Do You Need a Mouthguard if You Have Braces?
One of the most common questions I am asked by parents and orthodontic patients is whether they really need a mouthguard if they have braces.
The answer is yes.
Mouthguards not only help protect your teeth, but also help protect your lips, cheeks, tongue and gums. This becomes even more important when braces or aligner attachments are present. Mouthguards can also help protect other players from accidents where they may come in contact with brackets or wires.
Throughout my career as a dental hygienist, I have seen the damage that can occur when a player receives an impact to the mouth while wearing orthodontic appliances. Brackets and wires are incredibly effective at moving teeth, but during sport they can increase the risk of injury to the surrounding soft tissues if an impact occurs.
A properly fitted mouthguard does more than just protect the teeth. It creates a protective barrier between the braces, the soft tissues and another player, helping to reduce the risk of soft tissue injuries.
For anyone participating in contact sport while undergoing orthodontic treatment, a mouthguard should be considered as an essential part of their protective equipment.
Why Braces Increase the Risk of Soft Tissue Injury
Orthodontic treatment can create some unique challenges when it comes to sport.
Unlike natural tooth surfaces, orthodontic appliances introduce brackets, wires and springs that can cause damage in an impact. If a player is struck in the mouth, these appliances can be forced into the surrounding soft tissues, causing injury to lips, cheeks and tongue.
There is also the risk of damage to the orthodontic appliance itself. Broken brackets, bent wires and damaged attachments can slow treatment down and may require additional orthodontic appointments and repairs.
This is why orthodontists and dental professionals consistently recommend that patients wear a securely fitting mouthguard whenever they participate in sports where there is a risk of contact or probable impact.
That is where a mouthguard specifically designed for braces has an advantage.
What Should You Look for in a Mouthguard for Braces?
Not all mouthguards are suitable for orthodontic patients.
An ideal mouthguard for braces should provide protection while also allowing teeth to move throughout treatment.
When recommending a mouthguard for patients with braces, there are several characteristics we ideally need:
• Secure retention without needing to bite together and hold the mouthguard in place
• Adequate thickness for protection
• Comfort
• The ability to speak and breathe comfortably
• Re-mouldability this enables to mouthguard to adjust as teeth move throughout treatment
One of the most common frustrations I hear from orthodontic patients is that many traditional over-the-counter mouthguards feel bulky, uncomfortable and do not stay in place.
For patients undergoing active orthodontic treatment, secure retention, comfort, protection and the ability to be re-moulded as teeth move are all very important considerations.
Mouthguard for Braces:
What Types of Mouthguards Are Available for Braces?
| Feature | Silicone | Gel-Lined | Re-Mouldable |
| Accommodates braces | Yes | Sometimes | Yes |
| Can adapt as teeth move | No | Limited | Yes |
| Can be re-fitted | No | Usually No | Yes |
| Suitable during active orthodontic treatment | Sometimes | Check manufacturers recommendations | Yes |
Silicone Orthodontic Mouthguards
Some orthodontic mouthguards are supplied in a pre-formed shape and are made from materials that do not mould around the wearer’s individual teeth and orthodontic appliance. Designs vary: some are made from silicone and incorporate a fixed channel to provide space for brackets and wires, while others simply use an enlarged or flexible pre-formed shape without a defined channel.
Although these designs may provide additional room for an orthodontic appliance, they do not adapt closely to the wearer’s individual tooth positions or bracket placement. This is particularly relevant because many orthodontic patients have crowded, protruding or unevenly positioned teeth—the very conditions being corrected through treatment. A generic pre-formed shape or standard channel may therefore provide space for the braces without closely conforming to the wearer’s actual dental structure.
For patients wearing clear aligners, the small attachments bonded to the teeth are substantially less prominent than conventional brackets. A large pre-formed orthodontic mouthguard or fixed channel may therefore be poorly matched to the much smaller profile of the teeth, aligners and attachments.
Because these mouthguards cannot be moulded to the wearer’s individual tooth and appliance positions, they may feel bulky and can rely on gentle clenching to help keep them in place. While this may be acceptable for some wearers, it can affect retention, comfort, speech and overall wearability.
Gel-Lined Mouthguards
Another type of mouthguard is the gel-lined mouthguard. These typically combine a hard outer shell with a mouldable internal lining designed to shape around the teeth.
While these mouthguards can work well in some situations, they are often not suitable for wear with orthodontic appliances as the internal liner may not accommodate ongoing tooth movement. Many manufacturers of this type of mouthguard specifically advise that their products are not suitable for people wearing braces.
Re-Mouldable Mouthguards, Mouthguard for braces.
Re-mouldable mouthguards offer a different approach. Because they can be re-moulded as teeth move, they are often recommended for patients undergoing active orthodontic treatment.
The ability to adjust the fit throughout treatment helps with retention, comfort and protection.
Why Dental-Made Mouthguards Can Be Problematic During Orthodontic Treatment
Orthodontic treatment is dynamic. Teeth move, brackets are adjusted and aligners or wires are regularly changed.
Dental-made mouthguards are fabricated from a model of the patient’s teeth at a specific point in time and do not change shape once they are formed. While dental technicians can sometimes allow for anticipated tooth movement, the mouthguard will always retain its original form. This means that if a tooth was sticking out but has now moved back into a more aligned position the tooth will still be sticking out in the mouthguard because it was made like that.
For this reason, many orthodontic patients benefit from a mouthguard that can be adjusted throughout treatment as their teeth continue to move.
Can a Mouthguard Damage Braces?
A properly designed and correctly fitted mouthguard should not damage orthodontic appliances.
What Happens if Teeth Move During Treatment?
Tooth movement is the goal of orthodontic treatment, so it is normal and expected for the fit of a mouthguard to change as treatment progresses.
Regularly checking the fit of your mouthguard is important to ensure it continues to provide the retention, comfort and protection it was designed to deliver.
That is where a re-mouldable mouthguard for braces can be really helpful.
Can You Wear a Mouthguard with Clear Aligners?
Absolutely. Orthodontic treatment today is not limited to traditional braces. Clear aligner therapy has become increasingly common amongst both teenagers and adults.
Unless otherwise instructed by your orthodontist, the plastic removable aligner should be removed before participating in contact sport and moulding or wearing your mouthguard.
In fact it is highly recommended that any removable appliance be removed while playing sport and a securely fitting mouthguard worn.
Why I Developed NeoMorph
My interest in mouthguards developed through years of working as a Dental Hygienist in both general and orthodontic practice.
I repeatedly saw patients struggling with traditional over-the-counter (OTC) mouthguards during orthodontic treatment. Many found them bulky and uncomfortable. Others found they did not stay in place. Patients complained they could not communicate or breathe easily, and many removed them whenever they had the opportunity.
It seemed astonishing to me that after more than 50 years of mouldable over-the-counter mouthguards, we still had not adequately solved this problem for orthodontic patients.
This is what sent me searching for the ideal solution.
What we needed was a mouthguard that was comfortable to wear, protective, secure enough to stay in place and adaptable enough to accommodate tooth movement throughout orthodontic treatment. The goal was simple: to create the closest re-mouldable alternative possible to a dental-made mouthguard, while retaining the convenience and accessibility of an over-the-counter product.
While NeoMorph was created as a solution to these problems, the principles remain the same regardless of which mouthguard a patient chooses. The most important consideration is selecting a mouthguard that fits securely to stay in place, is comfortable enough to wear consistently, delivers adequate protection and can accommodate the tooth movement that occurs throughout orthodontic treatment.
The Bottom Line
Orthodontic appliances introduce additional risks to both the teeth, surrounding soft tissues, and potentially other players, yet these risks can be significantly reduced with a properly fitted mouthguard.
Orthodontic treatment should never be a reason to stop playing sport or to stop protecting your teeth during sport.
The right mouthguard should be comfortable, secure, protective and capable of adapting to teeth moving throughout orthodontic treatment.
Ultimately, the best mouthguard is the one that athletes are happy to wear consistently. When sportspeople feel comfortable wearing their mouthguard, they are far more likely to keep it in their mouth and that is the only way it can truly protect them.
About the Author
Amanda Trenerry is the Founder of NeoMorph Mouthguards and a Dental Hygienist with more than 30 years of clinical experience and over 38 years in the dental profession. Her experience spans across general dentistry, orthodontics, prosthodontics and dental education in both Australia and the UK. Amanda has spent much of her career educating patients about oral health and sports mouthguards and is passionate about improving access to comfortable, protective mouthguards for all athletes.
Disclaimer: This article is based on the professional experience and opinions of Amanda Trenerry, Founder of NeoMorph Mouthguards, gained through more than 30+ years working within the dental profession, including extensive experience in orthodontics. The information is provided for educational purposes only and should not be relied upon as individual clinical advice. Patients should consult their own dental or orthodontic practitioner regarding their specific treatment and mouthguard requirements.