Contamination of athletic mouthguards

Note: The following post will appear on the Women’s Boxing Archive Network.

Use of protective mouthguards is recommended for contact sports like boxing.

Athletic mouthguards or mouthpieces are critical pieces of equipment in contact sports like football, hockey, and boxing. The American Dental Association recommends them for all contact sports. But despite the fact that mouthguards are important protective equipment in these sports, athletes often pay little attention to their care and sanitation. A new study published in the May-June 2011 edition of Sports Healthsheds light on the microorganisms that can contaminate protective mouthguards.

Richard T. Glass, PhD, DDS et al. divided 62 Division I football players into four groups and then performed microbial analysis on the mouthguards of players in those groups. Group A practiced but did not compete in games, while group B practiced and competed in games. Players in groups A and B wore their mouthguards all season. Group C players wore mouthguards for practices and games but switched them at midseason. Group D players wore their mouthguards for practices and games and switched them at midseason but placed them in sanitizing solution after each practice or game until the next opportunity to wear them.

The authors found that the mouthguards became very contaminated with use. 81 mouthguards grew out 485 microbial isolates. Changing the mouthguards midseason helped but not significantly. However, soaking the mouthguards in a sanitizing solution did decrease the numbers of bacteria, yeast, and mold isolates significantly.

Keeping the mouthguard outside of the mouth can lead to bacterial contamination.

Two other factors can potentially increase the danger from this bacterial contamination. First, athletes, especially football players, often remove the mouthguards between plays and place them on their facemasks or hang them from helmets. Holding them outside of the mouth could increase the chance of contamination from contact with the environment.

Second, over time mouthguards wear out. They can develop jagged edges, which can cause injury to the mucosal lining of the mouth. The back of the mouthguard lies near a system of veins that could potentially help bacteria spread throughout the body. The bacteria isolated from the mouthguards in this study could spread, leading to pneumonia, endocarditis, pericarditis, meningitis, and other serious medical conditions.

In summary, athletes who wear protective mouthguards should keep the following recommendations in mind to keep their mouthguards in good condition and as free of contamination as possible:

Soak the mouthguards in an anti-microbial solution after practice or games until the following session and gently brush them with a toothbrush periodically.

Avoid hanging the mouthguard on helmets, facemasks, or other dirty surfaces between plays.

Inspect the mouthguards regularly for cracks, jagged edges, and general wear.

Replace the mouthguard when damage or wear develops.

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