Mouthguards and Dental Injuries in Sport: What Actually Protects Teeth

Dental injuries in sport have an unusual property: the damage is permanent, the prevention is cheap, and the gap between those two facts is where most of the harm happens.

An adult tooth knocked out on a Saturday can mean a lifetime of maintenance, and a replacement that never quite matches. A mouthguard costs a fraction of the first year of that. This is general information rather than advice about your own circumstances.

The injuries that actually happen

Sport produces a fairly predictable set of dental injuries.

Chipped and fractured teeth are the most common, usually to the upper front teeth, which sit forward and take the impact first. Some are minor, some reach the nerve. Our broken tooth repair page covers how the different fracture patterns are treated.

Displaced teeth, pushed out of position or loosened, need repositioning and splinting rather than being pushed back by hand.

Avulsed teeth, knocked completely out, are the most time-critical thing in dentistry outside a serious infection.

Soft tissue injuries to lips, cheeks and tongue often accompany the above, and a lower jaw driven into an upper jaw can also fracture back teeth.

The first thirty minutes for a knocked-out tooth

Worth committing to memory before you need it, because there is no time to look it up.

Pick the tooth up by the crown, the white part you normally see. Never touch the root, because the living ligament cells on its surface are what allow the tooth to reattach, and handling or wiping them destroys exactly what you are trying to save.

If it is dirty, rinse it briefly in milk, never scrubbing and not under a running tap. Put it straight back in the socket if you can and bite gently on a clean cloth to hold it. If you cannot, put it in a container of cold milk.

Then get to a dentist, ringing on the way rather than after. Our knocked out tooth page has the full detail.

Two things worth knowing in advance. Water is a poor storage medium and dry is the worst, so a tooth carried in a tissue has a poor outlook. And a knocked-out baby tooth must not be put back, because replanting it risks the permanent tooth developing above it.

Sports bags are a reasonable place for a small container and a long-life milk carton if you run a junior team.

Why custom mouthguards outperform the chemist version

Both a custom mouthguard and a boil-and-bite from a sports shop are better than nothing. They are not equivalent.

A boil-and-bite is softened in hot water and moulded by the wearer. The result is usually thinner in the places that matter, because pressing it into shape with your teeth and tongue squeezes material away from the front surfaces where impact lands. Fit tends to loosen over a season.

A custom mouthguard is made from a model of your teeth, so thickness is controlled where protection is needed, and it stays put without being clenched.

That last point is the one that decides whether it gets worn. A guard that has to be held in place with your jaw makes it harder to breathe and harder to talk, so players take it out. A guard that stays put on its own gets left in, and a mouthguard in a bag protects nothing.

Custom guards also last better through a season, and for children can be made in team colours, which does more for compliance than any amount of explaining.

Braces and mouthguards

If you or your child wear braces, a mouthguard is more important rather than less, because brackets turn an ordinary knock into a laceration of the lip.

Guards for braces are made differently, with room to accommodate the appliance and the tooth movement underneath. A standard boil-and-bite moulded over brackets can lock onto them, which is its own problem. Tell us if you are in orthodontic treatment, or wearing clear aligners, and we will make the right kind.

Which sports, around here

Canberra’s sporting participation is high, and the risk is not limited to the obvious codes.

Rugby union and league, AFL and hockey are the ones people expect. Basketball and netball produce a surprising number of dental injuries because of elbows and collisions, and neither has a strong mouthguard culture. Skateboarding and cycling account for a steady share, and falls onto hard surfaces are exactly the mechanism that avulses front teeth.

Our immediate catchment skews young: Braddon has a median age of around 30, the city 27, and the ANU campus at Acton 19. That is a lot of people playing social and university sport, often without the equipment culture that organised junior clubs enforce.

When to replace one

Children and teenagers need theirs remade regularly, because a mouthguard fitted to a mouth that is still growing and losing baby teeth stops fitting quickly. Once a year, or whenever the fit has clearly changed, is a sensible rhythm.

Adults get longer, but a guard that has become loose, thin, torn or permanently deformed is no longer doing much. Bring it to a check-up and we will look at it.

Store it in its ventilated case, not loose in a bag, rinse it after use, and keep it out of hot cars, because heat distorts it.

The blunt arithmetic

An avulsed permanent tooth that cannot be saved needs replacing, most commonly with a dental implant, and a young person who loses a front tooth at fifteen will maintain that replacement for decades. Even a well-managed replanted tooth usually needs root canal treatment and monitoring for years afterwards.

Against that, a custom mouthguard is a single appointment and a modest fee, and it is the one piece of protective equipment that reliably prevents an injury which cannot be undone.

If you play contact sport or your kids do, mention it at your next check-up and we can take the impression then. We are open Monday to Friday from 7:30am and Saturday from 9am.