How to Pick a Mouthguard

by Yvonne Solis
Mouthguard Pic

The Case for the Custom Fit

The smallest, most controversial and least understood piece of hockey equipment is the mouthguard. Virtually every dental professional agrees that mouthguards are essential for athletes who participate in aggressive sports for preventing serious mouth injuries. Moreover, there’s growing evidence that a wellfitted, custom mouthguard can help prevent concussions and jaw injuries.

So, why don’t players, coaches and parents take mouthguards seriously?

More often than not, the mouthguard is treated by many people as a mere nuisance.

We see mouthguards dangling from chin straps, half in/half out of mouths, missing or, worse—as witnessed by too many referees—traded by players switching shifts to satisfy the mouthguard rules. Yuk on all levels!

Both USA Hockey and Hockey Canada have set rules for mouthguard use and even assign penalties for violations. However, the rules are conflicting and are specific only to the use while providing little guidance as to the quality of the mouthguard. (See The Rules Below.)

A simple rule of thumb for female hockey players in most instances is that Americans are required to wear mouthguards and Canadians are not.

Do Mouthguards Prevent Concusions?

There is great debate over whether or not mouthguards prevent concussions. Until recently, there wasn’t any hard-core research to determine the connection, so most professionals were reluctant to make claims that weren’t supported by scientific evidence.

However, neurologist and sports physician Dr. Paul McCrory states, “Absence of proof is not proof of absence.”

With the increase in the number of concussions in aggressive sports, organizations are eager to discover ways to address the problem. Helmets are obviously the first line of defense, but scientists are looking at the mouthguard as another protective device that will help; and are using advanced technologies to not only prove the connection, but also to help design the perfect mouthguard.

What we do know is that dental professionals are beginning to accept the early testing results that confirm, in theory, that a properly designed mouthguard—given proper thickness, adequate coverage of teeth surface and custom fit—can, in fact, play an important role in preventing the incidence of concussions.

Is the Cost Worth the Protection?

Why spend upwards of $100 on a custom-fitted mouthguard when a cheap boil-and-bite can be found at any local sporting good store? Why should parents invest in a custom mouthguard when their child is growing and will probably need a new fit the next season? Why should a Canadian player wear a mouthguard even though it’s not required? For the best answers, we turn to the professionals.

The Neuromuscular Mouthguard

Many professional athletes are submitting to personalized fittings using computerized programs for the newest type of device called a neuromuscular mouthguard. According to USA Today, several athletes, including Shaquille O’Neal (Cleveland Cavaliers), Terrell Owens (Buffalo Bills), Michael Redd (Milwaukee Bucks) and Suzann Pettersen (LPGA), have worn the appliance and have paid more than $2,000 for it.

Why? Because neuromuscular dentists have claimed to unlock the secrets of the jaw, and say that proper mouthguards will increase performance, improve breathing, reduce fatigue and, yes, even protect against concussions.

There is still debate and more scientific data needs to be collected, but if professional sports organizations are teaming up with scientists and spending untold dollars on research for the perfect mouthguard, there’s probably a major benefit.


We all know boil-and-bites are better than nothing, but we also know that they have contributed to the mouthguard’s bad rap. All of the common reasons players don’t like mouthguards—and consequently tend not to wear them—can be said of a boil-and-bite:

+ Hard to breath
+ Doesn’t fit well
+ Have to keep jaws closed for it to stay in place
+ Can’t talk
+ Uncomfortable

Custom-Fitted Mouthguard

On the other hand, the snug fit of a custom mouthguard allows a player to breathe, talk and feel comfortable while wearing it. More important, the mouthguard stays in place until it’s removed. The fitting process is easy and simply involves having impressions and casts made of your teeth. Once the impressions are taken, the mouthguard is ready to wear in about a week.

Possibly the best part of getting a custom mouthguard is that they can be made in myriad colors and designs to suit the desires of all players.

The Rules According to the ruleboks:

USA Hockey:
Provides the most guidance. “All players, including goalkeepers, in the Girls/Women in the 12 & under through 19 & under age qualifications are required to wear a “colored (non-clear) internal mouthpiece that covers all the remaining teeth of one jaw, customarily the upper.” Taking it a bit further, “It is strongly recommended, in all classifications, that all players wear a mouthpiece form-fitted by a dentist.”

Hockey Canada:
Mouthguard use is dictated only by the type of face protector used. Its rulebook states, “For divisions of hockey that allow the wearing of the half-visor, the wearing of a mouth guard is compulsory (recommended but optional for Senior hockey).” Which pretty much means that no youth player is required to wear a mouthguard because full-face protectors are required for all players older than 10 years and goalkeepers of all ages?