Mouthguard Use and Oral Health in Youth Ice Hockey Players: A Cross-Sectional Study From Ontario, Canada

OBJECTIVE: To examine mouthguard usage, hygiene practices, and oral health status of youth ice hockey players in Ontario. DESIGN: Cross-sectional survey study. SETTING: Ontario, Canada; recruitment conducted online in collaboration with the Ontario Minor Hockey Association. PARTICIPANTS: Youth ice hockey players in Ontario who reported mouthguard use. INTERVENTIONS: Participants voluntarily completed an anonymous online questionnaire administered using REDCap. MAIN OUTCOME MEASURES: Frequency and consistency of mouthguard use, mouthguard cleaning practices, receipt of hygiene instructions, oral hygiene behaviors, and self-reported caries experience and oral health status. RESULTS: Complete responses were obtained from 214 players using mouthguards. Approximately 47% reported wearing mouthguards during both games and practices, with majority (59%) wearing boil-and-bite type. Among custom mouthguard users, 64% reported never receiving care instructions from a dentist, whereas 29% of stock or boil-and-bite users reported no manufacturer guidance. Overall, 52% reported cleaning their mouthguards, and 38% of these did so after every game or practice. Most participants brushed twice daily (71%), whereas fewer flossed daily (28%). Consistent mouthguard use was associated with significantly lower odds of self-reported caries (OR = 0.49; 95% CI: 0.28-0.85). Higher motivation toward oral health was associated with positive self-rated oral health (OR = 3.45; 95% CI: 1.20-9.97). CONCLUSIONS: Youth ice hockey players in Ontario demonstrated inconsistent mouthguard use and suboptimal hygiene practices, compounded by limited guidance from dental professionals and manufacturers. Improved education, clinical engagement, and policy initiatives are needed to enhance mouthguard effectiveness and oral health outcomes among youth athletes.