A Method for Detecting the Deterioration in the Shock Absorption Capability of Mouthguards

Objective methods for mechanical assessment of mouthguards used for a prolonged period of time are currently unavailable. The aim of this experimental study was to establish a quantitative method for assessing the preventive effect of mouthguards. 10 participants volunteered for this study. Impact loads were simulated by dropping a 250-g steel rod from a height of 100 mm onto upper front teeth of 10 custom ethylene vinyl acetate mouthguards fixed to a steel receiving rod. The mean output from load cells equilaterally placed between plates at the base of the apparatus was measured as the impact pressure (N). Its attenuation ratio (%) was calculated as the ratio of the difference in impact pressures without and with a mouthguard to impact pressure without a mouthguard. Impact pressure with mouthguard was approximately 60% of that without mouthguard in all cases. Intraclass correlations showed excellent intra-rater and inter-rater reliability for attenuation ratio (0.98 and 0.94, respectively). Bland-Altman plots indicated lack of systematic bias. The results suggest that attenuation ratio of impact pressure calculated by the proposed method is a valid criterion for assessing the preventive effect of mouthguards. The method may enable early detection of mouthguard deterioration and their timely replacement.