Comparing types of athletic mouthguards.

- There are 3 kinds of guards: Stock, Boil-and-bite and Custom. Each varies in how it's made, the level of protection it provides and cost. Custom-made mouthpieces are generally best.

Picture of a Custom athletic mouthguard.

A Custom sports mouthguard.

A) Custom mouthguards -

Custom athletic mouthpieces are appliances made in a dental laboratory, specifically for the person who will wear it. This is the best type of mouth protector, although admittedly the most expensive.
  • Cost: $100 to $300
  • Availability: From your dentist or companies that providing mail-in dental laboratory services.

Advantages / Disadvantages / Comparisons.

  • A well-designed custom appliance is generally considered to be the best type of guard and provides the highest level of protection.

    Its design can be individualized, not just for the athlete but also for the type of sport they play.

  • The fit and comfort of this type of guard are usually excellent (better than any other type of protector) and as a result, only creates minimal inconvenience when worn.

    (The more comfortable and unobtrusive a mouth guard is the greater the likelihood that it will be used.)

  • While the cost of a custom appliance is more than its stock or boil-and-bite alternatives, it should be considered money well spent (see below).


Having a custom guard made.

a) By your dentist.

The process of making a custom sports guard begins with taking dental impressions.

Picture of a dental impression used to make a custom mouthguard.

A dental impression.

  • The dentist will fill an "impression tray" with a putty-like substance and then squish it over their patient's teeth and gums. The putty will set in just a few minutes. Once it has, the completed impression is removed.
  • This process is repeated for both the upper and lower jaws.
  • The next step is to fill the impressions with plaster. This creates models (casts) of the patient's mouth.
  • Using these models, a dental technician will design and fabricate the appliance. (Some dentists will send this work out to an independent dental laboratory, others will make the appliance "in house.")
  • The turn-around time needed for the fabrication process is usually just a week or two.
  • Once finished, the dentist will evaluate the design of the guard on its cast.
  • When the patient returns for their appointment, its fit in their mouth will be checked and adjusted as necessary.


b) Online (mail-in) laboratory services.

Some dental laboratories offer mail-in custom mouthguard services.

  • The buyer purchases a kit that contains trays and impression material. They then take an impression of their teeth and gums at home, on their own.
  • The impressions are then sent to the dental laboratory who will fabricate the appliance and then return it to the customer.


Potential problems with using an online service.

  • Taking an impression will be a new experience for the buyer, and one they may not be very good at.

    Check with the company you do business with. Do they provide more than one set of materials, in case a second attempt at taking an impression is needed? What happens if you send in an impression that is inadequate, will they send a replacement kit?

  • Even a mouthguard made from a seemingly perfect impression may require adjustment so it fits right. The buyer will need to take responsibility for making these adjustments, properly, on their own.


Fabrication methods.

There are two techniques that can be used to fabricate custom sports guards. In most ways, the appliances made using either method can be considered to be equivalent. However, the pressure-laminated method may offer some slight advantages.

a) Vacuum-formed appliances.

This fabrication technique is the one that's most frequently used. One reason may be because it's common for dentists to have a vacuum-form machine in their office.

Using this technique, a thick sheet of resilient plastic is heated until soft. It's then sucked down (vacuum formed) over a model of the patient's teeth, giving it its customized shape.

As for disadvantages of this type of mouthguard:

  • Due to the nature of this fabrication process, it's possible that the appliance's Occlusal ("chewing") and Labial (cheek/lip side) surfaces are thinner than expected. This must be checked, otherwise the level of protection the guard provides may be compromised.
  • This type of mouthpiece may possibly tend to lose its shape and snug fit over time.

b) Pressure-laminated appliances.

This fabrication method may offer a more predictable product.

Using this technique, multiple sheets of resilient plastic are heated, layered and pressed together (using a machine that creates several atmospheres of pressure) over a cast of the athlete's teeth to form the appliance.

Due to its method of construction, this type of guard has a more predictable and uniform thickness than a vacuum-formed one. And its shape and fit have less potential to relapse or change.

Picture of a boil-and-bite mouthguard, before customization.

A boil-and-bite mouthguard (before customization).

B) Mouth-formed guards -

Mouth-formed appliances (including boil-and-bite products) are the most-used type of sports protector. An estimated 90% of all sports participants wear them. (Krachner 2016)
As their name implies, the fit of this type of appliance is customized by the end-user (at-home). This feature helps them to provide a higher level of protection than a stock guard (see below) but not as good as a custom-made one.
  • Cost: $3 (in bulk) to $40 (individually)
  • Availability: Local sporting goods stores and pharmacies. Online retailers.

User customization.

This type of product typically has a firm plastic outer shell and a relatively spongy internal layer. It's the internal layer that's customized by the end-user.

A) In the case of boil-and-bite products, the internal layer is thermoplastic in nature (meaning it softens up when heated).

  • The purchaser first places the appliance in warm water until the internal layer becomes soft and pliable.
  • They then squish it into place over their teeth and gums.
  • Using their fingers, lips, tongue, cheeks, and gentle biting pressure, the wearer seats the appliance and forms its contours as it cools.
B) With other products, the spongy internal layer is plastic acrylic or silicone rubber. When the appliance is inserted in the athlete's mouth, it forms to the shape of their teeth and gums and then is allowed to set.

Neither process is difficult.


Advantages / Disadvantages / Comparisons.

  • During customization, the thickness of the internal spongy layer of the appliance may get thinned out. If it does, this can compromise the level of protection that the guard can provide.
  • These appliances can be quite bulky. (Custom guards would rank best in regard to this factor.)
  • Due to product-size limitations, incorrect product selection or errors in the at-home customization process, a guard may fail to cover over the wearer's teeth and jaws adequately.
  • The retention of this type of mouthguard can be expected to be better than a stock one but typically inferior to the fit of a custom-made appliance.


Picture of a stock athletic mouthguard.

A stock sports mouthguard.

C) Stock mouthguards -

A "stock mouthguard" refers to a preformed mouthpiece that's sold ready-to-be-used without any additional customization by the wearer.
While they are the cheapest type of guard, the level of protection they provide is just minimal too. The other types of protectors discussed on this page make a better, safer choice.
  • Cost: $1 (in bulk) to $15 (individually)
  • Availability: Local sporting goods stores and pharmacies. Online retailers.

Advantages / Disadvantages / Comparisons.

The disadvantages of stock appliances far outweigh any cost or convenience considerations they offer.

  • Stock guards are often only available in a limited number of sizes (i.e. small, medium, and large). As a result, they're often ill-fitting, uncomfortable to wear and don't stay in place well.
  • This lack of available sizes may result in an athlete ending up with an appliance that doesn't cover their back teeth the way it needs to so to provide maximum protection.
  • To compensate for a slack fit, an athlete may be forced to hold their stock mouthguard in place by way of clenching their teeth together. This can make it difficult for them to speak or breathe normally.
  • In some cases, the wearer may attempt to improve the fit or comfort of their appliance by trimming it. This type of customization can unwittingly compromise the level of protection it provides.

The Academy of Sports Dentistry considers stock mouthguards to be unacceptable as an orofacial protective device. (Krachner 2016)

Don't be penny-wise and dollar-foolish.

Yes, getting an athletic mouthguard involves an expense. But when its cost is compared to the possible outcome of not wearing one, its price should be seen as a bargain.

Consider the following points:
  • Having a white filling placed as a repair for a chipped tooth (even a relatively minor one) can easily cost in the neighborhood of $120 or more.
  • Major dental repairs (root canal treatment, dental crowns, tooth replacement) can cost anywhere from just a few, up to several thousand, dollars. That's 10 to 30 times the cost of a Custom appliance.
  • Of course, the above fees don't include other important factors such as the time and inconvenience associated with having the work performed.
  • Beyond the cost of the initial dental work, you can also expect that additional treatment will be needed in the future. No type of dental restoration can be expected to last a lifetime.

With all of these issues considered, when it comes to sports mouthguards, an ounce of prevention really can be worth a pound of cure.

(Disappointingly, most athletes are likely to spend more money on their shoes than they do for protection for their mouth.)