Shoes, Uniform, Ball … Mouthguard?


By Polly Blake Buckey, D.D.S., M.S.


Mouthguards are a vital, often overlooked, piece of equipment in the athlete’s arsenal, particularly when competing in contact sports.  This is not an outrageous claim, considering that dental injuries are the most common type of injuries sustained in sports.  Anyone participating in a contact sport has at least a 10 percent chance of sustaining an orofacial injury.  You are 60 times more likely to be injured when not wearing a mouthguard.

The teeth most often traumatized by these facial injuries are the central and lateral incisors (front four teeth), which account for four-fifths of all cases.  A total of five million teeth are knocked out each year.  If these teeth are not properly preserved and replanted, dental costs to treat these traumatized teeth can range from $10,000 to $15,000 each, not including the costs of treating the gums and bone around the teeth.

Mouthguards prevent teeth from perforating soft tissues, such as the lips, tongue and cheeks.  They also play a crucial role in stabilizing the temporomandibular joints and are helpful in preventing jaw fractures.  However, the biggest asset of wearing a mouthguard may not be the protection that they offer to the teeth; a properly designed mouthguard reduces the incidence of concussion by absorbing the majority of the impact dealt to the mandible during a sharp blow.


Three types of mouthguards available:

  • Stock mouthguards are fairly rigid shells designed to be worn without further modification.  Often they have adequate mechanical properties, but the generally poor fit hinders speaking and breathing.  This likely leads to low user compliance.
  • Mouth-formed guards tend to be bulky and deteriorate fairly quickly.  These guards are formed by boiling the material in water, cooling it slightly and biting into it to adapt it to the teeth.  Initially the mouthguard may fit, but repeated usage causes lost retention as the unit slowly hardens.
  • Custom-made mouthguards are fabricated by the dentist by molding thermoplastic sheets to a cast of your child’s mouth.  This type of mouthguard provides the most optimal comfort and fit, with the close adaptation allowing for ease of speech and breathing.  The only drawback to custom mouthguards is a greater cost.

The success of the mouthguard speaks for itself.  In sports where the use of a mouthguard is mandated, there are simply fewer injuries than in other sports where no such rule exists.  But why are orofacial injuries not completely eliminated?  Often it is not a lack of rules, but a lack in enforcement of the rules.  In college hockey, a referee will not stop play simply because a player isn’t wearing his mouthpiece; however, referees in NCAA football watch for mouthguard use and will throw the penalty flag if there is an infraction.

Mouthguards should be introduced to children, as they are more willing to comply with usage and can develop positive attitudes about wearing them in order to reduce the number of orofacial injuries sustained during their athletic endeavors.  As a child’s mouth continues to change in size and number of teeth, a new custom-made mouthguard will need to be fabricated.  Check with your child’s dentist to see if he or she recommends a mouthguard to help protect your child while playing a sport.


Polly Blake Buckey, D.D.S., M.S., is a pediatric dentist.  She graduated from the University of Michigan’s School of Dentistry in 2000 and earned a master’s degree in pediatric dentistry from the University of Michigan in 2002.  She was the director of the dental clinic at Kosair Children’s Hospital from 2003 to 2006.  She loves working with children and making sure every child has the best care possible. 

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