Dentofacial trauma and players' attitude towards mouthguard use in field hockey: a systematic review and meta-analysis

Background Dentofacial injuries are a risk while playing field hockey. Wearing mouthguards is recommended. Objective To synthesise findings on the prevalence and characteristics of dentofacial injuries sustained by field hockey players. We also investigated the prevalence of regular mouthguard use and players' attitude towards use of mouthguard. Material and methods A literature search was performed using PubMed, EMBASE, OvidSP, Web of Science, Cochrane and Cinahl databases. Eligible studies were identified based on the title, abstract and full text of articles. If applicable, a random effects model was used to calculate the overall effect size; otherwise, pooled prevalence was reported. Results 11 studies were eligible for the analysis. The average proportion of field hockey players who had sustained at least one dentofacial injury varied from 12.7% (95% CI 8.5% to 17.0%) among junior and senior players to 45.2% (95% CI 39.3% to 51.0%) among elite players. We did not observe any significant differences with respect to gender. In the 2000s, a significantly higher proportion of players regularly wore a mouthguard, 84.5% (95% CI 69.3% to 99.7%) as compared with players 20 years ago, 31.4% (95% CI 22.7% to 40.1%). The most common complaints about the mouthguard were that it was unnecessary and uncomfortable. Conclusion Dentofacial injuries pose a serious problem in field hockey and a substantial number of players do not regularly wear a mouthguard. Greater use of mouthguards would be expected to reduce dentofacial injuries in field hockey.