The state of the art: DGSZM one4all sports mouthguard

Author Dr Stavros Avgerinos (Germany) is a Sports Dentist, Germany, Honorary President, Board Member of German Society for Sports Dentistry (DGSZM) and President of a professional ice hockey Club (EV Duisburg). Dr Stavros is a Keynote Speaker at the DentalReach Conference & Awards (DRDCA) 22: Sports Dentistry Edition. Brochure & Registration Link: Click here

In place of the usual introductory classification of the various types of sports mouthguards, a statement first: " From the perspective of sports medicine, there is only one type of sports mouthguard". Since the first international symposium of the European Association for Sports Dentistry (EA4SD) in November 2019, and as part of the 6th European College of Sports and Exercise Physicians (ECOSEP) Sports Medicine Congress in Paris, there has been clarity about this statement in the sports dentistry world, which is now networking internationally.

During my presentation of the German Society for Sports Dentistry (DGSZM) one4all sports mouthguard (for use in all contact and collision sports), the minimum requirements for a sports mouthguard was defined in the presence of internationally acclaimed colleagues in research and practice. This was the first step towards a consensus on an international standard. The current state of studies (the authors of the vast majority of publications on this topic were present) as well as many years of experience was taken into account in this process.

Requirements of a mouthguard

A mouthguard manufactured according to the latest scientific criteria of sports dentistry must meet the following minimum requirements:

• Individually manufactured and multilayer laminated (hard component to distribute the applied force and soft/elastic component for absorption).
• Maximum possible protection of teeth, jaws, temporomandibular joint and surrounding soft tissues
• High wearing comfort
• Shock absorbing function (e.g. concussion prophylaxis)
• Fabrication for the maxillary arch (except in the case of pronounced Angle Class III)
• Option of disinfection
• Cost effectivity
• Occlusion considered and verified by a dentist

A discourse on classification, or even the use of pre-fabricated or individually fitted sports mouthguards is therefore obsolete and should, in my opinion, at least be critically reviewed by sports associations, cost bearers and, last but not least, politicians!

The DGSZM mouthguard

The German Society for Sports Dentistry (DGSZM) one4all sports mouthguard already fulfilled all the criteria listed years before the "Paris Agreement" and is continuously being further developed, taking into account current research results and feedback received from athletes. In this context, cost-effectiveness plays a very important role while maintaining high quality, because this is the only way to ensure widespread use in school, recreational and popular sports. The materials, tools, equipment and work steps are clearly defined in terms of procedure and sequence, ensuring the reproducibility the maximum possible. In the next step, we are working towards a certification process in cooperation with the industry so that the trained colleagues can prove their qualifications and that the high standards are being maintained. For this purpose, the DGSZM will also offer international courses in cooperation with the Austrian Sports Dentistry Society (ÖGSZM), the EA4SD and probably also with the Academy for Sports Dentistry (ASD), USA. We are currently in exchange with further cooperation partners worldwide. In Germany, Austria and Switzerland, certification will be given as part of a continuum to the already very successfully established curriculum.

Materials & Design

Pre-laminated, three-layer splint material by Erkodent made from long-proven materials (EVA, COC) is used in this mouthguard, with two soft/elastic layers and a hard, highly reticulated intermediate layer. The manufacturing process corresponds to that of a single-layer splint with slight modifications to ensure the minimum incisal thickness and the optimum transfer of balanced occlusal conditions, ideally in myocentric bite position.

The DGSZM one4all sports mouthguard covers the vestibular part of the jaw exactly up to the mucobuccal fold. Palatally, it ends in a garland shape at the sulcus gingivalis, has impressions to ensure a balanced occlusion and a buccal or labial rampart to protect the teeth of the counter jaw.