Speech Adaptation When Using Mouthguards
Condition: Rugby
Study type: Interventional

Summary: 
      The aim of this study is to evaluate the speech performance of professional rugby players
      when using custom-fitted mouthguards over a six-month period. Consented players will be given
      custom-fitted mouthguards and they will be instructed on the use and care of the mouthguards.
      At five time points: baseline, immediately following mouthguard use (T1), one-week after-
      (T2), one-month after- (T3) and six-month after use (T4), participants are required to
      pronounce four selected phonemes. Three recordings will be made for each phoneme.
      Spectrspectrographic analysis will be performed to assess the acoustic characteristics of the
      sound. Concurrently, they will be asked to fill up a questionnaire on self-assessment of oral
      impairments. Throughout the six-month period, the compliance of wearing mouthguards and the
      occurrence of dental trauma during training will be monitored on-site by the researcher or if
      not available, an assigned coach. A 24-hour helpline will be provided as a surveillance tool
      to monitor problems with mouthguards and dental trauma.
    

Detailed description: 
      Rugby exposes players to increased risk of dental trauma. Thus, mouthguard use is recommended
      to provide a resilient surface for shock absorption and impact dissipation. However, some
      discontinued using mouthguard complaint that general discomfort and speech disturbance are
      the main barriers to their compliance. The nuisance is largely due to their use of
      poorly-fitted stock or boil-and-bite mouthguards. Therefore, the primary objective of this
      study is to evaluate speech adaptations when using custom-fitted mouthguards. The secondary
      objective is to assess the incidence of dental trauma within the six-month duration of
      mouthguard use. A prospective study will be carried out at the National Sports Institute.
      During the first day (T0), a workshop on the prevention and management of dental trauma will
      be carried out. Then, dental examination, dental impression, and recording of baseline speech
      performance will be performed. During the second visit (T1), mouthguards delivery,
      self-assessment of oral impairments, and speech recording will be carried out. After 6-months
      of monitoring (T2), all participants will be called again to fill in the self-assessment form
      and final speech performance will be recorded. Data analysis will be carried out to evaluate
      the self-assessment of speech performance and digital sonography of speech recordings over
      time. Also, the incidence of dental trauma will be reported.
    

Intervention name(s): Custom-fitted sports mouthguard
Intervention type(s): Device
Intervention description(s): Pressure dual laminated technique will be used to fabricate the mouthguards. Ethylene-vinyl acetate (EVA) thermoplastic sheets of 3 mm in thickness with 125 mm diameter (Dentsply International Raintree Essix, Court East Sarasota, USA) will be used. Two 3 mm sheets pressure-laminated together should form an even thickness of 4 mm mouthguard. The design of the mouthguards takes into consideration of the following limits: (i) the labial borders of the mouthguard were extended to within 2 mm of the vestibular reflection, (ii) the palatal margins were trimmed to the cervical area of the palatal surface of the upper teeth, (iii) enclosing the maxillary teeth to the distal surface of the first molars.
Intervention model: Single Group Assignment
Intervention model description: Single group pre- and post- design
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: dental trauma; rugby; mouthguard; speech; contact sports