Mouthguards and face protection in sport: when to wear them and how to choose

A ball to the face, an elbow or a fall can break a tooth or cut the mouth in seconds. These injuries are common in contact sports and in sports played with balls or sticks, and many can be prevented with simple equipment. Mouthguards and face protection are inexpensive compared with the cost of repairing a broken tooth.

Which sports they are recommended for

A mouthguard is useful whenever there is a risk of impact to the face or of collision between players. Examples:

• Combat sports: boxing, kickboxing, contact martial arts, judo and jiu-jitsu.
• Contact team sports: rugby, roller and ice hockey, basketball, handball, American football and water polo.
• Sports with hard balls or sticks: field hockey, lacrosse and cricket.
• Sports with a risk of falling: skateboarding, mountain biking, skating and horse riding.

In some sports and competitions, wearing one is compulsory under the rules. In others, such as football, it is not usual, but it may be advisable for people who wear braces or have already had dental injuries.

Types of mouthguard

There are three main types, offering different levels of comfort and protection:

• Stock mouthguards: sold ready to use in standard sizes. They are the cheapest, but fit poorly, make breathing and speaking harder and tend to slip out of place.
• Boil-and-bite mouthguards: softened in hot water and moulded to the teeth by biting into the material. They fit better and are a good option for most amateur players, as long as the instructions are followed carefully.
• Custom-made mouthguards: made by a dentist from an impression of the mouth. They are the most comfortable and protect best, and are especially suitable for people with braces, those who do combat sports or anyone who competes regularly.

A good mouthguard should cover all the upper teeth back to the last molars, stay firmly in place without having to bite down, allow you to breathe and speak, and not make you gag. In children and teenagers it should be checked often, because the mouth is still growing and teeth are changing.

Getting used to a mouthguard

Many players stop wearing their mouthguard because they find it uncomfortable at first. A few strategies help:

• Wear it in light training sessions first, so the mouth adapts before you use it in competition.
• Practise speaking and breathing with it in for a few minutes each day.
• Take small sips of water with the mouthguard in, rather than removing it at every break.
• If it causes sores, gagging or difficulty breathing, ask your dentist to adjust it.

Face protection: helmets, visors and masks

In some sports, protecting the teeth is not enough and the eyes, nose and cheekbones also need protection:

• Helmets with a cage or visor: compulsory in ice hockey, American football and many youth categories.
• Protective eyewear: recommended for squash, padel and racquetball, where the ball travels very fast at close range.
• Rigid face masks: worn temporarily, on medical advice, by athletes recovering from fractures of the nose or face, so they can return to competition safely.

Equipment should be approved for the sport, be the right size and be replaced when it is cracked, misshapen or after a heavy impact.

Care and what to do if an injury happens

To keep your mouthguard lasting and hygienic:

• Rinse it in cold water and brush it gently after each use; hot water can warp it.
• Store it in a ventilated case and let it dry.
• Do not share it with anyone.
• Replace it when it is worn, torn or no longer fits well, generally at least once a season.

If, despite everything, a tooth breaks or is knocked out:

1. Find the tooth or fragment and hold it by the crown (the white part), never by the root.
2. If it is dirty, rinse it briefly in water without scrubbing.
3. For a permanent tooth, if the person is conscious and cooperative, try to put it back in place and bite on a clean handkerchief.
4. If that is not possible, keep it in milk or saline solution, never dry or in water.
5. See a dentist or go to an emergency service as quickly as possible, ideally within the first hour.

Heavy blows to the head or face always require monitoring: headache, dizziness, vomiting or confusion are reasons to seek medical help immediately.

In summary

Mouthguards and face protection are a simple, effective way to prevent injuries to the teeth and face in contact sports, sports with fast balls and those with a risk of falling. A boil-and-bite mouthguard suits most players, while a custom-made one is the best choice for those who compete or wear braces. This article is for information only and does not replace the advice of a doctor, dentist or other health professional.