The German Society for Dentistry and Oral Medicine (Deutsche Gesellschaft für Zahn-, Mund-, und Kieferheilkunde) recommends, as per R. A. Mischkowski and J.E.
Zoeller, Cologne (Stellungnahme V 1.0, from 12/1999), DZZ 55(00) wearing a mouth guard for the following sports:

  • American Football
  • Baseball
  • Basketball
  • Boxen and other martial arts
  • Ice hockey
  • Field hockey
  • Soccer
  • Gymnastics
  • Handball
  • Inline skating
  • Biking, esp. mountainbiking
  • Horseback riding
  • Rugby Skateboarding
  • Waterball

DGZMK’s assessment and their scientific opinion is confirmed by several studies, which deem sports to be the cause of 23-39% of all tooth and mouth lesions. In about 80% of cases, the upper front teeth are impacted, which oftentimes leads to loss of one or several teeth. For the patients concerned, this often means they require life-long support because of the problems caused by early tooth loss.

It is further stated in the piece that wearing an appropriate mouth guard is an effective means of protection to prevent sports-related tooth, mouth and jaw lesions. Comparative statistics showed that the risk can be reduced by a factor of up to 60. In addition to the immediate protective effect for the teeth, the likelihood of a lesion on the lips, tongue, the upper or lower jaw as well as the jaw joints is also reduced.

Another important function of the mouth guard is that it absorbs the forces that affect the lower jaw and are passed on to the skull. This is said to reduce the risk of a brain concussion.

According to the DGZMK’s recommendation, a functional mouth guard should have the following properties:

  • It should cover the gums in the upper and lower jaw
  • It should not inhibit the bite and the jaw position
  • It should not affect the athlete’s performance
  • It should not inhibit breathing and articulation
  • It should be solid and durable
  • It should be easy to clean, have a neutral taste and smell
  • It should be able to be adapted to changing bite and fixed orthodontic devices

Bite splints should be worn in the upper jaw.
In exceptional cases (strong underbite), a lower jaw mouth guard might be necessary.

A mouth guard made individually by the dentist is recommended.
After taking impressions from both jaws, gypsum plaster models are cast. Then, splints made from 3-4 mm thick flexible ethilvenyl acetate or polyvenyl acetate films are suctioned on to these models, via a vacuum pressing process in a professional lab. Usually, the extension of the splint should end vestibularly, 2 mm under the vestibular fold.
Palatinally, the extension should extend 10 mm beyond the gum line. This kind of individually made mouth guard is said to have the greatest protective effect and be much better than ready-made or ready-made and molded mouth guards.

Due to the high occurrence of lesions in children, the authors of the opinion recommend giving children a mouth guard as soon as they start taking part in organized sports that involve body contact, risk of falling or the use of sports equipment.

The splints or guards should be cleaned thoroughly with a brush and water and soap after each use.
They should be prevented from drying up and losing flexibility, therefore they can be kept in an antiseptic mouth wash, for example.

The authors insist that only a mouth guard made individually by the dentist, which has the required qualities, is scientifically proven to prevent sports-related tooth, mouth and jaw lesions or significantly reduce their extent.

Example of an individually made mouth guard.
This one consists of 3 layers of different hardness for maximum protection.
The guards can be customized as needed, which can be very useful in team sports. Thanks to their excellent fit, they don’t inhibit breathing and there is almost no impact on articulation.
The impressions give additional support to the lower jaw.
This leads to optimal protection of teeth, mouth and jaws and reduces the risk of a brain concussion.

DGzPRsport recommends using individually-made mouth guards in elite sports and supports the statements made by Mischkowski and Zoeller in the spirit of DGZMK’s scientific guideline.