Custom-Made Versus Non-Custom Mouthguards in the Prevention of Sports-Related Oro-Dento-Facial Trauma: A Scoping Review of the Clinical Evidence

Sports-related oro-dento-facial trauma is a major clinical and socioeconomic burden, with oro-dento-facial injuries affecting approximately 30–40% of athletes. Mouthguards are widely recommended as primary protective devices, yet the comparative effectiveness of custom-made versus stock and boil-and-bite designs remains unclear. This scoping review aimed to map the clinical evidence on different mouthguard types for preventing sports-related oro-dento-facial injuries. The review followed the PRISMA-ScR guidelines. PubMed, Embase, Scopus, Web of Science, and the Cochrane Library were searched on 22 January 2026, without restrictions on language, date, or design. Eligibility was defined using the PICOS framework, and three reviewers independently performed selection and data extraction (Cohen’s kappa = 0.79). Of 820 records, eight studies published between 1989 and 2025 met the inclusion criteria, covering contact and non-contact sports across a wide age range. Custom-made mouthguards, mainly fabricated from ethylene-vinyl acetate, were consistently associated with reductions in dental trauma, intraoral lacerations, and temporomandibular joint injuries, with statistically significant effects in several studies (p < 0.05 to p < 0.001). Heterogeneity in design, materials, and outcomes precluded quantitative synthesis. Custom-made mouthguards are associated with favourable clinical outcomes; however, direct comparative evidence remains limited, and the heterogeneity of the available studies precludes definitive conclusions regarding their superiority over non-custom devices. Standardised reporting and large prospective studies are needed to define optimal material and design parameters.