Wearing a mouthguard is possible for individuals completely without teeth (edentulous). The approach shifts from relying on teeth for retention to using the underlying gum structure and specialized design principles. A protective guard is typically required either to shield the delicate gum tissue and jaw joint from impact during sports, or to prevent the effects of nighttime teeth grinding (bruxism). Standard, over-the-counter guards are unsuitable and may cause harm, necessitating a custom-made appliance.
Specialized Oral Appliances for Edentulous Patients
Traditional guards that rely on gripping the contours of the teeth are ineffective for an edentulous person. The appliance must be professionally custom-molded to the shape of the alveolar ridge (the remaining bone structure beneath the gums). This customization is necessary to distribute applied force evenly across the ridge surface, preventing localized pressure points that could cause soft tissue damage or bone resorption.
The material and thickness of the custom guard depend heavily on its intended use. A sports guard designed to absorb impact, such as from contact sports, is typically made from a thicker, resilient material like ethylene vinyl acetate (EVA). This layered material extends over the entire gum line and surrounding soft tissue to provide maximal shock absorption and protect the jaw joint.
Conversely, a bruxism guard is designed to create a physical barrier and stabilize the jaw relationship. These night guards are often thinner and may utilize a harder acrylic resin to resist clenching forces without rapidly wearing down. Both types must cover the full arch; the sports guard focuses on volume and resilience, while the night guard focuses on precise fit and material durability.
Retention and Stability Without Teeth
Achieving stability without the anchor provided by teeth is a major technical challenge in prosthetics. The primary mechanism for keeping an edentulous guard in place mimics the principles used for full dentures, relying on a physical phenomenon called the peripheral seal. This seal is formed when the edges of the appliance intimately contact the soft, movable tissue at the border of the palate and cheek. A properly extended guard creates a vacuum (negative pressure) between the appliance and the soft tissue, especially in the upper arch.
The success of this suction depends directly on the morphology of the alveolar ridge (the shape and height of the remaining jawbone). A well-defined, taller ridge provides a larger surface area for contact, which significantly improves retention and stability.
In the lower arch, where gravity and tongue movement are greater factors, the peripheral seal is more difficult to maintain. Stability relies heavily on the patient’s learned control of the surrounding musculature. The tongue and cheek muscles must rest against the polished surfaces of the guard, helping to hold it down and in place. Poor retention can lead to the guard moving, tipping, or causing painful chafing on the gums.
Guards Used in Conjunction with Dentures or Implants
Many edentulous individuals wear guards when they already have prosthetic devices, such as full dentures or dental implants. For dentures, a guard is often necessary to protect the prosthetic appliance itself from damage due to bruxism. Uncontrolled clenching or grinding can cause the acrylic denture base or the artificial teeth to crack, fracture, or wear down prematurely.
A custom guard is fabricated to fit precisely over the existing denture, acting as a sacrificial layer that absorbs grinding forces. This protective shell ensures the longevity of the expensive prosthetic, a major concern for patients with a history of grinding. The guard also helps stabilize the denture, preventing excessive movement that can accelerate the resorption of the underlying jawbone.
When dental implants are present, a guard serves to protect the implants and the attached restoration from impact or excessive lateral forces. Implants are osseointegrated (fused directly to the bone), making them vulnerable to damaging forces from severe grinding or athletic trauma. Specialized sports guards cushion the entire arch, dissipating energy away from the implant abutments and screws. Furthermore, some guards are engineered as hybrid appliances, featuring internal attachments that snap directly onto implant locators, providing superior retention and stability compared to soft tissue suction alone.