Influence of pre-laminated material on shock absorption ability in specially designed mouthguard with hard insert and space

Purpose

We have developed a new type of laminated mouthguard, the Hard & Space mouthguard, which incorporates a hard material insert and a space to prevent contact between the mouthguard and the buccal surfaces of the teeth. The purpose of this study was to investigate the effect of this new design on shock absorption.

Methods

Three types of mouthguard (a conventional laminated EVA mouthguard and two 3-layer type “Hard & Space” mouthguards made of 1.8-mm or 3.0-mm thick pre-laminated material (Konbiplast) and EVA with a 1.0-mm space) were impacted. Shock absorption was measured by means of a pendulum type steel ball impact testing machine at impact distances of 10, 20, and 30 cm and a dental study model with strain gauges attached to the lingual surfaces and an accelerometer fixed to the maxilla.

Results

Distortion of the impacted tooth and acceleration of the model were significantly reduced by all types of mouthguard at all 3 impact distances. The effect of the mouthguard was remarkable in terms of tooth distortion: both thicknesses of Hard & Space mouthguard showed more than 90% shock absorption, compared with only approximately 55–78% with an EVA mouthguard. Furthermore, shock absorption with the thicker 3.0-mm Hard & Space mouthguard reached more than 95% at the highest impact power.

Conclusion

Within the limitations of this laboratory study, Hard & Space mouthguards showed significantly greater buffer capacity than a conventional EVA mouthguard in terms of tooth distortion at the 3 impact powers tested.     

The incidence and severity of dental trauma in intercollegiate athletes

BACKGROUND: The use of protective devices such as mouthguards during participation in contact sports may be effective in reducing the incidence or severity of dental injuries. METHODS: Dental injuries reported to the athletic department at the University of Southern California, Los Angeles, were recorded from 1996 through 2005. The authors classified each injury and determined the severity of the injury. Severity was defined in relation to the treatment required and the prognosis of the teeth and supporting tissues involved. RESULTS: Fifty-one traumatic dental injuries were reported. Basketball was the sport with the highest injury rate; it had an incidence rate (IR) of 10.6 injuries per 100 athlete-seasons among men, and an IR of 5.0 injuries per 100 athlete-seasons among women. The IR for men's basketball players was five times higher than that for football players for whom mouthguard use is mandatory. CONCLUSIONS: Given the relatively high incidence of dental injury in basketball and the potential of mouthguard use to reduce the incidence and severity of the trauma, mandatory use of mouthguards among collegiate basketball players should be considered. CLINICAL IMPLICATIONS: Dental professionals have a responsibility to educate patients and the public about the importance of using mouth-guard protection in contact sports.     

Paired maxillary and smaller mandibular mouthguard for rugby player with malalignment

A rugby player who had frequently experienced soft tissue injuries while playing rugby and wearing a conventional custom‐made mouthguard came to the hospital clinic. The patient had suffered traumatic soft tissue injuries such as lip lacerations and bite trauma. Severe crowding due to ectopic maxillary and mandibular canines was observed. In response to the patient's request for better protection, a set of maxillary and mandibular mouthguards was designed: one covering the entire maxillary dentition and the other the mandibular front teeth only. The mouthguards were to be worn simultaneously. In this paper, we describe how these mouthguards were fabricated and discuss the results. The patient has experienced no injury to the stomatognathic system, including the lips, for five seasons since he began wearing this set of mouthguards. This new pairing of mouthguards appears to offer sufficient protection against injury, despite severe malalignment. We believe that this new type of paired maxillary and mandibular mouthguards has the potential to reduce sports‐related dental injuries.     

Does hard insertion and space improve shock absorption ability of mouthguard?

Abstract – Mouthguards are expected to reduce sports‐related orofacial injuries. Numerous studies have been conduced to improve the shock absorption ability of mouthguards using air cells, sorbothane, metal wire, or hard material insertion. Most of these were shown to be effective; however, the result of each study has not been applied to clinical use. The aim of this study was to develop mouthguards that have sufficient prevention ability and ease of clinical application with focus on a hard insertion and space. Ethylene vinyl acetate (EVA) mouthguard blank used was Drufosoft and the acrylic resin was Biolon (Dreve‐Dentamid GMBH, Unna, Germany). Three types of mouthguard samples tested were constructed by means of a Dreve Drufomat (Type SO, Dreve‐Dentamid) air pressure machine: the first was a conventional laminated type of EVA mouthguard material; the second was a three layer type with acrylic resin inner layer (hard‐insertion); the third was the same as the second but with space that does not come into contact with tooth surfaces (hard + space). As a control, without any mouthguard condition (NOMG) was measured. A pendulum type impact testing machine with interchangeable impact object (steel ball and baseball) and dental study model (D17FE‐NC.7PS, Nissin, Tokyo, Japan) with the strain gages (KFG‐1‐120‐D171‐11N30C2: Kyowa, Tokyo, Japan) applied to teeth and the accelerometer to the dentition (AS‐A YG‐2768 100G, Kyowa) were used to measure transmitted forces. Statistical analysis (anova , P < 0.01) showed significant differences among four conditions of NOMG and three different mouthguards in both objects and sensor. About acceleration: in a steel ball which was a harder impact object, shock absorption ability of about 40% was shown with conventional EVA and hard‐insertion and about 50% with hard + space. In a baseball that was softer compared with steel ball, a decrease rate is smaller, reduction (EVA = ～4%, hard‐insertion = ～12%, hard + space = ～25%) was admitted in the similar order. A significant difference was found with all the combinations except for between EVA and hard‐insertion with steel ball (Tukey test). About distortion: both buccal and lingual, distortions had become small in order of EVA, hard‐insertion, and hard + space, too. The decrease rate is larger than acceleration, EVA = ～47%, hard‐insertion = 80% or more, and hard +space = ～98%, in steel ball. EVA = ～30%, hard‐insertion =～75%, and hard + space = ～98% in baseball. And a significant difference was found with all the combinations (Tukey test). Especially, hard + space has decreased the distortion of teeth up to several percentages. Acceleration of the maxilla and distortions of the tooth became significantly smaller when wearing any type of mouthguard, in both impact objects. But the effect of mouthguard was clearer in the distortion of the tooth and with steel ball. Considering the differences of mouthguards, the hard‐insertion and the hard + space had significantly greater buffer capacity than conventional EVA. Furthermore, hard + space shows quite high shock absorption ability in the tooth distortion. Namely, hard + space has decreased the distortion of teeth up to several percentages in both impact objects.     

Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion

Abstract – Although it is widely accepted that mouthguards decrease the incidence of dental injuries, there is a controversy among sports medicine professionals as to the effectiveness of mouthguards in decreasing the incidence or severity of sports‐related cerebral concussion (SRCC). While some experimental data suggest that this may be the case, there exist a number of reports suggesting that mouthguards do not serve this purpose. These conclusions have been drawn, however, without actually measuring the extent of neurocognitive dysfunction in athletes following sports‐related concussion. The purpose of this study was to determine whether mouthguard use reduces the neurocognitive and symptomatic impairments that follow an injurious episode of SRCC. Preseason baseline data were collected as part of an ongoing clinical program that uses a computerized neurocognitive test to assess various faculties of brain function and symptoms reported at the time of testing. Follow‐up testing from 180 student‐athletes who had sustained an SRCC was analyzed for the purpose of this study. These athletes were separated into one of two groups: those who reported using mouthguards and those who did not. Neurocognitive testing was accomplished using the Immediate Post‐Concussion and Assessment Test (ImPACT). Results suggest that neurocognitive deficits at the time of the athletes’ first follow‐up assessment did not differ between mouthguard users and non‐users, suggesting that mouthguard use does little to reduce the severity of neurocognitive dysfunction and onset of symptoms following sports‐related head trauma. However, an interesting finding in this study was that athletes experienced significantly lower neurocognitive test scores and reported higher symptom scores following SRCC regardless of mouthguard use. This emphasizes a thorough clinical evaluation of athletes that have sustained an SRCC. Although it was found in this study that mouthguard use does not decrease the severity of concussion, it is important to note that the use of mouthguards is paramount in reducing maxillofacial and dental trauma and their use should continue to be mandated by athletic associations and supported by all dental and sports medicine professionals.     

Prevalence of dental trauma in Pan American Games athletes

Abstract – The aim of this cross‐sectional epidemiological survey was to assess the prevalence of dental trauma in athletes representing 42 countries competing at the most recent Pan American Games (XV Pan Am) held in Rio de Janeiro, Brazil in July of 2007, and to determine prior use and type of mouthguard among this group of athletes. The examiners participated in standardization and calibration training sessions before the field phase began. Invitations were sent to >5500 participating athletes competing in 41 sports and to the Medical Committee of the Pan American Sports Organization before and during the XV PAN. A convenience sample of 409 athletes was recruited. After signing an informed consent, all athletes answered a questionnaire. Data were collected at the clinical examination and recorded on a specific trauma form. The mean age of the athletes was 24.4 ± 5.3 years. Males comprised 55% of the sample; females 45%. The prevalence of dental trauma among the athletes was 49.6% (n = 203) with no gender‐based differences. Most of these injuries (63.6%) were related to activities during training or competition. Sports with the highest injury prevalence were wrestling (83.3%), boxing (73.7%), basketball (70.6%) and karate (60%). The most common injury was enamel fracture (39.8%); root fracture was the least common (0.4%). The teeth most affected were the maxillary permanent central incisors (n = 113), followed by the mandibular central incisors (n = 19). Based on the results of this study, nearly one‐half of the subjects had experienced previous dental trauma; the majority related to sports activities. Furthermore, only 17% of the athletes reported prior mouthguard use; the most frequent mouthguards reported were boil‐and‐bite. These results suggest the importance of enhanced educational efforts and the use of properly fitted mouthguards to reduce dental trauma among athletes in international sports competition, especially in sports where mouthguards are not mandatory.     

Influence of different types of mouthguards on strength and performance of collegiate athletes: a controlled-randomized trial

Abstract – Background: Prevention of traumatic dental injuries relies on the identification of etiologic factors and the use of protective devices during contact sports. Mouthguards are considered to be an effective and cost‐efficient device aimed at buffering the impacts or blows that might otherwise cause moderate to severe dental and maxillofacial injuries. Interestingly, besides their role in preventing injury, some authors claim that mouthguards can enhance athletic performance. Thus, the purpose of this controlled randomized trial was to evaluate and compare the effect of two different types of mouthguards on the athletic performance and strength of collegiate athletes. Materials and methods: Eighteen college athletes ranging from 19 to 23 years participated in this study. Devices tested in this study included an over‐the‐counter boil‐and‐bite mouthguard (O‐Flow? Max Under Armour^®) (UA) and a custom‐made mouthguard (CM). Physical tests were carefully selected by the head athletic trainer and aimed at evaluating the strength and performance. The following sequence was carried out on each test day: (i) 3‐stroke maximum power ergometer test, (ii) 1‐min ergometer test, and (iii) a 1600‐m run. A random assignment was developed to test all three experimental groups on each test day. Following the tests, each athlete completed a brief anonymous survey aimed at evaluating the athletes’ overall satisfaction with each type of mouthguard. Results: Custom‐made mouthguards had no detrimental effect on athletic strength and performance and 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. Conclusions: 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.     

Dental trauma prevention with mouthguard in a nose fracturing blow to the face: Case report

Orofacial injuries are common in sports activities and may vary in complexity and the tissues involved. Most sports‐related trauma occurs when a player hits another player, an object or the ground. This report presents a case of an injury caused by a punchlike blow to the face during a handball college team practice session. The patient suffered a traumatic blow to the left side of the nose and mouth and promptly attended a dentist. After a clinical examination and a CBCT scan, the following injuries were diagnosed: upper lip laceration, upper left lateral incisor subluxation and anterior nasal spine fracture. More severe teeth injuries were likely prevented because the patient was wearing a mouthguard.     

Traumatic injuries of the teeth in connection with general anaesthesia and the effect of use of mouthguards

Abstract— The aim of the present study was to describe the frequency of dental injuries over a 10-year period, where a mouthguard was used in approximately 10% of intubation cases or endoscopying. The types of injury are presented and the use of different types of mouthguard is discussed. Among 120 086 procedures involving anaesthesia carried out in thc period 1983–1992 at Bispebjerg Hospital, Copenhagen, 75 cases of dental trauma occurred. The incidence of dental traumatic injuries was 0.06'%. Although eight patients had used mouthguards they were registered with traumatic injuries to the teeth in connection with general anaesthesia. Of the patients, 58% were women and 42% men, with a mean age of 61 years. Seventy-eight percent of the injuries were located in the maxilla and 91% of these involved the ineisor area of the maxilla. Forty-one percent were classified as lateral luxations or mobile teeth, 47% were classified as fractured teeth, 10% tooth avulsions and the remaining 2% were classified as concussions. Because of the low frequency of traumatic dental injuries in connection with general anaesthesia and the non-significant effect of the use of mouthguards, routine use of mouthguards is not recommended. Only when a patient is to have an endoscopy done under general anaesthesia, and the surgeon or anaesthesiologist foresees problems (restricted mouth opening, extensive fixed prosthetics, extensive loss of marginal bone) is use of an individually made mouthguard indicated.     

Traumatic injuries of the teeth in connection with general anaesthesia and the effect of use of mouthguards

The aim of the present study was to describe the frequency of dental injuries over a 10-year period, where a mouthguard was used in approximately 10% of intubation cases or endoscopying. The types of injury are presented and the use of different types of mouthguard is discussed. Among 120,086 procedures involving anaesthesia carried out in the period 1983-1992 at Bispebjerg Hospital, Copenhagen, 75 cases of dental trauma occurred. The incidence of dental traumatic injuries was 0.06%. Although eight patients had used mouthguards they were registered with traumatic injuries to the teeth in connection with general anaesthesia. Of the patients, 58% were women and 42% men, with a mean age of 61 years. Seventy-eight percent of the injuries were located in the maxilla and 91% of these involved the incisor area of the maxilla. Forty-one percent were classified as lateral luxations or mobile teeth, 47% were classified as fractured teeth, 10% tooth avulsions and the remaining 2% were classified as concussions. Because of the low frequency of traumatic dental injuries in connection with general anaesthesia and the non-significant effect of the use of mouthguards, routine use of mouthguards is not recommended. Only when a patient is to have an endoscopy done under general anaesthesia, and the surgeon or anaesthesiologist foresees problems (restricted mouth opening, extensive fixed prosthetics, extensive loss of marginal bone) is use of an individually made mouthguard indicated.     

A literature review of sports-related orofacial trauma

This literature review evaluates the significance of dental injuries and their relationship to specific sports activities. Many studies have been published on individual sports or groups of sports but most pertain to specific age groups or levels of competition. Research suggests that many sports that do not require mouthguards should encourage male and female participants to use orofacial protectors. Athletes, coaches, athletic directors, athletic trainers, parents, and members of the dental community should be aware of how individuals who participate in sporting activities are at risk for dental trauma. Any sport where the potential for dental trauma can exist (such as basketball, soccer, or wrestling) should consider utilizing mouthguards to protect the competitors. The establishment of mouthguard programs for athletes of all ages, genders, and sports may help to reduce the incidence of dental trauma. A sports-related, orofacial/dental trauma reporting system is considered.     

Evaluation of athletic mouthguard through vibration test on maxillary teeth of human dry skull

The athletic mouthguard has been used for the prevention of orofacial injuries in contact sports. In this research, the effectiveness of a mouthguard was evaluated for its protection of the maxillary teeth of a human dry skull through experimental modal analysis. The upper central incisor was excited by an electrodynamic shaker. The frequency response functions of the upper teeth were then recorded on an FFT analyzer in order to identify modal shapes of the maxillary arch with and without a mouthguard. In addition, transient response simulations were carried out and decay rates of transient response waves were compared. As a result, when the mouthguard was in place, the resonance peaks of the frequency response functions were dampened, and the nodes of the modal shapes for the anterior teeth were indefinite in the frequency domain over 1 kHz. In the transient response simulation, the decay rates of transient response waves when the mouthguard was used were significantly higher than those when the mouthguard was not used (p<0.01). The results suggest that the mouthguard relieves the stress concentrated on the anterior teeth in a frontal collision by absorbing and dispersing some of the shock energy, thus quickly stopping the vibration of the maxillary teeth. These findings support the clinical fact that mouthguards prevent orofacial injuries in sporting activities.     

Forces transmitted through a laminated mouthguard material with a Sorbothane insert

Abstract— Sorbothane is a visco-elastic polyurethane that has been used in sports and orthopaedic applications because of its shock-absorbing properties. The aim of this laboratory study was to evaluate the effect of an intermediate layer of Sorbothane on the peak force transmitted through two thermoplastic ethylene vinyl acetate (EVA) sheets as used in the construction of a custom-made sports mouthguard. The EVA sheets were tested at room temperature after thermal lamination under pressure, either without (control) or with a Sorbothane intermediate layer of 1.1 or 2.65 mm thickness. A piezo-electric transducer was used to measure the peak force transmitted through each sample from a free-falling steel ram. The peak force recorded was sigmficantly less for laminated EVA samples with a Sorbothane intermediate layer than for controls of comparable thickness. We conclude that a Sorbothane intermediate layer between heat-cured laminated EVA sheets, as used in the fabrication of a custom-made sports mouthguard, may dissipate significantly the force of impact resulting from a blow to the teeth and jaws.     

Dental squash injuries – a survey among players and coaches in Switzerland, Germany and France

Abstract –  Squash belongs to sporting activities with medium risk of causing dental trauma. Because of high velocity, close body contact and the use of rackets the injury potential in squash has increased. The aim of this work was to conduct a comparative study between Switzerland, Germany and France on a number of issues: the frequency of dental and facial injuries in squash, athletes' habits of wearing mouthguards, as well as the general level of information about emergency measures after a dental trauma and the resulting consequences. Using a standardized questionnaire a total of 653 individuals, 600 squash players and their 53 coaches, were interviewed. In each of the three countries 200 players belonging to four different divisions (juniors, amateurs, semi-professionals and professionals) were surveyed. Of these 653 interviewees 133 (20.4%) have already observed a dental injury; 27 (4.5%) have experienced a dental trauma themselves. Less than half of all interviewed players and coaches (47.6%) were aware of the possibility of replanting avulsed teeth. Just 5.1% were familiar with the tooth rescue kit. Only one individual wore a mouthguard. The results show that the area of squash requires more information about prevention through sports associations, coaches and dentists.     

Are mouthguards necessary for basketball?

This literature review evaluates the significance of dental injuries and their relationship to a specific sport--basketball. Many studies have been published on individual sports or groups of sports, but most pertain to specific age groups or levels of competition. Research suggests that many sports that do not require mouthguards should encourage male and female participants to use orofacial protectors. Athletes, coaches, athletic directors, athletic trainers, parents, and members of the dental community should be aware of how individuals who participate in sporting activities are at risk for dental trauma. Any sport where the potential for dental trauma can exist, such as basketball, soccer, or wrestling, should consider utilizing mouthguards to protect the competitors. The establishment of mouthguard programs for athletes of all ages and genders who participate in basketball may help to reduce the incidence of dental trauma.     

Basketball players' experience of dental injury and awareness about mouthguard in China

Abstract –  The objective of the present study was to describe the occurrence of orofacial, particularly dental injuries in basketball, and to survey the athletes' awareness concerning the use of mouthguards during basketball training and competition. A pilot questionnaire was designed and tested with basketball players. Two hundred and thirty-six male athletes were surveyed. Seventy-seven players were professional players. Exactly 80.6% professionals and 37.7% semi-professional athletes had an experience of oral soft tissue laceration and dental injuries in basketball practice. The difference between the two groups is significant. The incidence of dental and oral injuries was related to the length of training time. About 59% of the athletes ranked the risk of orofacial and dental injury in basketball as medium. Although the awareness of mouthguards among the basketball players was very high (80.1%), only one of them had used the custom-made mouthguard. Most of the athletes gained the knowledge about mouthguards from foreign players (33.5%), media (24.8%) and teammates/classmates (24.3%). The influence of dentists was very weak. Athletes should be informed about the high risk of oral injuries when participating in contact sports. Dentists should play a more significant role in the program of promoting mouthguard use to prevent the occurrence of oral injury in sport participation.     

An in vitro study of the efficacy of mouthguard protection for dentoalveolar injuries in deciduous and mixed dentitions

Abstract Sports-related dental trauma remains a risk for children and adolescents. Although mouthguards provide protection, up to 25% of dentoalveolar injuries can occur with a mouthguard in place. This study examined the effect of mouthguard protection in an in vitro model. A total of 97 sheep mandibular segments with incisors at four developmental stages (early deciduous, ED, 11 = 37; middle deciduous, MD, n = 20; late deciduous, LD, n=18; mixed dentition, PD, 11 = 22) was used. Customised pressure formed mouthguards (MG) provided protection from trauma produced by a servohyclraulic materials testing machine to test incisors. Injuries were examined clinically, radiographically and by dissection. Mean forces required to produce dentoalveolar injury were significantly greater in test (with MG) teetli than control (no MG) teeth. Mean forces to produce injury in test teeth decreased with resorbing root lengths. Deciduous incisors differed in injury type: subluxalions and horizontal root fractures predominated in test teeth; lateral luxations and horizontal root fractures in control teeth. Predominant injuries in test and control permanent incisors were enamel infractions and snblnxations. The magnitude of lateral luxation measurements of individual teeth was reduced significantly by mouthguard protection in both deciduous and permanent dentitions. The mouthguard tended to increase the mobility of the teeth it encompassed and, in some instances, promoted dentoalveolar injury of adjacent teeth.     

Consumer products and activities associated with dental injuries to children treated in United States emergency departments, 1990–2003

Abstract – Objective: Describe the association of consumer products and activities with dental injuries among children 0–17 years of age treated in United States emergency departments. Design: A retrospective analysis of data from the National Electronic Injury Surveillance System, 1990–2003. Results: There was an average of 22 000 dental injuries annually among children <18 years of age during the study period, representing an average annual rate of 31.6 dental injuries per 100 000 population. Children with primary dentition (<7 years) sustained over half of the dental injuries recorded, and products/activities associated with home structures/furniture were the leading contributors. Floors, steps, tables, and beds were the consumer products within the home most associated with dental injuries. Outdoor recreational products/activities were associated with the largest number of dental injuries among children with mixed dentition (7–12 years); almost half of these were associated with the bicycle, which was the consumer product associated with the largest number of dental injuries. Among children with permanent teeth (13‐ to 17‐year olds), sports‐related products/activities were associated with the highest number of dental injuries. Of all sports, baseball and basketball were associated with the largest number of dental injuries. Conclusion: To our knowledge, this is the first study to evaluate dental injuries among children using a national sample. We identified the leading consumer products/activities associated with dental injuries to children with primary, mixed, and permanent dentition. Knowledge of these consumer products/activities allows for more focused and effective prevention strategies.     

The use of mouthguards

A mouthguard is a useful appliance to prevent oral injuries, and their emotional and financial consequences. Most sportsmen are aware of the benefits of a mouthguard. Nevertheless, a relatively small percentage of sportsmen in contact sports are using a mouthguard actually. Whether or not a mouthguard is used, is predominantly determined by its comfort. Therefore, a mouthguard must be optimally comfortable. However, to make sportsmen using an even optimal mouthguard, needs motivation. Stimulating of motivation is the task of parents, coaches, (team) physicians, and (team) dentists. Especially coaches seem to have great influence on sportsmen. Children are very much influenced by their parents. It is the task of general dental practitioners not only to inform sportsmen and their parents, but also their coaches and team physicians about the risks of oral injuries and about the benefits of preparing a mouthguard. General dental practitioners must put themselves disposal to prepare mouthguards for their individual patients as well as for all players of a team who wish to have a mouthguard prepared.     

Rugby athletes' awareness and compliance in the use of mouthguards in the North West of Italy

Abstract – Background: The prevention of dental injuries during full‐contact sports such as rugby is extremely important. Wearing a mouthguard can significantly reduce the frequency and severity of orofacial injuries, but it is not always used as athletes find it difficult to tolerate. The purpose of the present study was to determine the awareness and the extent of mouthguard use in a sample of young rugby athletes in the North West of Italy. Material and Methods: The athletes of four amateurs rugby teams based in the Province of Turin, Italy completed a questionnaire about playing history, current use and type of mouthguards, disturbs associated with mouthguard use, and general attitudes towards mouthguards. Results: 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. A statistically significant association between patients <22 years and non‐use of mouthguards was observed. Conclusion: Limited knowledge about oral injury prevention and limited use of mouthguards were observed. The present study suggests that educational courses for rugby players and coaches to promote the use of mouthguards would be extremely important to reduce common complaints about these devices and increase their usage.