Playing sports with braces is encouraged, provided the athlete takes proper precautions to protect their mouth and orthodontic appliances. The primary risk is facial impact, which can drive brackets against the lips and cheeks, causing painful lacerations. A blow can also dislodge or break brackets and bend wires, extending treatment time and requiring extra repair appointments. Using specialized mouthguards allows athletes to safely participate in nearly any sport without compromising treatment progress.
Mandatory Protection: Choosing the Right Mouthguard
A mouthguard acts as a protective cushion, absorbing impact shock and creating a barrier between the braces and the inside of the mouth. This prevents damage to the hardware and safeguards the lips and cheeks from cuts caused by the brackets. Standard, off-the-shelf mouthguards are insufficient for athletes with braces because they lack the necessary space to fit comfortably over the appliances.
The most common option is the “boil-and-bite” mouthguard, which softens in hot water and molds to the contours of the teeth and braces. This type is cost-effective because it can be reheated and remolded as teeth shift during treatment, maintaining a snug fit. Athletes must select a boil-and-bite product specifically designed for braces, as these have a larger profile to accommodate the appliance without the material locking into the brackets.
Custom-fitted mouthguards, made by an orthodontist from an impression of the mouth, offer the most precise and comfortable fit. Despite their superior fit, custom guards are more expensive and cannot be remolded as the teeth move. Because they quickly become ill-fitting, requiring a new impression and a new guard, the remoldable boil-and-bite guard is often a more practical solution throughout the treatment process.
Assessing Risk in Different Sports
The required level of protection depends heavily on the specific activity and the likelihood of facial impact. Sports are categorized by risk level, which dictates whether a mouthguard is required or merely recommended. Athletes participating in high-contact sports, where collisions and impact are frequent, must wear an orthodontic mouthguard at all times.
High-risk activities include:
- Football
- Hockey
- Rugby
- Wrestling
- Martial arts
In these sports, where a blow to the face is common, the mouthguard is a non-negotiable piece of equipment. Medium-contact sports, such as basketball, soccer, baseball, and softball, also carry a significant risk from accidental elbows, errant balls, or falls.
Although contact may not be intentional in medium-contact sports, the speed and nature of play make a mouthguard highly recommended to protect against unexpected trauma. Conversely, low-impact sports like running, swimming, cycling, and track pose a minimal risk of direct facial impact. A mouthguard is typically not required for these activities, but athletes should maintain general safety awareness to avoid accidents that could lead to injury.
Immediate Actions for Braces Damage
Even with protective measures, damage to braces can occur during play. After any incident involving a blow to the mouth, rinse the mouth thoroughly with water to assess the damage. If there is bleeding or irritation to the soft tissues, rinsing with warm salt water can help soothe the area.
If a wire is poking or a bracket feels sharp or loose, apply orthodontic wax immediately to prevent further injury to the cheeks or lips. Pressing a small piece of wax over the sharp edge creates a smooth surface, providing temporary relief until the athlete can see their orthodontist. If a loose wire cannot be pushed back into place, it can sometimes be carefully clipped with clean nail clippers, but only if the protruding end is causing significant discomfort.
The athlete should contact the orthodontist’s office immediately, even if the damage appears minor, to schedule an urgent repair appointment. Delaying the repair of a broken bracket or bent wire can slow the treatment process and lead to unwanted tooth movement. Prompt communication ensures the orthodontic team can address the issue quickly and keep the treatment plan on track.