Sports Mouth Guards in Boynton Beach
I originally wrote this as a letter to the parents of my son's hockey
teammates. However, it applies equally to all ages and all sports.
It's a bit long, but, I think you'll find it very
informative. If you have a child in youth sports, this is really
Athletic Mouth Guards vs. Over-the-counter
By Michael Barr, DDS
A few years ago, I became a “hockey dad.”
Previously, I knew very little about hockey other than it was a
notoriously rough contact sport.
Dental injuries traditionally top the list of hockey-related
incidents. In fact, hockey is
famous for producing toothless grins.
While my article may seem to be “hockey-centric,” it bears mentioning that
nearly ALL team sports can become “contact sports.”
That includes: baseball,
basketball, soccer, lacrosse, football, rugby, volleyball, martial arts
(karate, judo, taekwondo, ju-jitsu, mixed martial arts, etc.), and others I’m
probably forgetting at the moment.
And, protecting teeth isn't just for kids in sports. It's just as
important for adults!
Naturally, as a dad, I’m concerned about my son’s safety and well-being.
As a dentist, I have an even more acute awareness about protecting
his precious teeth. Teeth don’t
grow back if they’re broken or knocked out.
As a trained and experienced restorative dentist, I’ll tell you it’s better to preserve what nature gave you.
Furthermore, a single tooth traumatically lost may have a lifetime
cost of over $15,000 in maintenance and replacements.
Look out there on the ice.
Look familiar? The mouth guard
isn't being worn properly. Almost every player with a
store-bought guard is doing this... because he or she has no choice.
He can't breathe or talk during play with it properly on his teeth.
This is NOT acceptable, and it's dangerous.
It does nothing to protect the player.
Athletic mouth guards are rightfully required by many sports league rules.
But, from my observations at practices and games, VERY few are
actually WORN by the players.
By “worn,” I mean actually in the mouth, on the teeth, where they’re
supposed to be. Most of the
players simply bite and chew on one side while the rest of the mouth guard
hangs outside the mouth like a cigar.
They might as well not have them at all.
I compare it to the motorcycle helmets you see strapped to the side
of seat, as the rider goes down the road with nothing on his head.
Look at your player’s store-bought mouth guard.
Is it all chewed up and flattened?
See Figure 2 below.
Figure 2: Does your player's
guard look like this? All chewed up? The yellow arrows indicate
where the guard has split all the way through. This is a stock
store-bought mouth guard I bought as a temporary for my son right after he
got braces. He chewed through it in a WEEK. I've since made him
another custom mouth guard. I believe these stock mouth guards are
Athletic mouth guards can prevent tooth fracture or loss, jaw fractures, and
lacerations. While many of you have
heard that a custom athletic mouth guards
may prevent concussion
injuries, there is no current scientific evidence supporting this notion.
It is still a controversial issue not yet proven with repeatable
scientific data. The primary purpose of
athletic guards remains the protection of teeth, jaws, and related soft
Athletes don’t wear store-bought guards properly, because they can’t!
I submit it’s not a matter of the players simply not wanting to wear them.
The fact of the matter is that they CAN’T wear them properly AND
function as a sports team member simultaneously.
Here’s the real issue:
The majority (if not all) the mouth
guards that aren’t being worn properly are over-the-counter, boil-and-bite
mouth variety. That type of
mouth guard is nearly, if not completely, worthless…
Because they don’t fit (and stay put).
The fit is so poor, the player can only keep it on his / her upper
teeth by forcibly biting down on it. And, if
they do that, it restricts breathing significantly and prevents
communications with other players.
Because they are so bulky, the players can’t:
Talk to each
other on the ice, court, or field.
effectively when these bulky, loose mouth guards get in the way.
It’s been reported that a custom guard can increase oxygen intake by
And, that’s exactly the problem:
The boil-and-bite guards are IN THE WAY.
And, when they’re in the way of breathing, it’s a big problem to the
athlete. So, he or she spits it
out… or holds it sideways like a cigar out the side of the mouth to appease
the refs who want them to “wear” the guards.
The refs are too busy to strictly enforce this rule.
You should try to do a few hot-laps around the rink, court, or field and
BREATHE while holding a store-bought guard in place.
You won’t like it! And,
you’ll want to spit the guard out just like your young players do.
You may have also noticed the store-bought guards don’t seem to last very
long. Many parents have told me
they’re buying a new guard every few weeks or every month.
This is especially true if your player is chewing on it (see figures
1 and 2 above).
The answer is…
A professionally fitted CUSTOM mouth guard.
A custom mouth guard fits over the teeth and gums very intimately and
comfortably. When it goes in,
it STAYS in. It will not fall
off. It won’t get in the way.
See Figure 3 below.
Figure 3: Custom laminated
athletic mouth guard.
My son puts his custom mouth guard in when he gets dressed for practice or
the game. And, it stays in his
mouth, on his teeth, until he returns to the locker room.
He can talk with it and call
for a pass. He can drink water
and stay hydrated with it in place.
He can BREATHE on a breakaway without having to spit it out.
Figure 4: A custom guard is
very comfortable. It can also
be made in a number of colors.
How are custom mouth guards different than store-bought?
store-bought athletic guard is a pre-fabricated plastic guard.
Some of them are “boil-and-bite,” which means you place them in hot
water, softening the guard, and then molding it in the player’s mouth.
And, even those do not fit well… at all.
A custom guard can be made in one of two ways, and it’s important to note
the differences between them.
The first type is a
single layer of material that
is adapted to a model of your player’s teeth by heat and vacuum / suction.
Many dentists have the equipment to make vacuum-formed guards right
in their offices. So, some
default to this as their “custom athletic mouth guard.”
It is better than an over-the-counter, boil-and-bite guard.
But, it’s not the best.
The second type of custom guard is the BEST protection you can get for your
player’s teeth. It’s a
multi-layer guard that is
adapted to the model by heat and PRESSURE.
The reason I emphasized “pressure” is because it’s a far superior
method of adapting “thermo-formed” materials to a dental model.
This method uses special (and more expensive) equipment.
Pressure-forming creates a much more accurate (and snug) fit.
It also allows us to make a multi-layer, laminated guard, which
protects teeth more effectively.
When we add layers, we can add increased thickness to areas that need
extra protection. This method
takes more time and more materials.
Of course, it costs more, too.
Figure 5: Pressure-formed mouth
guards fit the teeth and gums like a tight glove.
It will stay put until the player intentionally removes it.
Many dentists do not have the special pressure-forming equipment.
If they don’t, they’ll have to send the case to a commercial lab that
does. Some dentists may not be
aware of the significant advantages to laminated, multi-layer,
pressure-formed guards if they are not up to date on the latest
Be sure to ask your dentist which type of guard he offers
(vacuum vs. pressure or single vs.
multiple laminated layers).
The differences are significant enough to be worth asking.
How do I get a custom mouth guard?
Making a professional custom mouth guard requires an accurate impression
(mold) of the player’s teeth.
This means you’ll have to bring him or her to a dentist’s office for the
impression. If you’ve had
braces, a dental crown, denture, or retainer made, you are probably familiar
with the impression process.
Figure 6: Dental impression.
A model is made and then sent to the lab for the mouth guard to be made. Or
they may be made right in the dental office if they have the proper
lab equipment. The player will then
need to return to the office to finish the fitting process.
It’s a two-appointment procedure.
If your player is growing or losing baby teeth, the guard will probably need
to be remade as necessary to accommodate those changes.
What if the player has braces?
If your player is currently in braces, custom guards can be unfortunately
difficult to fit, depending on what kind of hardware is on the teeth.
And, because the braces hardware can change during the course of orthodontic
treatment, a custom guard may only fit for a short time. A boil-and-bite designed for braces may be your best
bet in some cases until the braces come off. But, you can count on
having to buy many of them per season as your child will probably chew
through them in a short time.
Shouldn’t the guard have a strap (to attach to the
While straps can be added to a custom guard, they are simply not necessary.
Straps are popular with store-bought guards because they are often
spit out by necessity (for reasons already mentioned).
On the other hand, a custom guard stays put.
It’s not removed for talking, breathing, or even drinking water.
Accordingly, a strap is not needed.
Straps can even be dangerous with a custom mouth guard.
In football, a “face-mask” violation becomes even more worrisome if
the strap is grabbed along with the face-mask. In hockey, I've seen
helmets come off in collisions. A strap could cause trauma to the
teeth. I recommend not using a
Do mouth guards reduce concussions?
The short answer is: No. Despite advertising
claims and "urban legend," there is no scientific evidence that mouth guards
reduce the incidence of concussions. The primary reason to wear a
mouth guard is to protect the teeth and surrounding tissues.
What is the cost?
A pressure-formed, laminated custom mouth guard costs about the same as or
less than what you'd spend on multiple boil-and-bite guards.
So, yes… the price is higher than a single guard bought at a sporting goods
store. But, regardless of the
low price of a store-bought guard, it’s worth nothing if it DOES nothing.
A stock store-bought guard may last a few weeks to a month (doing
nothing, mind you). A custom made guard will easily last a whole season (or
more), effectively protecting a player’s teeth.
And, since a mouth injury can cause life-long and costly issues, I
believe custom mouth guards are an excellent investment and value.
There are few guarantees in life.
Of course, we know that hockey and other contact sports have risks.
And, no piece of equipment can guarantee an injury-free season.
Using the best equipment available certainly helps.
But, a chewed-up store-bought
mouth guard with half of it (or all of it) hanging outside the player’s
mouth is useless and will not help prevent any injuries.
As a dentist and a hockey dad, I would urge you to consider obtaining a
properly fitted, pressure-formed athletic mouth guard for your child athlete
or for yourself, if you're an adult playing sports.
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