Beyond protection: the growing role of instrumented mouthguards in sports

Instrumented mouthguards (iMGs) are being used in sport to help with sport-related concussion management, performance optimisation and injury prevention. iMGs represent a significant advancement at the intersection of sports dentistry, biomechanics, and wearable technology. Evolving from traditional protective mouthguards, iMGs integrate sensors that can measure head acceleration events, providing real-time biomechanical data during training and competition. These devices have gained substantial attention due to their potential to support concussion protocols, monitor athlete performance, and aid in injury prevention. World Rugby's 2024 mandate requiring iMG use in elite-level competition marks a pivotal shift in sports safety standards, setting a precedent for broader adoption. iMGs offer several benefits, including accurate impact measurement, data-driven injury risk assessment, and support for return-to-play decisions. Despite their advantages, challenges such as cost, data interpretation, data accuracy, technology malfunction and wearer comfort remain. Design improvements, such as the miniaturisation and strategic placement of components, have addressed many early limitations. As sensor technology continues to evolve, iMGs are expected to integrate additional features and become more widely accessible, potentially extending their use to youth and amateur sports. This review explores the development, functionality, applications, and future potential of iMGs, highlighting their growing role in enhancing player safety and performance across high-impact sports.