A major consideration in the performance of mouthguards is their ability to absorb energy and reduce transmitted forces when impacted. This is especially important to participants in contact sports such as hockey or football. The thickness of mouthguard materials is directly related to energy absorption and inversely related to transmitted forces when impacted. However, wearer comfort is also an important factor in their use. Thicker mouthguards are not user-friendly. While thickness of material over incisal edges and cusps of teeth is critical, just how thick should a mouthguard be and especially in these two areas? Transmitted forces through different thicknesses of the most commonly used mouthguard material, ethylene vinyl acetate (EVA) (Shore A Hardness of 80) were compared when impacted with identical forces which were capable of damaging the oro-facial complex. The constant impact force used in the tests was produced by a pendulum and had an energy of 4.4 joules and a velocity of 3 meters per second. Improvements in energy absorption and reductions in transmitted forces were observed with increasing thickness. However, these improvements lessened when the mouthguard material thickness was greater than 4 mm. The results show that the optimal thickness for EVA mouthguard material with a Shore A Hardness of 80 is around 4 mm. Increased thickness, while improving performance marginally, results in less wearer comfort and acceptance.

Previous studies into sporting mouthguards have been mainly attitudinal or epidemiological. The aim of the present study was to build an impact rig to measure the impact absorbed by mouthguard materials of various thicknesses. The acceleration of the pendulum of the rig was measured and used to calculate the force transmitted to the materials. Impact tests were also performed on three commercially available mouthguard materials. Tests showed that the force transmitted through mouthguard materials was inversely related to the material thickness. Mouthguard construction techniques with ethylene vinyl acetate (EVA) plastics should be monitored to avoid occlusal thinning especially on the incisal edges. Thinning results in reduction in the protection offered by the mouthguard.

Objective: To investigate the impact characteristics of an ethylene vinyl acetate (EVA) mouthguard material with regulated air inclusions, which included various air cell volumes and wall thickness between air cells. In particular, the aim was to identify the magnitude and direction of forces within the impacts. Method: EVA mouthguard material, 4 mm thick and with and without air inclusions, was impacted with a constant force impact pendulum with an energy of 4.4 J and a velocity of 3 m/s. Transmitted forces through the EVA material were measured using an accelerometer, which also allowed the determination of force direction and magnitude within the impacts. Results: Statistically significant reductions in the transmitted forces were observed with all the air inclusion materials when compared with EVA without air inclusions. Maximum transmitted force through one air inclusion material was reduced by 32%. Force rebound was eliminated in one material, and reduced second force impulses were observed in all the air inclusion materials. Conclusion: The regulated air inclusions improved the impact characteristics of the EVA mouthguard material, the material most commonly used in mouthguards world wide. M outhguards are worn by participants in contact sports to reduce damage to the orofacial complex. As well as providing protection to teeth against chipping, fractures, displacement, and avulsion, mouthguards can reduce the incidence of pulpal damage caused by impacts. Research has shown that soft tissue injuries, jaw fractures, and concussions are also reduced in those who wear mouthguards in sports that involve heavy body contact and possible impacts from sports equipment.

One of the suggestions for using laminated mouthguards is the inclusion of hard inserts to improve mouthguard performance. However, there is a paucity of published material on the use of such inserts and this study was designed to investigate this theory. Hard layers of ethylene vinyl acetate (EVA) were included in laminated mouthguard sheets which were then subject to repeated impacts with an impact rig. Hard inserts resulted in reduced energy absorption when compared with a control sheet of the same material and approximate thickness but without the hard inserts. A d d i t i o n a l l y, the further the hard inserts were located from the impact surface, the least reduction there was on energy absorption.Key words:Laminated mouthguard, transmitted forces, energy absorption, hard inserts.(Received for publication September 1998. Revised October 1998. Accepted October 1998 distribution of the residual energy over the maxillary arch. 5-7.

A modified mouthguard material which reduces transmitted forces is described. Tests showed that the inclusion of air cells in a 4 mm thick polyvinyl-acetate-polyethylene (EVA) copolymer reduced the effects of impacts of less than 10 kN when compared with a material of the same EVA composition and thickness. The EVA copolymer with air-inclusions is suitable for the construction of stock mouth-formed and vacuum-formed mouthguards. The improved elastic properties of the modified mouthguard material reduced transmitted forces by 32 per cent when compared with traditional EVA mouthguard polymers of the same thickness.