Background Mouthguards are important for injury prevention in athletes. The American Dental Association (ADA) advocates the use of a properly fitted mouthguard in thirty sports to reduce the incidence and severity of sports-related dental injury and oro-facial trauma. Despite this, many athletes cite a lack of formal guidance from individual sport governing bodies as a key reason for not wearing mouthguards.

Objective To audit the current recommendations on mouthguard use, as advised by individual sport governing bodies. The audit standard is the current recommendations from the ADA.

Design An online search was performed of each Olympic, international and national sport governing body. The websites were reviewed for medical guidance, and this was audited to determine whether mouthguards were ‘Mandated’, ‘Recommended’, ‘Optional’, ‘Not recommended’ or if there was ‘No guidance’. Where guidance was available, details on the type and fit of mouthguard recommended and mouthguard care/maintenance were recorded.

Setting Olympic, international and national sports.

Patients Athletes competing across the thirty ADA ‘at-risk’ sports.

Interventions (or Assessment of Risk Factors) N/A

Main Outcome Measurements The proportion of ‘at risk’ sports that have medical guidance on mouthguard use at the level of international governing bodies and national governing bodies. The number of sports with guidance on type, fit and maintenance were also assessed.

Results 10/30 ‘at risk’ sports issue medical guidance on mouthguard use at an international governing body level, of which five mandate usage. 11/30 sports issue guidance at a national governing body level, of which seven mandate usage. 5/30 sports have guidelines on mouthguard type or fit, and only 1/30 offered guidance on mouthguard care and maintenance.

Conclusions There is a lack of clear guidance for athletes on mouthguard use and care consensus across sports is needed, which could contribute to enhanced protection of athlete health and wellbeing.