The history of the sports mouthguard is reviewed from the early 1930s when it was first used by professional boxers, to the present, when American football, field hockey, ice hockey, and lacrosse players are required to wear a mouthguard. The methods whereby the mouthguard protects against injured teeth, broken jaws, and concussions are described.
The various types of mouthguards and the history of their use in those sports that require them are reviewed. The relatively inexpensive “boil and bite” mouthguard may be satisfactory for the stop-and-go action of American football, but it has no place in the high-speed, continuous action of upper level college hockey in which few time-outs are allowed. “Boil and bite” mouthguards are acceptable for youth and high school hockey, but college, junior, and professional players need custom-made mouthguards.
At the level of youth and high school hockey, compliance with the mouthguard rule is excellent. But at the college level, few players comply with the rule and little responsibility is taken by coaches or referees to see that the players comply, despite jaw fractures and an annual concussion rate of 4 to 5% over the past five years. The solution is not to discontinue the mouthguard rule as some have suggested, but to encourage the appointment of qualified team dentists, not only to fit players with proper mouthguards and identify untreated dental problems at the time of the preseason physical examination, but to ensure emergency dental services frequently required at the level of junior, international, and professional hockey where there are no effective face protection rules.