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Athletes, who use mouthguards (MGs) as a protective device, often experience obstruction of airflow and interferences with performance. The aim of this study was to investigate the influence of three custom–made MGs (MG1, MG2, MG3), which differed in design and thickness, on respiratory flow and blood lactate during exercise. Fourteen elite male boxers (Age: 26 ± 8 yr; Mass: 80±11) performed newly developed sport specific protocol under laboratory conditions on four occasions – without a MG and with each of the three MGs. The exercise consisted of 4 boxing rounds of 3 mins, with a minute rest after each round. Breath-by-breath analysis (METALYZER® 3B, Cortex) showed that there were no differences in the uptake of oxygen (p > 0.157) between the four conditions. Likewise, the use of different MG did not affect blood lactate accumulation (p = 1.00). However, at the end of the first round the minute ventilation was higher when MG3 was used (86.2 ± 17.5 L/min) compared to MG2 (71.7 ± 13.2) and having no MG (73.7 ± 16.4) (p = 0.002). The fact that a negative effect was not determined on physiological responses could further encourage players to use MGs during both training and competition.

Orofacial traumas account for a third from all injuries sustained during contact sports. Wearing a mouthguard (MG) could reduce the risk of such injuries. Yet, there is an underlying belief amongst many players that the device could cause impedances with comfort, breathing and speech. This might be due to the type of MG or athletes knowledge of which one is best. For example, custom-made MGs were found to provide superior protection and fit compared to ‘boil-and-bite’ or stock MGs. The aim of the present study was to examine the current attitudes and awareness of MGs in the UK via online questionnaire. An online survey was distributed to 308 participants via email and social media, which consisted of 18 questions, addressing the usage of mouth protection in different levels of sport (e.g. national/international), rate of dental injuries and common issues previously raised within the literature. The results showed that 23% of the 308 respondents competed at national level, 15% at international and 10% were part of a club. The majority were rugby union players (57%) and the rest participated in sports such as ice hockey (17%), martial arts (5%) and other team sports. It was found that 40% currently wore a customised MG, however many of them had experienced problems with discomfort and breathing. Almost half of the respondents highlighted that they had stopped wearing a MG due to the device being uncomfortable. These factors are raised quite considerably throughout the literature and within this study; it is therefore a recommendation that these issues need to be addressed. More education about why customised MGs should be worn is required to improve usage and compliance as well as improving manufacturing techniques to reduce the highlighted issues.