Custom Mouthguards: Protecting Teeth in Sport

A mouthguard is cheap insurance against an expensive and permanent injury. A knocked-out or fractured front tooth in a teenager is not a single event; it is a lifetime of restorations, replacements and eventually an implant, at a total cost that dwarfs the guard many times over.

The evidence that guards reduce dental injury in contact sport is solid. The more interesting question is what kind of guard, because the differences between them are larger than most people assume.

What they actually protect

The obvious function is a physical barrier that spreads impact force across a wider area and keeps teeth from being fractured or avulsed. Upper front teeth take the majority of sport-related dental trauma because they sit forward in the arch.

A guard also protects soft tissue, preventing the lips and cheeks from being cut against the edges of teeth, which is a common injury in basketball and football. By separating the upper and lower teeth, it prevents the lower jaw from slamming closed against the upper, which is how many tooth fractures on back teeth occur.

Guards are also thought to reduce the risk of jaw fracture and temporomandibular joint injury by cushioning a blow to the chin. The claim that they reduce concussion risk is frequently made and remains genuinely unsettled in the research literature, so it is not a claim worth relying on.

Stock, boil-and-bite, and custom

Stock guards come preformed in a few sizes. They are the cheapest option and the worst: they do not conform to the teeth, must be held in place by clenching, interfere with speech and breathing, and are frequently not worn as a result. A guard that is not worn protects nothing.

Boil-and-bite guards are softened in hot water and bitten into shape. They are a real improvement, widely available, and far better than nothing. Their limitations are that the material thins unpredictably where you bite hardest, precisely where protection matters most, the fit degrades with each cycle of use, and retention relies partly on clenching.

A custom guard is made from an impression or digital scan of your teeth over a laboratory model, in a pressure-laminated material of controlled and even thickness. It stays in place without clenching, allows normal speech and breathing, and covers the teeth and the areas that need protecting rather than whatever the mold happened to capture. Athletes wear them consistently because they are comfortable, which is ultimately the whole point.

Getting the specification right

Thickness is chosen for the sport. Higher-impact activities such as football, hockey, rugby, boxing and martial arts warrant a thicker, multi-layer laminate. Lower-impact sports such as basketball, soccer, skateboarding, gymnastics and mountain biking are well covered by a thinner guard that is easier to tolerate.

Coverage generally extends over the upper teeth back to the first molars, with an edge that stops short of the soft palate to avoid triggering a gag reflex. Lower guards are occasionally made for athletes with a protruding lower jaw or fixed lower orthodontic appliances.

Children and teenagers need guards remade as they grow and as permanent teeth erupt. A guard made at twelve will not fit properly at fourteen. Athletes in braces need a guard designed with space for the brackets, which most stock and boil-and-bite products cannot accommodate safely.

Care and lifespan

Rinse it in cool water before and after every use and brush it occasionally with a soft brush and mild soap rather than toothpaste, which is abrasive. Let it dry fully before storing it in its vented case, since a damp guard in a closed bag grows bacteria and starts to smell.

Keep it away from heat. A guard left on a dashboard or washed in hot water will distort and stop fitting. Do not chew on it, which is a hard habit to break in teenagers and destroys the guard quickly.

Bring it to dental appointments so the fit can be checked against any new restorations or tooth movement. A custom guard typically lasts one to several seasons for an adult and needs remaking more often for a growing child.

Worth it or not

For a recreational adult in a low-contact sport, a well-fitted boil-and-bite guard worn consistently is a reasonable choice. For anyone in a collision sport, anyone whose front teeth already carry restorations or veneers, anyone with prominent front teeth or a small overjet, and any child playing organized contact sport, a custom guard is the better investment by a wide margin.

The decisive factor is usually comfort, because comfort determines whether it gets worn. If you or your child play a sport where a guard makes sense, we can take a scan at a routine visit. Call Cedar Creek Dentistry in Portland.

Questions about your own care? The team at The Best Dentist In Portland, Oregon is happy to help — call us at (503) 646-1811.

This article is for general information only and is not medical advice.