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Does the use of sports mouthguards influence salivary parameters and oral health indices? A systematic review

Evidence-Based Dentistry volume 26, page 146 (2025)Cite this article

Subjects

Abstract

Aim

To investigate whether the use of sports mouthguards (SMG) influences salivary parameters and oral health indices.

Methods

Electronic searches were conducted across six major databases and two sources of gray literature in July 2024, with no restrictions on language or publication date. Interventional studies assessing oral parameters in participants with and without SMG were included. Risk of bias (ROB) was evaluated using the NIH—NHLBI Quality Assessment Tools for before-and-after studies. Descriptive synthesis was performed, and the certainty of evidence was assessed with the GRADE approach.

Results

Four studies met the inclusion criteria, encompassing a total of 202 male and female athletes aged 8 to 24 years. ROB ratings were classified as fair in three studies (75%) and poor in one study (25%). Evaluated salivary parameters included pH, stimulated and unstimulated flow rates, microbial count, saliva consistency, and buffering capacity. Additionally, oral indices such as full mouth plaque and bleeding scores were assessed. The studies demonstrated high heterogeneity in collection and analysis methods, outcome evaluation, and follow-up duration. Overall, the influence of SMG use on salivary pH (n = 4; 100%) and stimulated flow rate (n = 2; 100%) was inconclusive. SMG use did not affect microbial count (n = 2; 100%) or saliva consistency (n = 1; 100%) but was associated with a decrease in buffering capacity (n = 1; 100%). An increase was noted in unstimulated flow rate (n = 1; 100%) and oral indices (n = 1; 100%) with SMG use. The certainty of the evidence was rated as very low for all evaluated parameters.

Conclusion

SMG use appears to impact saliva’s buffering capacity but does not influence its consistency or microbial count. Despite the limited literature and methodological limitations of existing studies, this systematic review provides insights that could inform the design of more rigorous primary research, ultimately strengthening the evidence base on this topic.

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Data availability

All data are available in the manuscript or in the supplementary files. Additional information can be requested from the corresponding author.

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Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: to Brazilian Coordination for the Improvement of Higher Education Personnel (CAPES; DS-01), National Council for Scientific and Technological Development (CNPq; 310225/2020-5)  and Carlos Chagas Filho Research Support Foundation of the State of Rio de Janeiro (FAPERJ; E-26/010.1000992/2018). This study is part of the PhD thesis of the first author.

Author information

Authors and Affiliations

  1. Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Mariana Pires da Costa, Nicolli de Araújo Meckelburg, Lucas Alves Jural, Andreia Vaz Braga Pintor, Marcela Baraúna Magno & Lucianne Cople Maia

  2. Faculty of Dentistry, Universidade Veiga de Almeida, Rio de Janeiro, Brazil

    Andreia Vaz Braga Pintor & Marcela Baraúna Magno

  3. Department of Pediatric Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil

    Guido Maranon-Vásquez

  4. Department of Clinics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Tiago Braga Rabello

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  1. Mariana Pires da Costa
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Contributions

MPC contributed to the conception and design of the study, selection of articles, data extraction and writing the manuscript. NAM contributed to the selection of studies, data extraction and final review of the manuscript. LAJ contributed to the design of the study and final review of the manuscript. AVBP and GMV contributed to the design of the study, supervision of data extraction and final review of the manuscript. TBR contributed to the design of the manuscript, selection of studies, data extraction, supervision of qualitative syntheses and final review of the manuscript. MBM and LCM contributed to the design of the manuscript, selection of studies, data extraction, supervision of qualitative syntheses, certainty of evidence analysis and final review of the manuscript. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to Marcela Baraúna Magno or Lucianne Cople Maia.

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41432_2025_1129_MOESM1_ESM.docx

Supplementary File 1. Articles excluded after full-text reading and reasons due to inconsistencies in eligibility criteria

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Costa, M.P.d., de Araújo Meckelburg, N., Jural, L.A. et al. Does the use of sports mouthguards influence salivary parameters and oral health indices? A systematic review. Evid Based Dent 26, 146 (2025). https://doi.org/10.1038/s41432-025-01129-4

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