The American Dental Association has estimated that over 200,000 sports-related oral injuries are prevented each year by the use of mouth guards. Mouth guards, much like air bags, cushion the force of a blow to the jaw and dissipate the energy, greatly decreasing the incidence and severity of concussions because the lower jaw (the mandible), is not forced back into the base of the skull (the TMJ), and harmful forces are not transmitted to the brain. In addition, the teeth and soft tissues of the mouth are protected because the upper and lower jaws are not brought forcefully together, and the front teeth are cushioned. Costs related to replacing teeth lost due to trauma can run into the thousands, and can lead to a lifetime of dental problems.

TYPES OF MOUTHGUARDS

 

To be effective, a mouth guard must be comfortable, have excellent self-retention, retain no odor or taste, have little or no interference with speaking or breathing, wear well and resist deformation, not be bulky but have adequate thickness to be protective. Currently, there are 4 types of mouthguards available.

 

Stock Mouth Guards: These are the so-called “one-size-fits-all” type of sports guard that can be bought at sporting good and department stores. They are also carried at some pharmacy chains. They are inexpensive, used right out of the box, and offer the least amount of protection. They tend to wear out quickly, have poor retention, are bulky, and make speaking and breathing difficult. I do not recommend these guards for any type of sports activity.

 

Boil and Bite Guards: Approximately 90% of the sports guards used today by high schools and colleges are of this type. Marketed and advertised heavily to young athletes, they are made from a thermoplastic material that is softened in boiling water, then adapted by finger and tongue pressure in the mouth by the athlete. The problem with these mouth guards is that during the heating process and subsequent adaptation, thin spots develop in the material, offering greatly reduced protection. Since they are thermoplastic, the heat of the mouth can deform the material. Often, they do not cover all the posterior teeth, and are frequently cut and adjusted by the athlete to make a more comfortable fit, further reducing their effectiveness. They are bulky and interfere with breathing and speaking. While offering a perceived benefit for a low cost, I do not recommend these for sports activities.

 

Custom Sports Guards: Custom made mouth guards are superior in every way to the stock and boil and bite guards. After an impression is taken, most commonly of the upper teeth, there are two possible custom mouth guards that can be fabricated:

 

• Vacuum Mouth Guard: Using a vacu-form machine, a piece of material (commonly EVA – ethylene vinyl acetate) is heated above a stone model of the upper teeth. The material is lowered on the model, and a vacuum pulls the material over the teeth. However, these sports guards have their limitations. All material thins out when heated by as much as 50%, sometimes more. So, a 3mm sheet of EVA (the recommended thickness for most sports), can end up being 1.5mm, and offer greatly reduced protection. Additional layers cannot be added, because the material will not fuse unless heat and pressure are used. Because no pressure is used, the internal fit is compromised.
  
  
• Pressure Laminated Mouth Guard: By far the best sports guard available. These custom-fitted mouth guards are fabricated by a special machine, which fuses layers of material using heat and as much as 10 atmospheres of pressure. Therefore, the internal fit of these guards is extremely precise. These sports guards have virtually no elastic memory (they will retain their shape), will not deform with the heat of the mouth, and additional layers can be fused together to form a thicker guard, or to add material where extra protection is needed. These guards also have the additional advantage of being able to be customized. So, when a sports guard fits well, is personalized, and allows breathing and speaking, it is much more likely to be used.

~ Dr. Rob From