Sports activities can increase participants’ risk of orofacial trauma. Therefore, it is crucial to have a comprehensive understanding of various types of sports mouthguards. This study aims to present a narrative literature review on ergonomic mouthguards, including their indications for use, classifications, materials, manufacturing methods, and the current status of additive manufacturing in their production. Research of the existing literature was performed in the Google Scholar, MEDLINE/PubMed, Web of Science, and ScienceDirect databases to identify the currently available publications on the topic of sports mouthguards from January 1951 to August 2023. The terms used were “sports mouthguard”, “mouthguards and orofacial traumas”, and “mouthguards and additive manufacturing”. A total of 920 articles were found, and 39 articles were selected and included in this review. While consensus exists regarding the significance of using sports mouthguards with optimal attributes, there is a need for standardization in the methodology for manufacturing custom-made mouthguards. These can be fashioned with conventional ethylene vinyl acetate (EVA) copolymer reinforcements. Such standardization would ensure uniform stress distribution and guarantee ample protection for oral tissues, allowing for universal reproducibility among dental practitioners. Additive manufacturing stands as an innovative method for fabricating mouthguards, displaying promising benefits. However, the materials and methodologies employed in this workflow still require refinement and characterization for a safe clinical integration.