Temporomandibular Disorders (TMD) and Sports: Trauma, Overload, and the Role of Mouthguards

Abstract

Background: Evidence on the relationship between sports and temporomandibular disorders (TMD) is conflicting. While recent data suggest similar symptom rates between athletes and non-athletes, older reviews claimed higher risks for professionals, largely due to methodological flaws and self-reporting. Aim: To analyze literature on TMD prevalence in athletes, identify key cofactors (trauma, bruxism, anxiety), and evaluate the biomechanical role of custom versus standard mouthguards. Material and methods: A qualitative synthesis of 36 sources (2008–2026) from PubMed, Scopus, Web of Science, and Cochrane Library was conducted, focusing on studies utilizing DC/TMD or RDC/TMD diagnostic criteria. Results: General sports do not inherently raise TMD risk. Strict evaluations show elite athlete prevalence at ~10%, refuting older, unstandardized claims of up to 100%. Macrotrauma and internal strains are confirmed triggers. Custom mouthguards offer superior impact absorption, whereas standard "boil-and-bite" models force continuous clenching, inducing muscle fatigue. Conclusions: Recreational exercise may lower symptom burdens, while elite sports impose heavy mechanical and psychological loads. Custom mouthguards optimally prevent dental trauma, but their direct efficacy for TMD prevention remains a theoretical hypothesis rather than an established clinical fact.