Effectiveness of Custom-Made Mouthpieces in the Prevention of Diver's Mouth Syndrome (DMS)

Objectives The aim of the study is to evaluate the effectiveness of customized diving mouthpieces (CDMs) in preventing Diver's Mouth Syndrome (DMS), focusing on temporomandibular joint (TMJs) symptoms and associated clinical parameters during scuba diving. Materials and Methods A randomized controlled clinical trial was conducted including 38 scuba divers assigned to either a standard diving mouthpiece (SDM) or a CDM. Pain intensity (visual analog scale), otic examination, skin temperature (infrared thermography), and maximum mouth opening were recorded daily over seven consecutive diving days. Data were analyzed using repeated-measures statistical models (α = 0.05). Results Sixteen divers (42.1%) reported relevant pain during the study period. TMJs-related pain was observed in 40% of the SDM group, whereas no TMJs pain was reported in the CDM group (p = 0.003). Significant intergroup differences were observed in otic assessment between days 6 and 7 (p <0.05). TMJs thermography showed a significant temperature reduction in the CDM group between days 2 and 3 (p < 0.05). Maximum mouth opening demonstrated significant temporal changes over the study period (p < 0.05). Statistical Analysis Significant intergroup differences were observed in otic assessment between days 6 and 7 (p < 0.05). Conclusion CDMs significantly reduced TMJs-related pain and clinical signs associated with DMS compared with standard mouthpieces. Clinical Relevance The use of customized mouthpieces reduces the scuba diving practice-related conditions at the TMJ and associated muscles.