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Mouthguards: Types and Advantages

A mouthguard (mouth protector) is a flexible custom fitted device worn over teeth during athletic and recreational activities to protect them from damage. A good-fitting mouth guard may be especially important if you wear braces, have fixed anterior bridgework or just want to protect your teeth/smile from potential trauma.

Mouthguards can buffer damage to the teeth, the brackets and/or other fixed appliances from blows and physical contact. Mouthguards can also act as a barrier between teeth/braces and the cheeks, between the lips and tongue, thereby limiting the risk of soft tissue damage.

The ideal mouthguard also:

  • Allows speaking and does not limit breathing.
  • Stays firmly in place during action.
  • Provides a high degree of comfort and fit.
  • Is durable and easy to clean.
  • Is resilient, tear-resistant, odorless and tasteless.

Generally, a mouthguard only covers the upper teeth. However, dentists may suggest that athletes with a protruding jaw or those who wear braces or other dental appliances (such as retainers, bridgework or have implant-supported dentures) on their lower jaw wear a mouth guard on their lower teeth.

Who Should Wear a Mouth Guard?

Currently, the U.S. National Collegiate Athletic Association requires the use of mouthguards only for ice hockey, lacrosse, field hockey and football. However, the American Dental Association recommends the use of a mouth guard for 29 sports/exercise activities. These include the four activities already mentioned, plus acrobatics, basketball, boxing, discus throwing, gymnastics, handball, martial arts, racquetball, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, surfing, volleyball, water polo, weightlifting and wrestling. Essentially, whenever there’s a chance of contact with other players or hard surfaces, wearing a mouth guard makes sense.

For professional advice about how to protect your teeth during athletic activities, talk to your dentist or orthodontist about selecting a mouthguard that will provide the best protection for your particular needs.


Wearing a mouthguard is an important precaution for athletes of all ages and abilities, helping to protect against chipped or broken teeth, root and bone damage, and tooth loss. Mouth guards also safeguard against serious injuries such as jaw fracture, cerebral hemorrhage, concussion and neck injuries by helping to avoid situations where the lower jaw jams into the upper jaw. By keeping soft tissue in the oral cavity away from the teeth, mouth guards help prevent cutting and bruising of the lips, tongue and cheeks, especially for athletes who wear orthodontic appliances.

Why People Don’t Wear Mouth Guards

Since it is not mandatory for athletes – amateur or professional – to wear mouth guards, many do not because of fit, comfort, image (notion that it’s not “cool” to wear mouth guards) and complaints of impaired speaking. Not realizing the real safety value of mouth guards, some coaches do not reinforce the advantages of wearing them to their athletes, and neither do some parents, who are sometimes not fully aware of the level of contact and potential for serious dental injuries involved in their children’s sports.

Gender bias may also play a role, since there are people who mistakenly think that female athletes are less aggressive, less at-risk of injury and, therefore, less likely to need a mouth guard. Although mouth guards come in various price ranges, cost may be another consideration limiting their use, especially for custom-fitted mouthguards. The “hassle” factor – remembering to wear them, properly caring for them and dealing with the inconvenience of impaired breathing or speech – also contributes to non-use.

Types of Mouthguards

Mouth guards are available in three types:

  • Stock mouthguards, which can be purchased in sporting goods and drug stores, come pre-formed and ready to wear. Although they’re the least expensive, they are also the worst fitting and least comfortable or protective. Made of rubber or polyvinyl, these pre-formed guards can be bulky, increase the tendency to gag, and make breathing and talking difficult because they require the jaw to be closed to hold them in place.
  • Mouth-formed mouthguards can be either a shell liner or a boil-and-bite kind. The first type is lined with acrylic gel or rubber that molds to the teeth and sets to keep its shape. The second type, made of thermoplastic, is placed in boiling water then formed and molded to the contours of the teeth using the fingers, lips, tongue and biting pressure. Boil-and-bite mouth guards can be reheated and refitted if the fit isn’t comfortable initially.Both types of mouth-formed mouthguards are available online and at sporting goods and drug stores. While they do provide a better fit than stock mouth guards, they can be bulky and do not offer the same fit and protection as a custom-fitted mouthguard.
  • Custom-fitted mouthguards are more expensive than the other types of mouth guards, but they provide the greatest degree of fit, comfort and protection because they are made from a cast to precisely fit your teeth. Your dentist makes an impression of your teeth and a dental laboratory technician – either in the dentist’s office or at an off-site dental laboratory – uses the impression as a mold to create the custom-fitted mouthguard.

Custom-fitted mouth guards are designed to cover all the teeth and can cushion against falls and blows to the chin. Some custom-fitted mouthguards have hard outer layers and soft inner linings for comfort against the teeth and gums. Some are made of acrylic, while others are semi-rigid, flexible and made with materials for patients allergic to acrylics.

Because the mouth, like other parts of the body, experiences growth spurts, it’s important that a dentist evaluates a child or adolescent’s mouth before choosing a mouthguard. Additionally, different sports involve different levels of risk and potential injury; your dentist also can help customize a mouth guard based on your or your child’s specific activity.

Mouth Guards Vs. Other Kinds of Mouthpieces

Occlusal splints, also called bite splints, bite planes, Michigan splints or night guards, are types of removable dental appliances that are worn to protect the teeth and restorations. Custom-fitted to the upper or lower teeth, these dental appliances also can be used to manage problems caused by jaw issues, such as headaches and neck aches, as well as stabilize a person’s bite before undergoing dental procedures.

People who suffer from night-time teeth clenching or grinding (bruxism) should wear night guards to help lessen wear and tear on the teeth and reduce the possibility of tooth fractures. The main difference between night guards and other types of splints is that night guards should only be worn at night and splints are usually worn full time. Occlusal splints of any kind are not recommended for use during athletic or recreational activities, since they generally are not strong enough to provide the protection afforded by athletic mouthguards.

Anterior deprogrammers are mouth guard type devices that promote relaxation of the jaw muscles and work best for people who are chronic and severe clenchers and grinders. They can be worn day and/or night, depending on the severity and type of condition being treated.

Examples of anterior deprogrammers are NTI (Nociception Trigeminal Inhibitor), B (Bruxism) splint and Kois appliances.

The NTI is a small, clear plastic device that is worn over the two front teeth (either top or bottom) at night to prevent contact of the back teeth. It is used to reduce tension headaches, as well as alleviate symptoms of bruxism and TMJ disorders.

B splints are meant to be worn on either the upper or lower teeth and are generally worn during the day. However, they are usually worn at night when used with another appliance to prevent bite changes.

Kois appliances can be worn at night to relieve muscle fatigue and headaches.

Cost, Care and Cleaning

Stock mouthguards typically range in cost from $1 to $15 and are available in sporting goods and drug stores. Mouth-formed guards are priced at approximately $2 to $30 and also are available at sporting goods and drug stores. Custom-fitted mouthguards cost between $190 and $500 and are available from a dentist. Most dental insurance plans generally do not cover the cost of mouth guards. Check with your dental insurance company to determine your level of coverage. Either way, a mouth guard is a good investment in your oral health.

Properly maintaining, cleaning and caring for your mouthguard is important to help prevent infection and the spread of disease. This helps keep your teeth and gums healthy.

For the healthiest results, consider these recommendations:

      • Brush and floss your teeth before wearing your mouthguard.
      • Do not chew on your mouthguard, since this can distort its shape.
      • Never throw the mouth guard in with dirty, sweaty gear.
      • After each use, wash your mouthguard with soap and cool – not hot – water.
      • Before storing, soak your mouthguard in mouthwash.
      • Keep your mouth guard in a well ventilated, plastic storage box when not in use.
      • Avoid bending your mouthguard.
      • Heat can damage a mouthguard; don’t leave it in direct sunlight or in a closed vehicle.
      • Do not handle or wear someone else’s mouthguard; never share your own.
      • Do not try to change the fit of your mouthguard yourself; have your dentist adjust it.
      • Call your dentist if you experience any of the following warning signs of wearing a contaminated mouthguard: difficulty breathing, wheezing, diarrhea and nausea to the point of vomiting.

How long a mouthguard lasts depends on its construction and use. Stock and mouth-formed guards typically wear out after several months of repeated, hard use. Custom-fitted guards generally last a year or more. Check the condition of the mouth guard before each use, especially if you have a tendency to chew on it. It is a good idea to bring your mouthguard with you to your regular dental examinations for periodic evaluations.