Influence of mouthguards on the physical performance of soccer players Adriana Franco Vieira Rodrigues Queir  oz, Rui Barbosa de Brito Jr, Juliana Cama Ramacciato, Rog erio Hel adio Lopes Motta, Fl avia Mart~ ao Fl  orio S~ ao Leopoldo Mandic School of Dentistry and Research Center, Campinas, Brazil Key words: contact sports; mouthguard; dentoalveolar trauma; dental trauma Correspondence to: Fl avia Mart~ ao Fl orio, Rua Jos e Rocha Junqueira, 13, Campinas, S~ ao Paulo, CEP 13045-755, Brazil Tel./Fax: +55-19-3211-3650 e-mail: flaviaflorio@yahoo.com Accepted 6 November, 2012 Abstract – Aim: To evaluate the influence of different types of mouth- guard (MG) on physical performance of female soccer players. Material and methods: The sample was composed of 25 female soccer players from ‘Guarani Futebol Clube’, age range 18–22 years. For data collection, two tests were performed: agility test (shuttle run) and aerobic capacity and VO 2 (Cooper test), in addition to application of a perception questionnaire after wearing mouthguards during the tests. Results: Data analysis showed that mouthguard type III presented better results in the VO2 and aerobic capacity tests (P < 0.05). In relation to difficulties experienced when wearing MGs, there were no reports of pain, discomfort, or nausea. However, 100% of athletes affirmed that it was not possible to speak with MG type I, 80% (n = 20) with type II, and no athlete found difficulty in speaking when wearing MG type III. Distractions were reported by 35% (n = 6) only when athletes wore MG types I and II. Conclusions: Among the three types evaluated, the customized MG (type III) presented better results in the athletes’ physical performance evaluation, even taking into account physical tests performed without the use of mouthguards. The search for perfection has raised the level of com- petitiveness in sports, and consequently, there are increasingly greater demands on athletes’ technical and physical performance, which could increase the risk of traumatic lesions in contact sports (1). From this aspect, the use of mouthguards allows the absorption and distribution impacts on the oral cavity, thus preventing contusions or mandibular fractures, dislocations and traumas affecting the temporomandib- ular joint (1–8). When considering athletes, this type of result is an extremely worrying condition because it can be asso- ciated with difficulty in respiration and consequently the drop of physical performance. An athlete who uses mouth breathing may present 21% lower physi- cal performance, suggesting that the use of an inade- quate mouthguard may interfere in his/her performance (2,9). Some characteristics make the mouthguard suitable for sporting practice, and these protectors must be made of a strong but comfortable material, not ham- per verbal communication or respiration, and cover all the teeth up to the second molar, in addition to being used preferably in the maxilla. In addition, that must have good retention and minimal occlusal inter- ference, not cause pain, and be of adequate thickness (10–12). In the literature, there are few reports on the effect of the use of different types of mouth- guards on the physical performance of football play- ers, and not one is considered a sample of participants in an age range that characterizes a single profile of expected performance; thus, the aim of this study was to evaluate the influence of differ- ent mouthguard uses in the physical performance of female soccer players. Material and methods This study was conducted in accordance with the regu- lations determined by Resolution 196/96 of the National Health Council of the Ministry of Health and approved by the Research Ethics Committee (Protocol 2009/0163). The 25 players were members of the women’s football team of ‘Guarani Futebol Clube’ Campinas – S~ ao Paulo in the year 2010. To evaluate the athletes’ performance, the following three mouthguards were used, in random sequence, by all the volunteers: 1 Type I: Universal Protector, a mouthguard bought in sporting goods stores (Protector Fight â - Dogma Ind ustria e Comercio de Pl asticos LTDA, S~ ao Paulo, S~ ao Paulo, Brazil). It is of standard size and is retained in the oral cavity when the arches are in occlusion. 2 Type II: Thermoplastic mouthguard made of EVA or PVC, which must be molded in the athlete’s oral cavity after immersion in hot water (Protector Fight â – Dogma Ind ustria e Comercio de Pl asticos LTDA, S~ ao Paulo, S~ ao Paulo, Brazil). 3 Type III (custom-made): Fabricated from an impres- sion taken of the athletes maxillary arch, under vacuum in a forming machine. © 2013 John Wiley & Sons A/S 1 Dental Traumatology 2013; doi: 10.1111/edt.12026