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  HISTORY OF THE MOUTHGUARD

The exact origins of the mouthguard are unclear. Most evidence indicates that theconcept of a mouthguard was initiated in the sport of  boxing. Originally, boxersfashioned rudimentary mouthguards out of cotton, tape, sponge, or small pieces ofwood. Boxers clenched the material between their teeth. These boxers had a hardtime focusing on the fight and clenching their teeth at the same time. Since thesedevices proved impractical, Woolf Krause, a British dentist, began to fashionmouthpieces for boxers in 1892. Krause placed strips of a natural rubber resin, gutta-percha, over the maxillary incisors of boxers before they entered the ring. PhillipKrause, Woolf Krause‟s son, is often credited with the first reusable mouthpiece.Phillip Krause‟s invention was highlighted in a 1921 championship fight between

Jack Britton and Ted "Kid" Lewis. Lewis was a school friend of Krauses‟ and the firstprofessional to utilize the new technology, then called a „gum shield.‟ During thefight, Britton‟s manager successfully argued that the mouthpiece was an illegaladvantage. Philip Krause was an amateur boxer himself and undoubtedly used hisown device before 1921.

There have been other claims to the invention of the mouthguard as well. In the early1900s, Jacob Marks created a custom fitted mouthguard in London. An Americandentist, Thomas A. Carlos, also developed a mouth guard at approximately the sametime as Krause. Carlos claimed that he made his first mouthpiece in 1916 and latersuggested his invention to the United States Olympian Dinnie O‟Keefe in 1919.

 Another dentist from Chicago, E. Allen Franke, also claimed to have made manymouth guards for boxers by 1919. The mouthguard‟s relevance was again brought tothe center of attention in a 1927 boxing match between Jack Sharkey and MikeMcTigue. McTigue was winning for most of the fight, but a chipped tooth cut his lip,and he was forced to forfeit the match. From that point on, mouthguards were ruledacceptable and soon became commonplace for all boxers. In 1930, descriptions ofmouthguards first appeared in dental literature. Dr. Clearance Mayer, a dentist andboxing inspector for the New York State Athletic Commission, described how custommouthguards could be manufactured from impressions using wax and rubber. Steelsprings were even recommended to reinforce soft materials. In 1947, a Los Angelesdentist, Rodney O. Lilyquist, made a breakthrough by using transparent acrylic resin

to form what he termed an "acrylic splint." Molded to fit unobtrusively over the upperor lower teeth, the acrylic mouthguard was a distinct improvement over the thickmouthguard worn by boxers. It meant that the athlete could talk in a normal mannerwhile the mouthguard was in place. In the January 1948 issue of the Journal of the American Dental Association, the procedure for making and fitting the acrylicmouthguard was described in detail by Dr. Lilyquist. He immediately receivednationwide recognition as the father of the modern mouthguard for athletes. The firstathlete to wear the acrylic mouthguard was a member of the UCLA basketball team,Dick Perry, who modeled the device at a convention of the Southern CaliforniaDental Association. Another early wearer was Frankie Albert, quarterback for theSan Francisco 49ers. Since then Mouthguards have become common in manysports.

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FUTURE RESEARCH

There have been advances in mouthguard design which includes the dentaltechnique of jaw-repositioning to not only prevent negative effects but to enhanceathletic performance. Improved posture and proprioception have been observed withthe use of jaw-repositioning appliances. In other studies, a jaw-repositioningmouthguard improved muscular power in athletes. The comparison between aneuromuscular dentistry-designed jaw-repositioning mouthguard to a standardmouthguard was done in a crossover study evaluating muscular endurance andanaerobic capacity in male athletes. The advanced jaw-repositioning mouthguard led

to improved muscular power performance. Although effective, the neuromusculardentistry-designed mouthguard was highly expensive causing it to be impractical forthe typical athlete. Two other studies utilized affordable versions of the abovemouthguard to expand the practical application of the findings. A battery of exercisetests was completed in a randomized, controlled, crossover study. No significantdifferences between the jaw-repositioning mouthguards, the placebo mouthguard,and the no-mouthguard. Another study evaluated the effects of two jaw-repositioningmouthguards on aerobic performance. Jaw-repositioning devices treat sleep apneaby increasing the size of upper respiratory airways. Jaw-repositioning mouthguardsmay have similar effects on the airways in athletes lending to improved aerobicperformance. The effects of two jaw-repositioning mouthguards on aerobic dynamics

at rest and during a graded treadmill test in male athletes were evaluated. Nosignificant differences between the jaw-repositioning mouthguards and the controlswere observed in respiratory functional tests, ventilation, gas exchange, or maximalaerobic performance. These results indicate that the affordable jaw-repositioningmouthguards did not have any effect, positive or negative, on various performanceaspects. This information can be used to encourage mouthguard compliance anddissuade the concerns of performance impediments. Incorporation of advanceddental techniques and individualized design may be necessary to obtain an “optimal jaw position” that promotes positive physical responses. Future research on jaw-repositioning mouthguards should use advanced dental techniques and exploreeffects on other aspects of physical performance.

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Sportsguard Laboratories (SLI) is working alongside the Cleveland Clinic to research

and innovate ways, through a mouthguard, to monitor the effects of concussions thathappen when playing sports. SLI is working on the mouthguard aspect of thisresearch project by providing technology advanced materials for state of the artmouthguard designs while the Cleveland Clinic implements technology andresearches and analyzes the data. Concussions in athletes have been increasing, sothis non-profit organization and mouthguard company have paired up to takeaction. SLI and the Cleveland Clinic could eventually have outcomes that influencethe way the sports and medical industry interact.

SLI is a recognized industry leader in the design of mouthguard material andtechnology. Since 1996, SLI has custom fabricated tens of thousands of

mouthguards for athletes of all ages and levels of competition. SLI has customdesigned mouthguards for more than 30 professional teams in the NFL, NBA, NHL,and MLB, in addition to numerous colleges, high schools, and youth athleticprograms. Regardless of competition level, all of SLI‟s athletes have competed withconfidence and have benefited from the maximum protection of SLI mouthguardtechnologies.

The Cleveland Clinic is currently working on the aspect of this project that entailsresearching ways to monitor sport related concussions. Research teams have beenformed to help create and research technologies that could ultimately be used in thefuture. Vince Miele, Edward Benzel. And Adam Bartsch are working onincorporating technology with mouthguards in order to track the movements of anathlete‟s head after he or she takes a hit.

For this project, 10 St. Ignatius High School hockey players will be wearingmouthguards made by Sportsguard in order to start testing certaintechnologies. Each player has a special mouthguard that they wear in the gamewhich contains an accelerometer and gyroscope. The accelerometer is capable ofmeasuring the acceleration while the gyroscope measures how the neck rotateswhen taking a hit. This research allows the Cleveland Clinic to analyze data to figureout the kinds of hits that are associated with concussions. This also allows

researchers to figure out how these hits can affect players in the short and long run.This technology can ultimately convey data to coaches and athletic trainers when anathlete is at medical risk from a serious hit.

While SLI provides state of the art mouthguards, the Cleveland Clinic have beenable to research and potentially change the way concussions are handled. Thisproject has brought numerous people together with different professionalbackgrounds to help research, create, and implement technology that couldultimately impact the future of athletes and concussions.

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MY OWN OPINION

First of all there is no doubt in my mind that in most sports, mouthguards are an

absolute necessity. I also think in a way it does improve the sports it is used in. it

gives the athlete that extra bit of confidence that he or she needs to give it their all in

whatever they are doing. If you really think about it, Gumguards are keeping some

sports alive. Without it there could be some serious damage/injuries in many sports,

none worse so than boxing. Mouthguards could detract from the athletes natural

ability and that is why the research being done is so important to find that common

ground where the mouthguard doesn‟t influence the athletes performance and also

provides absolute safety. For the time being athletes should take safety first and

wear the mouthguard even if it does influence their performance a little bit. Sayingthat, there are many custom mouthguards available that works perfectly but

unfortunately costs a lot.