Athletic mouthguards: Features to look for.

- The level of protection your guard can provide is determined by its design.

A stock athletic mouthguard.

Stock athletic mouthguards don't make the best choice.

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.

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 properties for a guard to have are:

  • It should be comfortable to wear.
  • It should stay in place well.

If it doesn't meet these two criteria, it probably won't be worn, at least not all of the time.

How appliance fit affects 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.

A boil-and-bite mouthguard, before customization.

Single-arch, boil-and-bite mouthguard (before customization).

a) Single-arch designs.

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

  • The lower jaw's joint allows it to move freely. That means when a blow lands on it, some of the force will be buffered by the jaw's reactive motion.
  • In comparison, the upper jaw is firmly fixed in place. And that means any traumatic force directed 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 in an accident.)

b) Dual-arch designs.

Some mouthguards fit over both the upper and lower jaws. The advantages of this design are:

  • It provides a greater level of protection for the lower teeth.
  • It may provide greater protection for the jaw joint too.

As a disadvantage, this type of mouthpiece can be more uncomfortable to wear than a single-arch design, and therefore not worn as consistently.

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.

It should also extend over the gums somewhat. This helps to disperse forces away from the teeth and to the jawbone.

Some studies suggest that guards that fail to include a significant number of back teeth can place the wearer's lower jaw at greater risk of fracture. (There is some debate, however, regarding the necessity to cover over erupted wisdom teeth.)


A custom mouthguard.

A custom sports mouthguard typically offers the greatest level of protection.

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 injury would be higher than a tennis player's.

In correlation with this, the thickness of a sports guard is often tailored to the type of sport 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) is often considered adequate.
  • Heavier contact sports necessitate a thicker mouthguard, more along the lines of 1/8th of an inch (4mm) or more.
  • Extreme contact sports require an even thicker protector yet.

E) Resiliency and Stiffness.

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

A guard's stiffness has more to do with the level of protection it can provide than its resiliency. Rigidity helps to distribute the forces of a blow over a larger area, thus buffering the level 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. However, even similar-looking products may differ greatly in design and therefore the level of protection they provide.

As explained on our next page, there are three basic types of guards: Stock, Boil-and-bite, and Custom.

  • A Custom appliance is usually 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.

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 likelihood or severity of concussions. Their explanation is as follows:

  • 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 lessen, 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 the potential for damage by it or to it.

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