Mouthguards: protecting your smile during sport

We Australians are a sporty bunch. From Cathy Freeman's 400m to Lleyton Hewitt's come on! to the right foot of Matildas captain Sam Kerr, the list of sporting achievements is a long one — and so is the list of teeth lost on suburban ovals every winter.

A substantial share of traumatic dental injuries are sports-related, and dental injuries are among the more common injuries in junior sport. Almost all of them are preventable with a piece of moulded plastic that costs a fraction of what the repair does.

What a mouthguard does

A mouthguard fits over your teeth and absorbs and redistributes the force of an impact, so it is spread rather than delivered to a single tooth. It also cushions the lips and cheeks against being driven onto the tooth edges, and offers some protection against the lower jaw being slammed into the upper.

An injury to the face can result in the loss of one or more teeth, broken or chipped teeth, jaw fracture, and lacerations to the soft tissues.

The cost nobody thinks about

A mouthguard is an affordable alternative to repairing extensively damaged teeth — and a knocked-out front tooth is not a single repair. It is a lifetime of maintaining and eventually replacing whatever goes there instead.

The realistic sequence after losing an upper front tooth at fifteen: emergency treatment and splinting, root canal treatment within a year or two, a crown, then — because a tooth lost in adolescence usually cannot be implanted until growth finishes — a temporary replacement through the teens, then an implant in the twenties, then a replacement crown on that implant every decade or so.

That is the honest comparison. Not a mouthguard versus a filling; a mouthguard versus sixty years of dentistry.

Custom-fitted versus over-the-counter

Custom-fitted mouthguards are made from an impression or digital scan of your own teeth. They are specifically fitted to your teeth and contour the soft tissue of your mouth, allowing an exact fit. That makes them more comfortable and secure, better at distributing impact, and compatible with normal speech and breathing.

Over-the-counter guards from a sports store offer some protection, but they are moulded to an approximation of your mouth. They commonly loosen during play — and a guard sitting on the bench is protecting nobody. Players tend to clench them in place, which interferes with breathing and speech, and the material distorts with repeated use.

The central problem with a boil-and-bite guard is not obvious: biting into hot material squeezes it thinnest exactly over the front teeth, which is where the impact lands.

What a good guard looks like

Worth knowing so you can judge one, whoever made it.

• Covers the upper teeth back to the last molars. A guard that stops at the canines protects the front teeth and leaves the back ones to take the jaw impact
• Adequate thickness over the biting edges — usually 3–4mm over the front teeth for contact sport, built in layers
• Edges that finish short of the gum fold, so it does not dig in or rock
• Stays put when you talk, and when you tip your head forward without being clenched
• You can breathe and be understood. A player who cannot call for the ball takes it out

Which sports

The Australian Dental Association recommends a custom-fitted mouthguard for:

AFL · Basketball · Boxing · Cricket · Hockey · Ice hockey · Gymnastics · Lacrosse · Martial arts · Rugby · Soccer · Squash · Volleyball · Water polo · Wrestling

The contact sports are obvious. Basketball, soccer and cricket cause more dental injuries than most people expect — an elbow or a ball does not need to be a tackle to cost you a tooth.

Also worth including, and often missed: skateboarding and BMX, mountain biking, netball, trampolining, horse riding and skiing.

And wear it at training, not just on match day. A large share of injuries happen at training, precisely where players are least likely to be wearing protection.

Some sports and leagues mandate mouthguards; many junior competitions do. Check with your club, and note that a mandated guard is a minimum, not a recommendation.

How one is made

1. A short appointment, about fifteen minutes, for a digital scan or an impression
2. Colour choice — single colours or combinations, club colours included
3. Fabrication by an Australian dental laboratory, usually a few days
4. A fitting, where it is checked for coverage, comfort and how it sits when you bite
5. Wear it in at a training session before a match, so anything that rubs can be adjusted

Book before the season starts. Every year we are asked for one the day before round one, and the laboratory turnaround does not bend.

Children need them replaced

A child's mouth is a moving target — teeth erupt, jaws grow, and last season's guard may no longer fit. Bring it to your child's six-monthly check-up so we can assess it. Expect to replace it more often than an adult's.

A reasonable rule: a growing child needs a new guard roughly every season, and sooner if a front tooth has been lost or an adult tooth has come through since it was made.

If your child wears braces, tell us. Orthodontic mouthguards are constructed differently to accommodate the appliance and allow for tooth movement. A guard made before braces went on will not fit over them, and forcing it can move teeth or break brackets.

When to replace an adult's

• It no longer clicks firmly into place
• You can see thin or worn-through patches, or tooth marks right through it
• The edges have gone rough or the shape has distorted
• You have had any dental work since — a new crown, an extraction, orthodontics
• It smells persistently despite cleaning
• It has been left in a hot car

Caring for it

Rinse in cold water before and after use, brush gently with a soft brush, and store it dry in its ventilated case. Keep it out of hot cars — heat distorts it permanently — and away from dogs, who consider mouthguards a delicacy.

• No toothpaste, which is abrasive and scratches the surface; scratches hold bacteria
• No hot water, ever — it warps the fit permanently
• Dry it before it goes in the case, and let the case air out too
• Soak occasionally in a denture-cleaning tablet solution if it develops an odour, then rinse thoroughly
• Never share one, and never lend one between siblings
• Take it out to drink anything but water, and rinse before it goes back in

Mouthguard or night splint?

Different devices, not interchangeable.

A sports mouthguard is thick, soft and designed to absorb a single large impact. A night splint for grinding is hard acrylic, designed to resist sustained pressure over hours. Wearing a soft sports guard at night can actually encourage clenching, and wearing a hard splint to play sport offers little impact protection and can itself cause injury.

If you do both — play contact sport and grind at night — you need both. See occlusal splints.

If a tooth gets knocked out anyway

Handle it by the crown, not the root. Do not scrub it. Keep it moist in milk or saliva — never water. Reimplant it if you can, and get to a dentist immediately. Full first-aid steps are on our dental emergency page, and it is worth reading before the season starts.

A practical suggestion for clubs: keep a small carton of long-life milk in the first aid kit. It costs almost nothing and it is the single most useful thing in there for a knocked-out tooth.

Questions we are asked

Do I need one for the lower teeth too? Usually not. An upper guard is standard. A lower guard is sometimes made where there is a protruding lower jaw, or for some combat sports — ask.

Will it make me gag? A well-made guard ends short of the soft palate and most people adapt within a session or two. Tell us if you have a strong gag reflex; the design can be adjusted.

Can I wear it with a retainer? Not at the same time. Raise it with whoever is managing your orthodontic treatment.

Does it affect my breathing or performance? A custom guard does not meaningfully restrict breathing. Ill-fitting ones do, which is most of why players take them out.

My child's guard smells. Common, and it means it is not being dried and aired. Clean it, air the case, and if the smell persists, replace it.

What if I lose it mid-season? We keep the scan or model on file where possible, which can shorten the remake. Tell us straight away rather than playing without one.

Are they claimable? Most extras policies contribute, and eligible children may be able to use the Child Dental Benefits Schedule. Current pricing, health fund claiming and eligibility are on our mouthguards page.

Getting one made

An appointment for an impression or scan takes about fifteen minutes. Your guard is fabricated by an Australian dental laboratory and ready in a few days, available in a wide range of single colours and combinations — club colours are a common request, and a guard a child likes is a guard a child wears.

Book before the season starts — fabrication takes a few days.

Who provides this here

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. Custom mouthguards are made by our dentists and oral health therapists from a scan or impression taken here. We will also check an existing guard at a routine appointment at no separate charge — bring it in.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · book online

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.