Prevalence and Risk Indicators of Orofacial Trauma and Mouthguard Awareness Among Youth Water Polo Players

Abstract

Background: Sports-related orofacial injuries are common among young athletes, and water polo carries a moderate risk for dental trauma. However, awareness of emergency management and mouthguard use remains limited.

Objectives: This study evaluated the prevalence of dental and orofacial trauma, avulsion management awareness, and attitudes toward mouthguard use among junior male water polo players in Istanbul.

Methods: A cross-sectional survey was conducted among 80 male athletes (8–18 years) from three youth water polo clubs in Istanbul using a structured 19-item questionnaire. The survey evaluated trauma history, avulsion management awareness, and mouthguard use. Data were analyzed using chi-square tests (p<0.05).

Results: Eighty athletes were included (response rate: 94.1%). The most common orofacial injury was bruising (81.3%), followed by lip/tongue injuries (48.8%), with no reported avulsion cases. Dental trauma occurred more frequently during training (45%) than matches (13.8%) and contact with other players (52.5%) was the leading cause. Injury type was significantly associated with age group (p=0.0056) and weekly training time (p=0.00795), but not with years of experience (p=0.352). Awareness of avulsion management was low, and although 67.5% were aware of mouthguards, none reported using one.

Conclusions: Junior water polo players in Istanbul demonstrated limited awareness of dental trauma management and no reported use of mouthguards. Greater exposure time was associated with trauma risk, while the absence of mouthguard use despite existing awareness indicates a substantial preventive gap.

Keywords:

Athletic Injuries, Mouth Protectors, Water sports, Water polo, Dental trauma

References

Gassner R, Tuli T, Hächl O, Moreira R, Ulmer H. Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years. Journal of Oral and Maxillofacial Surgery. 2004;62(4):399–407.

Levin L, Day PF, Hicks L, O'Connell A, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dent Traumatol. 2020;36(4):309–13.

Mohammadi H, Roochi MM, Heidar H, Garajei A, Dallband M, Sadeghi M, et al. A meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies among children and adolescents. Dent Traumatol. 2023;39(5):403–17.

Spittler J, Keeling J. Water Polo Injuries and Training Methods. Curr Sports Med Rep. 2016;15(6):410–6.

Federation Dentaire International (FDI). Commission on dental products. Working party No. 7; 1990.

Galic T, Kuncic D, Poklepovic Pericic T, Galic I, Mihanovic F, Bozic J, et al. Knowledge and attitudes about sports-related dental injuries and mouthguard use in young athletes in four different contact sports-water polo, karate, taekwondo and handball. Dent Traumatol. 2018;34(3):175–81.

Hersberger S, Krastl G, Kühl S, Filippi A. Dental injuries in water polo, a survey of players in Switzerland. Dent Traumatol. 2012;28(4):287–90.

Tadin A, Buzov J. Knowledge and Self-Assessment of Dental Injuries and Oral Health among Croatian Professional Water Polo Players: A Cross-Sectional Study. Sports (Basel). 2023;11(11).

Zamora-Olave C, Willaert E, Montero-Blesa A, Riera-Punet N, Martinez-Gomis J. Risk of orofacial injuries and mouthguard use in water polo players. Dent Traumatol. 2018;34(6):406–12.

Lieger O, von Arx T. Orofacial/cerebral injuries and the use of mouthguards by professional athletes in Switzerland. Dent Traumatol. 2006;22(1):1–6.

Lang B, Pohl Y, Filippi A. Knowledge and prevention of dental trauma in team handball in Switzerland and Germany. Dent Traumatol. 2002;18(6):329–34.

Pranitha V, Mounika PB, Dwijendra SK, Shaik N, Ramana PU, Meghana C. Sports Cult in Hyderabad: Role of a Pedodontist in Protecting Winning Smile. Int J Clin Pediatr Dent. 2021;14(5):652–6.

Świątkowska M, Kargol J, Turska-Szybka A, Olczak-Kowalczyk D. What do polish parents know about dental trauma and its management in children's treatment? A questionnaire study. Acta Odontol Scand. 2018;76(4):274–8.

Baglar S, Kurdal M, Torun E. Evaluation of Turkish Athletes' Awareness Regarding the Use of Mouthguards. Current Research in Dental Sciences. 2025;35:128–32.

Özkal Eminoğlu D, Kaşali K, Gençoğlu C, Ulupinar S, Özbay S, Şeran B, et al. Mouthguard use, hygiene, and maintenance practices among combat and team sports athletes: A comparative study. PLoS One. 2025;20(1):e0317952.

Sogukpınar A, Eroğlu H, Aksoy C. Faculty of sports science students, physical education teachers, and athletes’ level of knowledge and attitude about mouthguards. BMC Oral Health. 2024;24.

Gerreth K, Hoffmann-Przybylska A, Kicerman M, Alejski M, Przybylski P. Traumatic Dental Injuries Among Individuals with Disabilities and Chronic Diseases Practicing Sports. J Clin Med. 2025;14(14).

Dagon N, Blumer S, Peretz B, Ratson T. Prevalence of dental trauma in individuals with special needs participating in local Special Olympics games. Spec Care Dentist. 2019;39(1):34–8.

Topdaği B, Özen GY, Özen AK. Mouthguard use and awareness among athletes in Turkey: a cross-sectional study with multivariable analysis. BMC Sports Sci Med Rehabil. 2025;17(1):339.

Zebrauskas A, Birskute R, Maciulskiene V. Prevalence of Dental Erosion among the Young Regular Swimmers in Kaunas, Lithuania. J Oral Maxillofac Res. 2014;5(2):e6.