Sports mouthguards and orthodontics: Current evidence and clinical perspectives - a narrative review

Orofacial injuries are common due to sports, and they are also a significant concern among orthodontic patients, especially those undergoing fixed appliance therapy. Mouthguards are an essential intervention to lower these risks. This review evaluates the types, fabrication methods, clinical effectiveness, wearability, regulatory requirements, and recommendations for mouthguard use in orthodontic patients. A literature search was conducted across PubMed, Scopus, and relevant organisational guidelines (2000–2025). It synthesises data from laboratory mechanical studies, systematic reviews, clinical trials, and professional standards to assess the protective value and user experience of different mouthguard types. Evidence suggests that custom-made mouthguards are the gold standard in terms of comfort, protection, and patient adaptability during orthodontic treatment. However, practical limitations such as the need for periodic replacement during active tooth movement and compliance challenges among adolescents remain. Addressing these challenges through education, innovation, and continuously improving clinical protocols is required for improving adoption rates and reducing dental trauma in this vulnerable population.