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Mouthguards - By the Skin of Your Teeth

Mouthguards - By the Skin of Your Teeth

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By Dr. David Leader

I received a phone call at home one Saturday. The tense but calm voice of a baseball coach on the other end reported that a young outfielder had caught a baseball in his mouth. The coach said that this child had a couple of loose teeth and was bleeding heavily . I sped to the office to see what could be done.

The baseball coach, the child's upset mother, and the teenage outfielder holding a blood-soaked bath towel to his face were waiting at the office door. Upon examination, we found that two teeth were pushed back 45 degrees and one front tooth was missing . The child's lip and gum were torn requiring several stitches. This young man would need an expensive bridge to replace his missing tooth. This situation was very emotional, expensive and painful . Wearing a mouthguard could have prevented all of the damage.

The Massachusetts Interscholastic Athletic Association (MIAA) requires the use of mouthguards for all levels of high school play in many sports such as field hockey, soccer, and football . The MIAA recommends mouthguard use in baseball. Interestingly, since mouthguards once became required in high school football basketball became the sport with the most orofacial injuries. In addition, mouthguard use has been an important factor in reducing concussive head injuries in football. Sherry Bryant, assistant director of the MIAA, pointed out that mouthguards are required for basketball players this year for the first time.

Even our youngest athletes should always wear a mouthguard. They need the protection, and they will be more accustomed to wearing a mouthguard as they grow.

There are three basic types of mouthguards:

  • The stock mouthguard is bought in a store and worn unchanged. This type of mouthguard is very inexpensive. Unfortunately, the stock mouthguard does not fit to the teeth and is easily lost during an incident. When athletes opens their mouths to breath or speak, the mouthguard falls out of place.
  • Boil and bite mouthguards are supplied by sporting goods stores as well. They cost only a little more than the stock mouthguards . These mouthguards are fitted to the teeth by heating them in boiling water, and then biting into them while forming the sides by rubbing the cheeks and upper lip. The quality of the fit is determined by the person doing the fitting . If the mouthguard is too thin, forces will be concentrated in that area on impact, and teeth in that area will be more likely to break. Boil and bite mouthguards are made of softer material than custom made mouthguards and also do not last as long. They are made thinner than custom made mouthguards to make them safe to form in the mouth . Some athletes often chew right through them in a few weeks. Although some brands are thicker than others, these mouthguards are in general too  thin to be most effective but certainly will provide limited protection against injury
  • Custom made mouthguards are fabricated by a dentist or a dental lab technician on a plaster model of the athlete's teeth. The fit and size of the mouthguard is assured by the dentist. These mouthguards stay in place while breathing and talking. The sides are extended as far as possible to allow comfort and maximum protection . The thickness of the mouthguard is dependant on the sport and the age of the player. Obviously, boxing mouthguards would have to be thicker than mouthguards for young soccer players. The materials used to make this type of mouthguard must be heated to a very high temperature to change their shape. They are very strong and usually last through an entire sports season.

Store-bought mouthguards often carry a warrantee that offers a dollar amount when teeth are damaged while wearing the device. Read these warrantees carefully. Even when it seems as if the manufacturers will pay a large sum for treatment of an injury, actually they will pay only a small amount per tooth or per injury.

Now is the time to get your child outfitted for the fall sports season. Buy the right protective gear. If you are not sure what type of mouthguard is best for you or your child, consult your dentist.

Please see for some alternative choices to dentist made mouthguards.

Dr. David Leader is the Chairman of the Health Advisory Committee of the Lynnfield Schools, a member of the Professional Advisory Committee of Tri-CAP Head Start, and is a member of the Mass Dental Society Council on Dental Care and Benefits Programs.