Effectiveness of Custom-Made Mouthpieces in the Prevention of Diver's Mouth Syndrome (DMS)

The aim of the study is to evaluate the effectiveness of customized diving mouthpieces (CDMs) in preventing Diver's Mouth Syndrome (DMS), focusing on temporomandibular joint (TMJs) symptoms and associated clinical parameters during scuba diving.

A randomized controlled clinical trial was conducted including 38 scuba divers assigned to either a standard diving mouthpiece (SDM) or a CDM. Pain intensity (visual analog scale), otic examination, skin temperature (infrared thermography), and maximum mouth opening were recorded daily over seven consecutive diving days. Data were analyzed using repeated-measures statistical models (α = 0.05).

Sixteen divers (42.1%) reported relevant pain during the study period. TMJs-related pain was observed in 40% of the SDM group, whereas no TMJs pain was reported in the CDM group (p = 0.003). Significant intergroup differences were observed in otic assessment between days 6 and 7 (p <0.05). TMJs thermography showed a significant temperature reduction in the CDM group between days 2 and 3 (p < 0.05). Maximum mouth opening demonstrated significant temporal changes over the study period (p < 0.05).

Significant intergroup differences were observed in otic assessment between days 6 and 7 (p < 0.05).

CDMs significantly reduced TMJs-related pain and clinical signs associated with DMS compared with standard mouthpieces.

The use of customized mouthpieces reduces the scuba diving practice-related conditions at the TMJ and associated muscles.