Braces and sport: mouthguards, impacts and what to ask

Why a mouthguard matters more during treatment

The Canadian Dental Association's position on sport mouthguards is that a properly fitted mouthguard should be worn for any activity with a risk of contact, collision or falls. That advice applies to everyone, and it applies with more force to someone wearing fixed appliances.

Two things are being protected. The first is the teeth themselves, which is the usual reason for a mouthguard. The second is the soft tissue: without a barrier, an impact can drive lips and cheeks against brackets and wires and cause lacerations that would not otherwise have happened.

A damaged appliance also costs time. Repairs take an unscheduled appointment, and an interruption at the wrong stage of treatment can extend the plan.

Mouthguards that fit over braces

A standard boil-and-bite guard moulded to bare teeth will not fit correctly over brackets, and it may not stay in place. Guards made for orthodontic patients are designed with more depth and flexibility to sit over the appliance and to tolerate teeth moving during treatment.

Ask your provider which type they recommend for your appliance and your sport, whether they supply one or refer you to a general dentist, and how often it needs to be replaced as the teeth move. Some patients wear an upper and a lower guard depending on the sport and the appliance configuration.

Check the fit yourself as treatment progresses. A guard that fitted at bonding may not seat properly several months later.

Which sports need more thought

Collision and contact sports are the clear cases: hockey, football, rugby, lacrosse, basketball, martial arts and boxing. Many organizations require a mouthguard at these levels regardless of whether a player wears braces.

Sports usually classed as low contact still carry risk. Falls in skateboarding, cycling and skiing, a stray elbow in soccer, and a ball in baseball or squash all produce facial impacts. If you wear braces, a mouthguard is worth considering even where the league does not require one.

Where a sport involves deliberate blows to the face, discuss it specifically with your provider. That conversation should cover the risk to the appliance as well as the risk to you, and it may affect the timing of treatment.

What to do after an impact

Check the mouth as soon as you can. Look for teeth that feel loose or have moved, for brackets that have come away from a tooth, for wires that have bent or are protruding, and for cuts inside the lips and cheeks.

Contact your provider for anything beyond minor irritation, and do not wait for the next scheduled appointment to report a loose tooth. Orthodontic wax over a protruding wire is a reasonable temporary measure while you arrange to be seen. General soreness can be managed the way you would manage any bruise, and if you use an over-the-counter analgesic it is worth asking your provider which they prefer during orthodontic treatment.

An impact that involves loss of consciousness, a suspected concussion, or a significant facial injury is a medical matter first and an orthodontic one second.

Questions that compare providers on this

Emergency handling is an underrated way to compare practices, and it is a fair thing to ask about before treatment starts rather than after a breakage.

• How quickly can a patient be seen for a broken bracket or a poking wire, and is there a route outside regular appointment times?
• Are repairs included in what I have been quoted, or charged separately?
• Does a repair change the treatment plan or the projected end date?
• Do you recommend a specific type of mouthguard for my appliance, and do you supply it or refer me?
• Are there stages of my treatment where an impact would be more disruptive than others?

Compare the answers across providers using the same questions. Clarity here often reflects how the practice is organized generally.

Planning treatment around a season

If you play at a competitive level, the timing of bonding, of appliance changes and of debonding can reasonably be discussed against your season. Providers are used to this conversation and can often sequence stages around a tournament or a training block.

What should not happen is treatment being deferred indefinitely on the assumption that sport and braces are incompatible. With a properly fitted guard, most athletes complete orthodontic treatment without incident. The point is to plan for the risk rather than to hope it does not arrive.

Why this page is kept

The original 2021 article duplicated its entire text twice on the same page, once naming one practice and once another, and was written in a clinic's voice. It is retained here because the underlying guidance is sound and the page has an established address, and it has been rewritten in this publication's editorial voice with the duplication removed.

Day-to-day treatment questions of this kind are covered in more depth on the treatment-experience site in the network, which is linked below.