Investigation of the effect of digitally made custom mouthguards on sports performance in children and adolescents playing basketball and evaluation of their opinions regarding mouthguard use

Objective: The aim of this study was to investigate the effects of digitally fabricated custom-made mouthguards on sports performance in child and adolescent basketball players, and to evaluate the participants' opinions regarding mouthguards use. Methods: A total of 72 voluntary amateur and semi-professional basketball players aged 86-196 months (mean 127.08 ± 24.27) were included. Participants were grouped as children (86-119 months; mean 106.21 ± 9.66; n=33) and adolescents (120-196 months; mean 144.74 ± 18.01; n=39). For each, a digital intraoral scan was taken, and a 4 mm EVA custom mouthguard was fabricated by pressure-vacuum forming on a 3D model. Performance was tested with and without the mouthguard using the Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1). Perceptions were assessed on a 4-point Likert scale for breathing, speech adaptation, comfort, perceived performance effect, and overall satisfaction. Results: Across the entire sample, the performance difference was not statistically significant (p = 0.358). According to Yo-Yo IR1 test results, mouthguard use did not have a statistically significant effect on performance in either the Child Group (p = 0.103) or the Adolescent Group (p = 0.970). In the questionnaire evaluation, overall satisfaction was high in both groups (Children: 63.6%, Adolescents: 64.1%). Positive responses regarding breathing comfort were 48.5% in the Child Group and 53.8% in the Adolescent Group. Regarding perceived effect on performance, the Adolescent Group (58.9%) reported more favorable views compared to the Child Group (36.4%). Conclusion: Custom-made mouthguards produced through a digital workflow do not negatively affect the performance of child and adolescent basketball players. With high satisfaction rates and acceptable comfort levels, these protectors can be safely recommended to prevent dental injuries in young athletes. The findings suggest that concerns about mouthguard use reducing performance are unfounded.