A new study found that athletic mouth guards may cause a marked increase in the number and severity of oral lesions during the course of an athletic season. Researchers recruited 62 Division I football team players who were told they could choose the type of mouth guard they wanted to wear, either a custom device, or a 'boil and bite' style that's heated until softened, then bitten into to conform to the mouth. Each also was given a thorough oral exam at the beginning of the season, during which 85 oral lesions were found among 47 participants. There were 17 gingival lesions on the soft tissue that lines the mouth and surrounds the teeth; 60 buccal mucosal lesions in the mucous membrane on the inside of the cheek; eight lesions on the palate and none on the tongue. Fourteen of the players were examined mid-season to see if the lesions were getting worse. They were, with 28 lesions counted, or two per person. At the end of the season, 53 players had a total of 198 lesions, or 3.7 per person. Broken down, there were 96 gingival lesions, 79 buccal mucosal lesions, five lesions on the palate, and 18 on the tongue. Some of the lesions also became worse over time. Although the increased number of lesions could have come from poor oral hygiene or tobacco, that would have been noted at the preliminary exam. The players' lesion pattern is different from what was seen in the general population during another study of 17,235 adults (including smokers). Most lesions in this group were found in the hard palate, followed by the gingiva, tongue and buccal mucosa. Because mouth guards are important for tooth safety, researchers recommend that they should be worn, but thrown out at the first sign of distortion or when sharp, jagged edges appear, or when lesions occur. They also should be replaced regularly, and sanitized daily using an antimicrobial denture-cleaning solution to reduce the risk of harboring bacteria. The study appears in the September/October issue of the journal Sports Health: A Multidisciplinary Approach. 