Athletic mouthguards - Features to look for.

Sports mouthguards are dental appliances that help to protect the hard and soft tissues of the mouth (teeth, jawbones, lips, cheeks, gums and tongue) from injury caused by traumatic blows and collisions.

How important is it to wear one?

The value of a guard cannot be overstated.

• It's thought that as many as one third of all injuries treated by dentists are sports related.
• During any single season, it's estimated that an athlete participating in a contact sport runs about a 10% chance of experiencing some sort of orofacial injury.

What features should you look for?

Here's a listing of characteristics that a good sports mouthpiece should have.

A) Fit and comfort.

Two of the most important characteristics for a mouthguard to have are that it's comfortable to wear and stays in place well. If it doesn't meet these criteria, it probably won't be used, at least all of the time.

Difficulty with speaking and breathing.

Athletes sometimes complain that wearing their mouth protector makes it hard for them to speak or breathe. In most cases, both of these difficulties stem from the same problem, a loose-fitting appliance.

If a guard doesn't have good retention, the athlete will tend to hold it in place by way of clenching their teeth. It's this constant clenching action that makes it difficult for them to speak and breathe.

B) Design considerations.

Single-arch designs.

Most sports mouthguards are only fitted to the wearer's upper jaw. Here's why.

The lower jaw has a free range of motion. That means when a blow is directed to it, some of the force will be buffered by its reactive motion.

In comparison, the upper jaw is fixed in place. And that means any traumatic force delivered to it will be fully absorbed by it and the teeth it holds. (This difference in jaw anatomy explains why a person's center two upper teeth are the most likely ones to be damaged by an accident.)

Dual-arch designs.

Some mouthguards have a design where they fit over both the upper and lower jaws.

As an advantage, this design does provide a greater level of protection for the lower teeth. And it may provide greater protection for the jaw joint.

However, this type of mouthpiece can be more uncomfortable to wear than a single-arch model and therefore not used as consistently as the latter.

Protection for orthodontic patients.

Dual-coverage appliances can be an especially beneficial for athletes whose lips and cheeks need protection from their braces.

C) Shape.

The overall shape of a sports mouthpiece should cover all of the athlete's teeth, including their back ones (there is some debate regarding the necessity to cover over erupted wisdom teeth). Some studies suggest that those that fail to encompass a significant number of posterior teeth can place the wearer's lower jaw at greater risk of fracture.

A mouthguard should also extend over the gum tissue somewhat. This helps to disperse forces away from the teeth and to the jawbone.

D) Thickness.

Different types of sporting activities involve different levels of expected risk. For example, it's easy to imagine how a boxer's anticipated risk for mouth trauma would be higher than a tennis player's.

In correlation with this, the thickness of a sports guard is often tailored to the activity its wearer will be participating in.

• For sports that don't entail a high degree of physical contact, a thickness on the order of 1/16th of an inch (2mm) may be adequate.
• Heavier contact sports would necessitate a thicker mouthguard, more along the lines of 1/8th of an inch (4mm) or more.
• Some contact sports may require an even thicker protector.

E) Resiliency.

A protector's resiliency (sponginess) can help to absorb some of the force delivered by a traumatic blow. Equally important, if a mouthguard isn't somewhat flexible it may cause irritation when worn.

F) Stiffness.

A guard's stiffness may have more to do with the level of protection it can provide than its spongy resilience. Rigidity helps to distribute the forces of a blow over a larger area, thus buffering the amount of force directed to any one tooth or mouth area.

Choosing the right appliance.

To the uninitiated, all athletic mouth protectors may seem pretty much the same. To the contrary, however, even similar-looking products may differ greatly in design criteria and level of protection.

As explained on our next page, there are three basic types of guards: Stock, Boil-and-bite, and Custom. A Custom appliance has usually been specifically designed to fulfill the requirements outlined above. In comparison, some Boil-and-Bite products may be able to meet these same criteria but not always. In most cases, Stock appliances will be found to be lacking.

Additional benefits and protections.

Beyond just protecting oral structures and soft tissues, a sports mouthpiece can provide other benefits too.

A) Protection from concussion.

Some studies have suggested that wearing a mouthguard can help to reduce the incidence or severity of concussions. Their explanation is this.

Traumatic forces directed to the jawbones are, in turn, transmitted to the bones of the skull (this is what creates the potential for concussion). Wearing a mouthguard can help to absorb and disperse, and therefore mitigate, these forces.

B) Psychological benefits.

You can spin the argument that wearing a sports mouthguard may provide a psychological edge for an athlete, in the sense that they may feel more confident (and therefore perform better) when they know they have proper mouth protection.

C) Protection from secondary sources of trauma.

• That portion of a guard that covers over the chewing surface of the athlete's teeth can help to cushion the forces created if their jaws are violently slammed together.
• For those athletes who have missing teeth, the fit of a custom-formed mouthpiece will help to support and stabilize their remaining teeth. This means any removable appliance (such as partial denture) can be left out, thus avoiding any potential damage by or to it.