Playing sports with braces

Yes, your child can keep playing

This is the first question most parents ask after bonding day, and the answer is short. Kids in braces play sports. The American Association of Orthodontists puts it plainly in its patient FAQ: you can play sports during orthodontic treatment, and you should talk with your orthodontist about the type of mouthguard to wear while you do. The season is not the problem. Going in without a guard is.

Why a mouthguard matters more once braces are on

A mouthguard cushions a blow to the face. The American Dental Association describes the job as minimizing the risk of broken teeth and injuries to the lips, tongue, face, or jaw, and it recommends a properly fitted guard to reduce how often sports injuries to the mouth happen and how severe they are.

Braces add a second reason. Brackets and wires sit right between a knock and the soft tissue inside the lips and cheeks, and the AAO notes that those sharp edges can do real damage to the inside of the mouth if a hit lands without protection. The ADA makes the matching point from the appliance side: a properly fitted mouthguard may be especially important for people who wear braces, because a blow to the face can damage brackets and other fixed appliances. A broken bracket also means an unplanned repair visit, which can stretch a treatment plan out.

It is not only football and hockey, either. The ADA points out that dental injuries show up in limited-contact and non-contact activities too, naming gymnastics and skating, with basketball and skateboarding on the list as well. If there is a ball, a board, or a hard floor involved, the guard is worth packing.

The three kinds of mouthguards

There are three common types, and they are not equally protective.

• Stock guards come ready to wear off the shelf. They cost the least and fit the least well. The ADA notes they are often bulky and can make breathing and talking harder.
• Boil-and-bite guards soften in hot water so your child can bite them into rough shape at home. The AAO describes this type as better than nothing.
• Custom guards are made from a mold of your child's teeth. The AAO recommends having your orthodontist take that mold, especially during orthodontic treatment, to get what it calls “the best, most protective fit”, and says a custom-fitted guard stays in place during play.

Researchers have looked at the difference for kids in braces specifically. A randomized trial published in the European Journal of Orthodontics had young patients in fixed appliances try a custom laboratory-made guard, a boil-and-bite guard, and a prefabricated guard during contact sport, then rate each one and name a favorite.

Whatever type you land on, the fit rule does not change: the ADA says a mouthguard should completely cover all of the teeth, including the back ones. Ask your orthodontist which type suits the appliance your child is wearing right now, and ask again when the appliance changes. If your child has braces on the lower teeth, you may be told to cover those as well.

Clear aligners and retainers on game day

If your child is in clear aligners, the AAO's advice for athletes is to take the aligners out for contact play and wear a mouthguard instead. Send the case along in the sports bag so the trays have somewhere safe to live for an hour.

Retainers work the same way. Wear it exactly as prescribed, because the AAO reminds patients that teeth keep shifting throughout life, but take it out and swap in the guard before the whistle.

Cleaning it, and knowing when to replace it

Clean the guard after each use and follow the instructions it came with, which is what the ADA's guidance says to do. Let it dry before it goes back in the bag. The AAO says to replace a guard once it is cracked, chewed, or loose, and a growing mouth means your child's guard will not fit forever anyway. The start of each season is a good moment to look it over.

Not sure where to start?

If your athlete has not seen an orthodontist yet, that is the place to begin. A consultation at Beeline Orthodontics is free, and it includes an exam, photos, a digital scan, and a treatment plan with an exact, all-inclusive fee in writing. Every case is planned by Dr. Tim Glesener, orthodontist, and you will leave knowing where things stand, with no pressure to start anything. Make a beeline for our consultation request form, or call or text (704) 912-5234.

Sources

• American Association of Orthodontists, Mouthguards
• American Association of Orthodontists, Oral health tips for athletes
• American Association of Orthodontists, Why mouth guards are essential
• American Dental Association, Athletic mouth protectors (mouthguards)
• American Dental Association, MouthHealthy, Mouthguards
• Kalra et al., Wearability and preference of mouthguard during sport in patients undergoing orthodontic treatment with fixed appliances: a randomized clinical trial, European Journal of Orthodontics