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TABLE 2  State Efforts to Mandate Mouthguards for High School   3.  Zadik Y, Levin L. Oral and facial trauma among paratroopers in
          Sports 60                                             the Israel Defense Forces. Dent Traumatol. 2009;25:100–102.
                        Year                                  4.  Mitchener TA, Dickens NE, Simecek JW. Causes of maxillofacial
              State   Instituted  Sports       Disposition      injuries of U.S. military personnel in Iraq and Afghanistan, 2001-
           Minnesota   1993   Soccer, baseball,   Rescinded April   2014. Mi Med. 2018;183:e219–e224.
                              basketball,    1994             5.  Levin L, Zadik Y. Incidence and severity of maxillofacial injuries
                              volleyball, wrestling             during the second Lebanon War among Israeli soldiers and civil-
                                                                ians. J Oral Maxillofac Surg. 2008;66:1630–1633.
           Maine       1999   Soccer         Still in effect  6.  National Institute  of Dental and Craniofacial Research.  2000
           New         1990   Soccer, basketball  Still in effect  Surgeon General’s report on oral health in America. https://www
           Hampshire                                            .nidcr.nih.gov/research/data-statistics/surgeon-general. Accessed
           Massachusetts  2003  Soccer, basketball  Basketball   12 April 2020.
                                             rescinded in 2007,   7.  Kumamoto DP, Maeda Y. A literature review of sports-related
                                             soccer in 2009     orofacial trauma. Gen Dent. 2004;52:270–280.
                                                              8.  Kvittem B, Hardie NA, Roetger M. Incidence of orofacial injuries
                                                                in high school sports. J Pub Health Dent. 1998;58:288–293.
                                                              9.  Andrade RA, Evans PLS, Almeida ALS, et al. Prevalence of den-
          Despite the relatively limited number of sports currently requir-  tal trauma in Pan American Games athletes.  Dent Traumatol.
          ing MGs, the ADA Council on Scientific Affairs and the ADA   2010;26:248–253.
          Council on Access, Prevention, and Interprofessional Relations   10.  Dursun E, Harslan YD, Ozgul O, et al. Prevalence of dental
                                                                trauma and mouthguard awareness among weekend warrior soc-
          specifically recommend that properly fitted MGs be worn in   cer players. J Oral Sci. 2015;57(3):191–194.
          29 sports and activities. These include acrobatics, baseball,   11.  Tiryaki M, Saygi G, Yildiz SO, et al. Prevalence of dental injury
          basketball, bicycling, boxing, equestrian events, field events,   and awareness regarding mouthguards among basketball players
          field hockey, football, gymnastics, handball, ice hockey, in-line   and coaches. J Sports Med Phys Fitness. 2017;57(11):1541–1547.
          skating, lacrosse, martial arts, racquetball, rugby, shot putting,   12.  Ma W. Basketball players’ experience of dental injury and aware-
          skateboarding, skiing, skydiving, soccer, softball, squash, surf-  ness  about mouthguard in  China.  Dent  Traumatol.  2008;24:
                                                                430–434.
          ing, volleyball, water polo, weightlifting, and wrestling. 67  13.  Levin L, Friedlander LD, Geiger SB. Dental and oral trauma and
                                                                mouthguard use during sport activities in Israel. Dent Traumatol.
                                                                2003;19:237–242.
          Conclusions                                        14.  Vucic S, Drost RW, Ongkosuwito EM, et al. Dentofacial trauma
          During the 20th century, MGs progressed from a crude device   and players’ attitude toward mouthguard use in field hockey: a
          used to protect a boxer’s teeth to a much more sophisticated   systematic review and meta-analysis. Br J Sports Med. 2016;50:
                                                                298–304.
          device that can be shaped to the teeth of Soldiers and athletes.   15.  Hendrick K, Farrelly P, Jagger R. Oro-facial injuries and mouth-
          The US Army regulations currently require commanders to   guard use in elite female field hockey players. Dent Traumatol.
          enforce use of MGs to protect Soldiers from orofacial inju-  2008;24:189–192.
          ries during exercise and training activities. MGs are nationally   16.  Emerich K, Nadolska-Gazda E. Dental trauma, prevention and
          required for football, ice hockey, field hockey, and lacrosse,   knowledge concerning dental first-aid among Polish amateur
          although the ADA advocates MG use in a much broader vari-  boxers. J Sci Med Sports. 2013;16:297–301.
          ety of sports and exercise activities than is currently mandated.   17.  Mayer C. Tooth protectors for boxers.  Oral Hyg.  1930;20:
                                                                298–299.
          Part 2 of this series will examine the evidence that MGs pre-  18.  Watts G, Woolard A, Singer CE. Functional mouth protectors for
          vent orofacial injuries in sports and exercise.       contact sports. J Am Dent Assoc. 1954;49:7–11.
                                                             19.  Knapik JJ, Marshall SW, Lee RB et al. Mouthguards in sport ac-
          Acknowledgement                                       tivities: history, physical properties, and injury prevention effec-
          We thank Patricia Bremner, Kristin Goel, and Claudia Cole-  tiveness. Sports Med. 2007;37:117–144.
          man, who aquired many of the more-difficult-to-obtain refer-  20.  American Society for Testing and Materials (ASTM). Standard
                                                                practice for care and use of athletic mouth protectors. American
          ences for this article.                               Society for Testing and Materials, Report No. F697-00. West
                                                                Conshohocken, PA: American Society for Testing and Materials;
          Disclaimer                                            2000.
          The views expressed in this presentation are those of the au-  21.  Parker K, Marlow B, Patel N, et al. A review of mouthguards: ef-
          thors and do not necessarily reflect the official policy of the   fectiveness, types, characteristics and indications for use. Br Dent
          Department of Defense, Department of the Army, US Army   J. 2017;222(8):629–633.
          Medical Department or the US Government. The use of trade-  22.  Tuna EB, Ozel E. Factors affecting sports-related orofacial inju-
                                                                ries and the importance of mouthguards. Sports Med. 2014;44:
          mark names do not imply endorsement by the US Army but   777–783.
          is  intended  only  to  assist  in  the  identification  of  a  specific   23.  Dhillon BS, Sood N, Sood N, et al. Guarding the precious smile:
          product.                                              incidence and prevention of injury in sports: a review. J Int Oral
                                                                Health. 2014;6(4):104–107.
                                                             24.  Bergman L, Milardovic-Ortolan S, Zarkvic D, et al. Prevalence of
          Disclosure                                            dental trauma and use of mouthguards in professional handball
          The authors have indicated they have no financial relation-  players. Dent Traumatol. 2017;33:199–204.
          ships relevant to this article to disclose.        25.  Cetinbas T, Sonmez H. Mouthguard utilization rates during sport
                                                                activities in Ankara, Turkey.  Dent Traumatol.  2006;222:127–
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