interviewed had initiated discussion about mouthguards with their patients. Although boil-and-bite mouthguards were recommended most often by orthodontists with only a single orthodontist recommending a stock type, stock was the most commonly used type [football (59%), basketball (50%)] followed by boil-and-bite [football (27%), basketball (35%)]. Only two of the 75 patients surveyed (<3%) reported using a custom mouthguard. All football players reported using a mouthguard, as mandated by this sport. Basketball does not mandate mouthguard use and only 38% of basketball players reported wearing one. Players who used mouthguards cited forgetting as the most frequent reason for not always using one. A greater percentage of football (91%) than basketball (32%) players reported their coach recommended a mouthguard ( P <0.001). Orthodontists differ in how they approach mouthguard use by their patients, which likely reflects a lack of evidence-based guidelines. The beliefs, recommendations, and practices of orthodontists concerning mouthguard use and the use of mouthguards by orthodontic patients are discussed. Research directions to improve mouthguard use are suggested.