Could you imagine football without helmets, soccer without shin pads or even basketball without a hole cut out of the bottom of the basket? It’s amazing to consider the evolution of sports equipment – from where games started and where they have come.
Oftentimes, though, it’s hard to imagine a primitive version of the game. Helmets, shoulder pads, and yes, even the mouthguard didn’t always exist. Through the years, the mouthguard has played a huge role in sports protection and now has become as much of a staple in protection as any other piece of equipment. But how did the mouthguard come to be? What is the best type of mouthguard? And what injuries do they prevent? Well, the history of the mouthguard has taken us a long way and now plays an important role in keeping athletes in the game smiling.
The mouthguard origin: Giving a puncher’s chance
While it’s somewhat unclear the exact origin of the mouthguard, historic references have gone back to about the turn of the 20th century. Boxing appeared to be the first sport in which mouthpieces were used, as boxers originally fashioned primitive mouthguards out of cotton, tape, sponge and even small pieces of wood. Woolf Krause, a London dentist, developed a mouthguard or ‘gum shield’ in 1890 to protect boxers from debilitating lip lacerations. These injuries were quite common and hindered boxing competition during this time. Krause’s gum shields were originally made from gutta percha and were actually held in place by clenching the teeth. Later on Philip Krause, Krause’s son, modified the design and made the from vella rubber. The earliest recording of a U.S. mouthguard-type device was in 1916 when Thomas Carlos, a Chicago Dentist, designed a mouthpiece for U.S. Olympian Dinnie O’Keefe. The next few years, there are a handful of other dentists who claimed to create or modify the first mouthguard.
Mouthguards become prevalent in 1927 during a boxing match between Mike McTigue and Jack Sharkey. McTigue was clearly winning the fight, however, a chipped tooth severely cut his lip and forced him to forfeit the match. From then on, mouthguards become commonplace for boxers and also opened the possibilities for mouthguard use to flourish.
Three years following the infamous McTigue/Sharkey fight, mouthguards found its way into dental literature. Dr. Clearance Mayer, who was a dentist and also a boxing inspector, wrote about how custom mouthguards could be created from impressions using wax and rubber. He also suggested using steel springs to reinforce the materials.
Evolving the mouthguard: Everyone’s wearing it now
Finally in 1947, a major breakthrough was made when Los Angeles dentist Rodney O. Lilyquist used transparent acrylic resin to form the first acrylic splint. This mouthguard was molded to fit over the upper and lower teeth and made for a much more unobtrusive object. During this time, dental injuries were responsible for around 24-50% of all American football injuries. The Journal of American Dental Association picked up Lilyquist’s technique, which led to nationwide recognition. Dick Perry, a UCLA basketball player, was the first known athlete to use an acrylic mouthguard. Later on Frankie Albert, the quarterback for the San Francisco 49ers, was the first known professional athlete to wear this type of mouthguard.
During the 1950s the American Dental Association (ADA) started researching mouthguards and promoted the mouthguard benefits to the public. By 1960 the ADA recommended the use of latex mouthguards in all contact sports and by 1962 all high school football players in the U.S. were required to wear the mouthguards. The NCAA followed suit in 1973 and made mouthguards mandatory. Since the promotion of mouthguards the number of dental injuries have dramatically decreased.
Presently, mouthguards are standard or required in many sports. The ADA recommends mouthguards to be used in 29 sports: acrobatics, basketball, bicycling, boxing, equestrian, football, gymnastics, handball, ice hockey, inline skating, lacrosse, martial arts, racquetball, rugby, shot putting, skateboarding, skiing, skydiving, soccer, softball, squash, surfing, volleyball, water polo, weightlifting and wrestling.
Mouthguard smorgasbord: Colors, styles, decals, oh my!
Today there are plenty of mouthguard options that range in price, style and protection. The typical mouthguard is called a boil-and-bite, which can be purchased at any athletic store. These mouthguards are inexpensive options to protect the mouth. However, the drawbacks include less protection, bulky and a short lifespan. The other type of mouthguard is more custom made. These require an impression cast of the patient’s dentition as the initial step. The mouthguard is then made from this cast. Vacuum formed guards are made from single or multilayered polyethylene. Other techniques include pressure lamination to sandwich material together under high pressure.
These custom designs, such as vacuum forming, helps create a true custom mouthguard. With better retention and secure fit, it’s more protective and enables the athlete to breath and talk freely. Custom mouthguards also enable athletes to be more selective about their styles, color and even decals on the mouthguard. Professional athletes are often seen wearing these custom mouthguards and of course, all levels of athletes look to imitate the pros.
Smile and thank your mouthguard (and dentist)
Now that mouthguards are mainstream, what kind of protection do mouthguards offer? What are the benefits?
Mouthguards are mostly used in sports where deliberate or accidental impacts to the face and jaw may cause injury. Mouthguards protect injuries such as missing teeth, lacerations, cracked teeth, injured gums, and bone damage. Mouthguards may also reduce or prevent concussions during an impact to the jaw. Now, more than 200,000 oral injuries are prevented annually by mouthguard use. Athletes who don’t wear a mouthguard are 60% more likely to suffer damage to the mouth.
However, not all mouthguards prevent face, head and mouth injuries. Customization and personalization of mouthguards greatly increase the protection through a more form-fitting appliance. The tighter the fit, the less chance the mouthguard will fall out during impact. To get the fully custom fit a dentist needs to take an impression of the athlete’s mouth. That impression is then cast in stone and the mouthguard material is formed around the cast. This will create a nearly perfect match and form of the mouth and teeth; thus, providing better retention and enabling better breathing and communication.
These custom mouthguards spread the force of the blow over all the teeth that are covered by the mouthguard. They stop violent contact of upper and lower teeth. They also keep lips away from misaligned teeth, which protect the lips, teeth and orthodontic treatment (example: braces). Mouthguards always hold the jaws apart to act as shock absorbers and prevents upward and backward displacement of the condyles in their fossae. This alone can help reduce concussions.
Mouthguards are here to stay
It’s hard to refute the importance of a mouthguard. Whether it’s a high impact sport or a low impact sport, someone’s mouth, teeth and head are always vulnerable. With the evolution of the games came the evolution of protection. Mouthguards are beginning to be the norm, instead of the exception. Because of that, mouthguards have become better protectors, easier to use and of course, they look good too. Soon, it’s going to be hard to imagine sports without mouthguards.