Midrand Dental Excellence

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Mouth Guards

A properly designed mouth guard may save your child's life

The value of mouthguards

Perhaps the most valuable piece of sporting equipment that you can purchase for your child is a correctly made, custom fit mouthguard. Not only for obvious contact sports like rugby and boxing (compulsory to wear a mouthguard) but also for any sport where trauma to the face is possible e.g. hockey, soccer etc. Trauma due to a collision, a bat, a ball, a fist, or the ground are all equally damaging and can have dire consequences.

Mouthguards protect the teeth from fracture, not only the visible front teeth but also the back teeth as well. Teeth, unlike skeletal bones, are unable to repair themselves. A fractured upper front incisor or any other tooth is damaged forever! Although there are ways to repair or replace these valuable teeth, the old saying that "nothing is as good as your own" is especially true with regard to your teeth and smile. Prevention with a mouthguard is cheaper and better than any cure.

Mouthguards can also prevent concussion and death. Trauma/force to the lower jaw forces it upward against the top jaw- causing concussion or jarring of the brain. Today concussion is considered to have occurred even if loss of consciousness is for a fraction of a second. Damage to the brain within its' bony confines of the skull, can result in nausea and vomiting, headaches and if severe enough, can cause loss of respiratory reflex, swelling, bleeding and even death.

Not all mouthguards are equal and adequate and they must be manufactured accurately in order to effectively protect the teeth and mouth. They must be thick enough to protect and cushion against the enormous forces of trauma. Some will need wire strengtheners and/or extra sheets of plastic to be effective. Generally they need to be at least 2 mm thick. The better they fit the more comfortable they will be and the easier they will be tolerated by the wearer. Although one can buy "generic" mouthguards from sport shops, which can be heated and moulded in the mouth, they are generally inadequate, too thin and because they fit poorly provide little protection.

We recommend that you have a mouthguard made by your dentist. Your dentist will take an impression of your upper jaw, which will be cast into a stone model. Onto this upper model, the mouthguard is made, when a heated and thin pliable sheet/s of plastic are sucked onto the model, in a vacuum. Various designs and strengtheners can be built into the mouthguard, if necessary. Cost of these mouthguards is more expensive compared to shop bought mouthguards but they are really worth every cent!

More about mouthguards


ental injuries are the most common type of orofacial injury sustained during participation in sports; the majority of these dental injuries are preventable.


  • A sportsman/woman is 60 times more likely to sustain damage to the teeth when not wearing a protective mouthguard.
  • The cost of a fractured tooth is many times greater than the cost of a dentist diagnosed and designed professionally made mouthguard
  • Every athlete involved in contact sport has about a 10% chance per season of an orofacial injury, or a 33-56% chance during an athletic career.
  • The cost to replant a tooth and the follow-up dental treatment is about R20 000-R50 000.
  • Victims of tooth loss tooth who do not have a tooth properly preserved or replanted may face a lifetime of dental costs, hours in the dental chair, and the possible development of other dental problems such as periodontal disease.
  • The stock mouthguard which is bought at sports shops without any individual fitting, provide only a low level of protection, if any. If the wearer is rendered unconscious, there is a risk that the mouthguard may lodge in the throat potentially causing an airway obstruction.
  • Types of dental injuries (direct and Indirect) and intrinsic and extrinsic factors:

  • Direct Trauma for example to the upper top front teeth (four times more common than other teeth) and the mouthguard must be well fitting and thick enough to prevent these injuries.
  • Indirect Trauma for example under the chin causing damage to the teeth and concussion.
  • Intrinsic Factors for example teeth and jaw position e.g. Class 2 or 3 when the teeth protrude from the mouth, making them more vulnerable to trauma.
  • Extrinsic Factors for example a hockey ball, fist etc.

I encourage my patients to have proper mouthguards made – one day your properly designed mouthguard may save your life!

Classification of Mouthguards: From worst to best

  • Type 1. Stock (Small, Medium and Large)
  • Type 2. Boil and Bite (Bought from stores and made from thermoplastic materials)
  • Type 3. Custom, single layer, vacuum. (Types 3 and 4 supplied by the dentist)
  • Type 4. A custom fabricated mouthguard formed on models of the users jaws, using multiple layers of plastic adapted under pressure to specific designs
  • General design principles

  • Mixed dentition- to distal of maxillary first molar.
  • 2-3 mm labially.
  • 3 mm occlusally.
  • 2 mm palatally.
  • Labial flange 2mm from vestibular reflection.
  • Palatal flange 10 mm from gingival margin.
  • Even occlusal contact.
  • For extreme sports the mouthguard should be extended to the distal of the second molars. Mouthguards are made by pressure lamination at 140 C at 6 atmospheres of pressure with machines like a Drufomat or a Biostar.

    Recommendations from Prof. Francois De Wet - Pretoria University

  • Gr 1-5: 1 x 3 mm sheet
  • Gr 6-9: 1 x 4 mm sheet
  • Gr 10-12: 1 x 2 mm sheet with a 1 x 3 mm sheet over it
  • Seniors: 1 x 2 mm sheet, then a layer of sponge, then a 1 x 3 mm sheet over everything
  • Boxers: Same as seniors. Can increase the thicknesses even more.
  • Dr. Brett Dorney's Recommendations

  • Rookie (up to 14 years of old) 3mm +2mm (labial 3mm and occlusal 3mm)
  • Classic (teenage years) 3mm+3mm (labial 3mm and occlussal 4mm)
  • Elite 2mm+3mm+3mm with balanced occlussion distal of first molar ( labial 4mm and occlusal 4mm)
  • Boxer 4mm+3mm extended over all the upper teeth with balanced occlussion (labial 5mm and occlusal 4mm