# Comparative Evaluation of Orofacial Injuries in Children Playing Roller Skating With and Without Mouthguards: A Non-randomized Controlled Trial

## TL;DR

This study found that custom-fitted mouthguards reduce orofacial injuries in children roller skating, especially dental fractures and jaw pain, without increasing fall risk.

## Contribution

The study provides empirical evidence on the effectiveness of custom-fitted mouthguards in reducing orofacial injuries in children during roller skating.

## Key findings

- Custom-fitted mouthguards significantly reduced intraoral soft tissue injuries in roller-skating children.
- Athletes using mouthguards reported significantly less temporomandibular joint (TMJ) pain compared to those without.
- Mouthguard acceptance among athletes was high, with most rating it as excellent or good.

## Abstract

Background: Engagement in sports offers substantial physical and psychological benefits for children and adolescents, but also elevates the risk of orofacial injuries such as fractured teeth, soft tissue trauma, and jaw damage. Roller skating, a popular and growing activity among children, presents particular risks due to high speeds and balance challenges. While standard protective gear like helmets, knee pads, and wrist guards are commonly included in skating kits, the use of mouthguards, despite their importance in preventing orofacial injuries, remains limited. Custom-fitted mouthguards made from materials such as ethylene-vinyl acetate offer superior fit, comfort, retention, and protection compared to stock or boil-and-bite types. Key characteristics such as ease of speech and breathing, resistance to tearing, and coverage of teeth, gingiva, and lips make them ideal for young athletes. Parental awareness and involvement are critical factors influencing the adoption of such preventive measures.

Aim: The study aims to evaluate orofacial injuries in 8- to 14-year-old children playing roller skating with or without a mouthguard.

Methods: A non-randomized controlled clinical study was carried out in skating academies across the Nagpur region and at the Department of Pediatric and Preventive Dentistry. Roller skating athletes aged 8 to 14 years were enrolled and divided into two groups, each consisting of 43 skaters. Group A included athletes whose parents consented to both participation in the study and the use of conventional mouthguards during skating; these athletes were provided with 4 mm-thick conventional mouthguards. Group B consisted of athletes whose parents agreed to participation but declined the use of mouthguards for their children; thus, these athletes skated without any mouthguards. Participants were monitored over a one-year period, with incidents of falls and skating-related orofacial injuries recorded throughout the study duration.

Results: Eighty-six athletes (43 in each group) between 8 and 14 years old were included in the study. There were 28 males and 15 female athletes in Group A and 26 males and 17 females in Group B. The prevalence of falls in both groups was 100%. A non-significant difference was observed in the hard and soft dental tissue injuries in permanent teeth (p=0.229) as well as deciduous teeth (p=0.494) between the two groups. Additionally, 4.7% of athletes in Group B suffered from comminution of the alveolar socket. Intraoral soft tissue injuries depicted a statistically significant difference between both groups (p=0.002). No significant difference was observed in the occurrence of extraoral injury and other body parts injury in both groups. Following one year of intervention, a significantly lower number of athletes in Group A reported temporomandibular joint (TMJ) pain compared to Group B, relative to baseline values at the start of the study. Based on the questionnaire evaluation conducted after one year of use, athlete acceptance of the mouthguard was rated as excellent by 19 athletes, good by 21, and moderate by three.

Conclusion: Custom-fitted mouthguards significantly reduce orofacial injuries, especially dental fractures and TMJ pain in children who roller skate, without affecting balance or fall risk. The study supports promoting mouthguard use in pediatric high-risk sports and encourages further education and innovation in design.