A mouthguard is a protective dental appliance designed to shield the teeth, gums, and soft tissues of the mouth from impact during sports or high-contact activities. When undergoing orthodontic treatment, the presence of metal brackets and wires changes the dynamics of this protection. Braces introduce new risks that a standard mouthguard cannot address, making specialized protection necessary for safe athletic participation. This guidance details the selection, fitting, and maintenance required for safely wearing a mouthguard while undergoing orthodontic treatment.
Why Orthodontic Patients Need Specialized Mouth Protection
The metal components of braces create a dual vulnerability when the face experiences sudden impact. Without a protective barrier, a blow to the mouth forces the lips and cheeks directly against the sharp edges of the brackets and wires. This contact frequently results in severe soft tissue lacerations, requiring immediate medical attention.
The orthodontic appliance itself is also susceptible to damage from impact. A strong hit can dislodge or break brackets and bend the archwires, which are precisely calibrated to move the teeth, interrupting the treatment plan. This damage requires an unscheduled emergency visit for repair and potentially extending the overall treatment time. Specialized mouthguards create a buffer zone that distributes the force of impact away from the appliance and surrounding soft tissues.
Selecting a Mouthguard Designed for Braces
Choosing the correct mouthguard is the first step in ensuring adequate protection. Standard stock mouthguards, which are pre-formed and offer a generic fit, are inappropriate because they lack the capacity to fit securely over the metal brackets. These ill-fitting guards are bulky, may not offer sufficient cushioning, and often interfere with orthodontic work.
The most common and accessible option is a boil-and-bite guard specifically designed for braces. These guards are made from a thermoplastic material that softens when heated, allowing the user to mold it around the teeth and brackets. Unlike standard versions, orthodontic boil-and-bite models feature a deeper channel and use a softer material, such as medical-grade silicone or specialized polymers, to accommodate the bulk of the brackets. This design allows the material to be remolded multiple times as the teeth shift during treatment, preventing the guard from becoming rigid and locking around the appliance.
The gold standard for protection is the custom-fitted mouthguard, fabricated by an orthodontist from an impression of the patient’s mouth. Custom guards offer the most secure and precise fit, maximizing comfort and protection using a dense, shock-absorbing material like polyethylene vinyl acetate (pEVA). While more expensive, the tight fit allows for easier speech and breathing. The need for periodic replacement or modification as teeth move must be considered. When selecting any mouthguard, the material should be latex and BPA-free to minimize the risk of allergic reactions.
Step-by-Step Guide to Fitting and Wearing
The fitting process for a boil-and-bite mouthguard requires careful attention to avoid damaging the braces. Begin by consulting the manufacturer’s instructions for the exact time and temperature required for softening the guard. Typically, the mouthguard is submerged in boiling water for 20 to 30 seconds to make the thermoplastic pliable. Use a slotted spoon to quickly remove the mouthguard and place it into cool water for one to two seconds before inserting it into the mouth.
Next, place the softened guard over the upper arch, ensuring it fully covers all brackets and extends to the back molars. Press the guard firmly against the teeth and braces, using your fingers to push the material up and back against the gums and roof of the mouth. Gently bite down to create an impression of the lower teeth on the underside of the guard, avoiding excessive force that could distort the orthodontic wires. Simultaneously, suck in to create a vacuum seal, holding this position for about 30 seconds to secure the fit.
Once the impression is set, remove the mouthguard and place it in cold water for several minutes to permanently harden the material. Ensure the guard is worn during all practices and games, as impacts can occur at any time. The guard must fit snugly enough to stay in place without being held by the tongue or jaw, allowing for comfortable breathing and communication. If the guard feels too tight, loose, or uncomfortable after an orthodontic adjustment, it should be remolded or replaced immediately to maintain protection and avoid interfering with tooth movement.
Cleaning and Storing Your Mouthguard
Maintaining the mouthguard’s hygiene is necessary to prevent the buildup of bacteria, which can affect the health of the teeth and gums surrounding the braces. Immediately after each use, the mouthguard should be thoroughly rinsed under cold or lukewarm water to remove saliva and debris. Hot water must be avoided entirely, as the heat can soften and warp the thermoplastic material, destroying the custom fit.
For a deeper clean, gently scrub the entire appliance using a soft-bristle toothbrush and a mild soap or non-abrasive toothpaste. Harsh chemical cleaners or abrasive materials should not be used, as they can degrade the mouthguard’s structure and leave irritating residues. After cleaning, the mouthguard must be allowed to air-dry completely before storage to prevent the growth of mold or mildew. A vented storage container is the preferred method for keeping the guard safe and allowing air circulation.