From the professional game to the grassroots level, field hockey is a fast-paced sport enjoyed by many around the world. The sport is one for the adrenalin junkie, rapid ball speed, flying sticks and fierce strikes of the rock-hard ball mean there is never a dull moment, no matter the level. The nature of the sport means accidents or injuries are never far away with mouthguards pivotal to minimise the risk of oral injury, or are they?
Mouthguards are readily available to the consumer with a range of options being available from high street retailers to convenient e-commerce sites. Opro, a brand which is a leading pioneer in oral protection offers seven different self-fitting mouthguards ranging in price from £4.99 to £29.99 for their leading product, which are inexpensive in comparison to dental mouthguards which usually range £100 to £160.
A range of oral injuries including teeth breakages can be prevented by mouthguards which are positioned on the top teeth to reduce the force on the teeth from an impact such as a hockey ball or stick. Consequently, players who don’t wear mouthguards run a considerably larger risk of emergency dental treatment which can cost from £300 to £350 for a chipped tooth and much more for a complete breakage of the enamel.
The nonchalant attitude of players when it comes to the risk carried by participating in grassroots field hockey was highlighted in a survey where 62 grassroots players stated their opinions on the use of the product. A staggering 27% of participants admitted to not wearing mouthguards at all when playing field hockey with a further 23% stating they don’t wear oral protection as often as they should.
Joshua Coetzee represents Solent Hockey Club in Hampshire but originates from Gauteng in South Africa and has previously represented Beaulieu Hockey Club before moving to England. Coetzee no longer wears his old dentally fitted mouthguard when playing field hockey due to personal negative experiences stating “I don’t think dental mouthguards are worth buying because although they’re molded, they stop communication and I personally can’t stand them”.
The negative impact that traditionally clunky mouthguards have on communication while playing grassroots field hockey is likely a key factor as to why only 50% of grassroots players wear mouthguards.
The use of mouthguards is strongly recommended by England Hockey but strangely not mandatory despite the evident risk of oral injury due to the nature of the game combined with the threat caused by the hardness of hockey balls and sticks. 24 respondents (39%) to my survey admitted to being unaware that it is not mandatory to wear a mouthguard while participating in the sport.
In addition, Coetzee was heavily in favor of mouthguards not being mandatory arguing that protection in grassroots sport should only be required if protecting a vital organ adding
“In sports like American Football and Ice hockey if you hit the ice or get tackled you could have brain damage”
Despite acknowledging the risk of injury, he argued “a ball to the jaw won’t kill you” adding the attitude towards mouthguards was even more relaxed in his home country “it’s a lot more affordable to fix your teeth in South Africa”.
Coetzee was not alone with his opposition of the product being mandatory to adults competing in the sport, multiple responses of the survey agreed with the following opinions.
One stated, “It can be difficult and expensive to get a well fitted mouth guard and if I find if it isn’t dentist made it can hinder my performance on the pitch via falling out, affecting breathing ability and I personally find it more difficult to speak and breathe with a mouthguard even when moulded by a dentist”.
“I think it should be up to a player’s personal preferences as mouth guards can be uncomfortable and irritating during games” another added.
The comfort and practibility issues with many products in the market are further conveyed with another survey response claimed “mouth guards trigger my gag reflex and are impossible for me to wear. Making their use mandatory would mean I’m unable to take park in many sports that I would otherwise enjoy. I take a calculated risk that that I am willing to accept every time I play”.
Ultimately, it seemed evident that the dear price tag that comes alongside dentally fitted mouthguards has dissuaded grassroots players from purchasing the more premium and effective products. On the contrary, the lackluster quality, comfort and overall effectiveness of budget shop bought options has had an equally dissuasive effect on consumers leading to a worrying low proportion of adult grassroots field hockey players using oral protection.
- 68% claimed that shop bought mouthguards don’t sit comfortably during play.
- 71% admitted they would wear a mouthguard if it was affordable but carried the same comfort as that of a dentally fitted product.
- Only 26% of those who wear mouthguards got theirs dentally fitted.
Per contra, those who have experienced serious injury or emergency dental treatment have a contrasting opinion on the use of mouthguards. Nearly 1 in 4 participants of the investigation survey stated they had experience trauma, injury or an impact to the mouth area when competing in field hockey.
Hector Smith has experienced the grassroots game from both perspectives having umpired in matches across the South coast as well as representing Southampton Hockey club in the Southern Hockey League.
While playing a league match, Smith was struck by a hockey ball and injured, “I got hit in the mouth by the hockey ball, it hit my top lip and cracked a tooth the top gum with part of the tooth lodged in my lip”.
“I think hockey players need to have mouthguards that have a high level of protection as hockey balls are hard and can be travelling fast, I use a dentally fitted product which was a little pricey but worth it as getting my tooth fixed was more”.
On the contrary, Smith accepted “the chances of getting in the face are very low”. Outside of competing and work, he spends his spare time umpiring in the Hampshire area. The prospect of officials checking that players have mouthguards before the start of a match has been compared to the referee checking the studs of rugby player’s boots before kick off in order to increase player safety.
However, the difficulty of enforcing these checks and regulating mouthguard use throughout the entirety of a match didn’t seem feasible to Smith with him adamant it would be “so hard to implement”. Furthermore, only 56% of survey responses believed that pre-match checks would reduce injuries which is hardly an overwhelming majority with 31% confident that checks would make no impact.
The mixed opinions on the survey of the overall efficacy of mouthguards on the market highlighted a clear gap in the market with it being evident that a product that has the comfort and fit of a dentally fitted option at an affordable price would likely increase the use of mouthguards by adults at the grassroots level.
When speaking to Molly Pates, a first team player for Southampton Women’s Hockey Club, she claimed SISU, a new brand of mouthguard had been revolutionary for her while competing in comparison to the previous products she’d used.
“I have used many styles and brands of mouthguard in my time playing hockey but I have found that the SISU mouthguard is best suited for me.
The folding technology of the mouthguard allows for better comfort throughout while wearing it. It allows for better and clearer communication when making calls to my team mates”.
The SISU mouthguards initially didn’t seem a viable solution for me, I questioned how could a product so minimal and lightweight carry adequate protection in contrast to the traditional more bulky mouthguards that are widely available on the market. Following more members of Pate’s team admitting they use the SISU products, I consequently contacted the company which are based in the United States to ask for a statement on what makes their product unique.
The UK director of SISU products, Alistair Crawford, kindly answered the following questions as I attempted to learn more about their unique technology.
- What separates the SISU brand from other leading mouthguard brands?
“The SISU Mouthguard brand is proudly based on an innovative and proprietary thermoplastic material, coupled with a deliberate and thoughtful design. Most other mouthguard brands are made from a typical material, such as Ethylene Vinyl Acetate (EVA), which cannot effectively provide as much impact protection.
Traditional mouthguards made with EVA are usually at least 3 or 4 millimeters thick, and they act as pillows/cushions for the teeth, ultimately allowing for a substantial amount of impact force to transfer through to the teeth. Compare that to SISU mouthguards, which are made from our rigid plastic material and usually only 1-2 millimeters thick”.
“SISU material is designed to diffuse the impact forces across the surface of the guard, therefore preventing much more of the impact force from getting through to the teeth. And furthermore, we back this all up with our global $50,000 dental warranty”.
- My research suggests that 1 in 4 people don’t wear mouthguard when playing contact sports because of a lack of comfort. What does your product offer in terms of comfort?
“Most mouthguards are not worn because they aren’t comfortable. Also, traditional mouthguards are usually not a snug custom fit, like SISU, so it is tough for athletes to stand to wear them for an entire game or practice. SISU clips right onto the teeth and doesn’t fall out or wiggle around”.
- What does your products offer contact sports players in terms of combining comfort, ease, practicality and protection?
“Not only are SISU Mouthguards very thin, but they are also perforated with holes to allow liquid and saliva to pass through. Athletes enjoy wearing SISU for any game or practice because they can easily talk, breathe, and drink, without having to remove their mouthguard. Plus, the custom-fit process is guaranteed to work perfectly, since you can re-fit the mouthguard as many times as you need to get it right”.
Evidently, the SISU product is of a different design, look and feel to the traditional mouthguard market that we have known over the last few decades. There are many independent hockey shops in England that stock a variety of different mouthguard options. Crawford provided me with a great understanding of the product offered, however, I wanted to hear first-hand whether the relatively new to the market mouthguard is indeed flying off the shelves.
The Stick Club, an independently owned shop selling hockey equipment in Cheltenham since 1993, provided figures that described the buyer trends, sales and success of the mouthguards that they stock. The four team members at the store boast 153 years of playing experience between them at the grassroots level and their expertise ensure hockey players are being supplied only the best performing products on the market.
Sara Jane Thompson, a hockey specialist at The Stick Club explained the four products they sell as being Adidas Opro Snap Fit, Makura, Shockdoctor and SISU with the percentage spread of sales for these products being as follows…
1.88% – Adidas Opro Snap Fit
43.96% – Makura Ignis Pro
18.33% – Shockdoctor Gel Max
35.83% – SISU Aero and 3D
The specialist suggested that Makura sell well to the younger audience as the parents enjoy the cheaper price of the brand. She added that Makura and Shockdoctor products likely sell at the volume they do due to not being remouldable and being chewed to a point beyond repair by younger children during the fitting process.
Sara believes it has become apparent that consumers are often hesitant to purchase the SISU products due to the fear of the unknown and alien fitting process that comes with the comparatively new fitting process of the US based manufacturer.
“Overall, the positives outweigh the negatives but it is a constant education process with our customers. We highly recommend SISU and all wear them ourselves. They combine high protection with comfort of wear and I personally will never go back to the more ‘traditional’ mouth guard now” she concluded.
Similarly with other markets, consumers are often reluctant to move away from the norm and continuing to help educate them on changing trends could eventually lead to further increased popularity and an overall greater use of mouthguards at the grassroots level.
Despite the concerning low use of mouthguards in the grassroots hockey scene, there are promising signs that the clearly outdated clunky products are being replaced by more effective, convenient and comfortable products that will protect players from oral injury more and more as time moves on.
