Sports Mouth Guards: Custom, Boil-and-Bite or Stock?

Which mouth guard gives the most protection?

A mouth guard that fits well and gets worn every time gives the most protection. The American Dental Association (ADA) lists three types: custom-made, boil-and-bite and stock. It says custom guards are considered by many to be the most protective, and it also says other types can be effective if they are made well and worn consistently.

The ADA describes a mouth guard as a cushion. It helps absorb a blow to the face. That lowers the risk of broken teeth and of injuries to the lips, tongue, face and jaw. It does not remove the risk. Your dentist will talk with you about what to expect from each type.

The rest of this guide explains how to choose, how to make any guard work better, and when to ask a dentist.

Who needs a mouth guard?

Anyone who plays a sport with a risk of a hit to the face should consider one. The ADA says collision and contact sports such as boxing carry higher risk for the mouth. It also says any athlete can have a dental injury in non-contact activities such as gymnastics and skating.

The ADA also reports that school and college rules name only some sports. It says the National Federation of State High School Associations and the NCAA require mouth guards in football, field hockey, ice hockey and lacrosse, and for wrestlers who wear braces. A sport that is not on that list can still carry a risk to teeth.

Think about these questions for each athlete in your family:

1. Does the sport involve contact with other players, a ball, a stick or the ground at speed?
2. Has the athlete had a dental injury before?
3. Does the athlete wear braces or have fixed bridge work?
4. Is the athlete still growing, with baby teeth falling out or new teeth coming in?
5. Does the athlete also grind teeth at night? A sports guard is not the same as a night guard. Our night guard and mouth guard post explains the difference.

If you answer yes to any of these, ask your dentist at the next checkup. A dentist can look at the teeth and the sport and suggest a type.

How do custom, boil-and-bite and stock guards compare?

Custom guards fit closest and cost the most. Boil-and-bite guards cost less and fit better than stock guards. Stock guards cost the least and fit the worst. The ADA uses these same three groups.

Custom-made guards

A dentist makes a custom guard for one person. The ADA says it provides an optimal fit, but it is the most expensive option and needs dental visits for fitting. Our site describes this type under custom mouth guards. The practice also describes its own sports guard service. The practice does not publish prices, so ask the office for an estimate.

A custom guard can feel less bulky than a store guard. That matters for comfort and for speech. An athlete who finds a guard annoying may take it out. A guard that stays in does more than a better guard that sits on a shelf.

Boil-and-bite guards

The ADA says boil-and-bite guards are widely available at sporting goods stores and drugstores. Our post on boil-and-bite mouth guards covers fit and care in more detail. You soften the guard in hot water, place it in your mouth, and shape it with bite pressure, your tongue, your fingers and your lips. The ADA says these guards are generally designed to be fitted by the user at home.

The ADA also says a dental professional can help with the final molding, especially for someone with orthodontic appliances. Follow the maker’s directions for timing and water temperature. A guard softened for too long or too hot can lose its shape.

Stock guards

The ADA says stock guards are ready-made and come in a generic design. It calls them the least effective type because of poor fit and weak retention. That means they may need frequent repositioning during play. The ADA’s MouthHealthy site adds that if a custom guard is out of reach, you should still wear a stock or boil-and-bite guard from the drugstore.

What the evidence says about wearing one

The ADA cites a 2019 systematic review. It concluded that people who did not use mouth guards had more than twice the increased risk of orofacial injury compared with mouth guard users. That is a review of past studies, so it shows a link and not a promise about any one athlete.

How does a mouth guard work with braces or a retainer?

A properly fitted mouth guard may matter even more with braces. The ADA says a blow to the face could damage brackets or other fixed appliances. A guard also puts a barrier between the braces and the cheek or lip. That helps avoid cuts to the gums and cheeks.

Some guards cover only the upper teeth. The ADA says a dentist may suggest a guard for the lower teeth if you have braces there. A boil-and-bite guard can be hard to fit around brackets. The ADA notes that a dental professional can help with final molding for people with orthodontic appliances.

Removable retainers need one rule. The ADA says not to wear a retainer or other removable appliance during contact sports. Take it out and store it in its case before you play.

Our dentists can look at how a guard sits over braces. If your child is in treatment with a separate orthodontic office, tell that office about the sport as well.

How often should kids and teens replace a mouth guard?

Children and teens often need a new guard sooner than adults. The ADA says their mouths are still growing and changing. Baby teeth fall out and adult teeth move into place. A guard that fit last season can be too small or too loose this season.

Replace any guard right away if it shows wear, is damaged or fits poorly. The ADA also says to ask your dentist when the right time to replace it is.

Use this checklist at the start of each season:

How do you clean and store a mouth guard?

Rinse it, wash it, and let it dry in a vented case. The ADA gives these steps:

1. Rinse the guard before and after each use, or brush it with a toothbrush and toothpaste.
2. Clean it regularly in cool, soapy water, then rinse it well.
3. Store and carry it in a sturdy case with vents so it can dry and keep bacteria from growing.
4. Never leave it in the sun or in hot water.
5. Check the fit and look for wear and tear.

The ADA adds a practical warning. Family pets sometimes treat mouth guards as chew toys, so keep the guard and case where a pet cannot reach them.

Bring the guard to regular checkups. The ADA says your dentist can evaluate it and may also clean it.

What should you do after a hit to the mouth?

Call a dentist as soon as you can after any injury to the mouth. A chipped tooth, a loose tooth or a tooth that is out of the mouth all need prompt attention. Our guide to a knocked-out tooth in the first 30 minutes lists the steps. The glossary also explains an avulsed (knocked-out) tooth in plain words.

Any blow to the head also needs a doctor’s attention, not only a dentist’s. The Town Center Dental office is closed Friday through Sunday. If an injury happens on a weekend, use an emergency room or urgent care for anything serious and call the office on the next open day.

How do you choose for your athlete?

Start with the sport, the age and the fit. Then add budget. This simple order keeps the choice from turning into a price comparison alone.

This table is a way to start a conversation. It is not a prescription. Your dentist knows your mouth and can advise on your own case.

Questions to bring to the visit

• Which type fits this sport and this mouth?
• How long should this guard last, and when should we check it?
• Does the guard fit over braces, or should we plan for the lower teeth too?
• Will the guard make speech or breathing harder, and can the fit be adjusted?
• What is the estimate for each option?

Our practice’s own page for sports guards is the place to read how the office describes its service. Its page says: “Wearing a well-fitted mouthguard in contact sports can prevent dental and orofacial injuries.” That sentence is the practice’s own claim, published on its site.

How do you get a new guard to feel right?

Give the guard a short trial before the first game. Many athletes quit a mouth guard because it feels odd for the first few uses. Wear it around the house or at practice first. Check these points:

1. Breathing. You should be able to breathe through your mouth while wearing it. If breathing feels blocked, the guard may be too thick or may sit wrong.
2. Speech. Some bulk is normal at first. A guard that makes speaking very hard is hard to keep in during play.
3. Gag reflex. A guard that reaches too far back can trigger gagging. Tell your dentist if this happens.
4. Pressure points. A spot that presses on the gum or cheek can become sore. Do not trim a guard yourself without advice, because a rough edge can cut the lip or cheek.
5. Staying put. The guard should stay in place without you biting hard to hold it.

The practice’s sports guard page lists the same complaints that athletes have about older guards. It says some athletes “forget to wear it, they degrade over time, they impair speech, or make it difficult to breathe.” That list shows why fit and comfort matter as much as the type you buy.

If a boil-and-bite guard feels wrong after one try, follow the maker’s directions about whether you can repeat the fitting. Do not keep wearing a poor fit and hope it improves. Ask your dentist to look at it.

What about cost?

Cost is a real part of the choice, and the ADA says so plainly. It says custom guards are the most expensive option, and its MouthHealthy site says that if a custom guard is out of reach, you should still wear a stock or boil-and-bite guard from the drugstore. The practice does not publish prices. Ask the office for an estimate for a custom guard, and ask your dental plan whether it covers athletic guards. Plans differ, so ask before you buy. Our guide to dental insurance explains how to read a plan.

What do mouth guards not do?

A mouth guard is not a promise of no injury. The ADA says mouth guard use lowers risk. It does not say it removes it. A guard also does not replace a helmet or face mask where those are needed.

On concussions, the evidence is mixed. The ADA describes one systematic review that found a modest effect and another that found no significant effect on concussion rates in professional ice hockey players. The ADA says further research is needed. Do not choose a mouth guard on the belief that it will stop concussions. Talk with a doctor about head injury safety in your sport.

Next step

If your athlete needs a guard, or an old one no longer fits, read about our sports guard service and call (636) 273-5866 or request an appointment. Bring the current guard to the visit so your dentist can check the fit.