Sports and Braces: Mouthguards, Contact Sport and Staying Safe

Wearing braces or other orthodontic appliances does not mean putting sport on hold for the duration of treatment. Most patients with braces can continue to participate in the sports they enjoy with appropriate precautions. The key difference from pre-treatment sports participation is that the braces themselves introduce a specific risk: if a blow to the face occurs, the brackets and wires of fixed braces can lacerate the inside of the mouth.

A mouthguard designed for use with braces is the primary protective solution for this risk. Liverpool Orthodontics’ patient information includes guidance on sports participation and mouthguard use. This article explains the key considerations for athletes wearing braces.

Why Braces Create a Sports Safety Consideration

Fixed braces (metal or ceramic brackets bonded to the teeth with an archwire) create a hard structure inside the mouth that is not present in patients without orthodontic appliances. If a ball, elbow, fist, or hard surface makes contact with the face during sport, the brackets and archwire can be driven into the soft tissue of the lips and cheeks, causing lacerations. This risk is in addition to, not instead of, the normal dental injury risks that mouthguards protect against in all athletes.

The severity of soft tissue injuries from bracket-related impacts ranges from minor lacerations to significant wounds requiring attention. In addition to the soft tissue risk, a hard impact can knock brackets off the teeth or bend the archwire, which requires an orthodontic appointment to repair and may delay treatment progress.

Types of Mouthguards for Athletes in Braces

Boil-and-bite mouthguards for braces

Standard boil-and-bite mouthguards are not suitable for athletes in fixed braces because they mould to the teeth and brackets and then harden, locking the appliance in place. If the mouthguard is subsequently hit, it can transmit force directly to the brackets and cause damage. Specific boil-and-bite mouthguards designed for orthodontic use are made from a softer material that accommodates brackets without moulding rigidly around them, providing some protection while the teeth continue to move through treatment.

Custom orthodontic mouthguards

A custom mouthguard made specifically for a patient in braces is fabricated from a model of the current tooth positions with additional space built into the design to accommodate bracket height and the changing tooth positions that occur throughout treatment. These are the highest level of protection available for athletes with braces. They are typically fabricated by the orthodontist or dentist from impressions or digital scans.

The trade-off of custom orthodontic mouthguards is that they are more expensive than boil-and-bite options, and as the teeth move through treatment, the fit may need to be updated with a new mouthguard fabricated at the midpoint and end of treatment.

Clear aligners and mouthguards

Patients in clear aligner treatment (such as Invisalign) have a significant advantage over patients in fixed braces for sport: the aligners themselves can be removed for high-contact sport and a regular, well-fitted mouthguard worn in their place. After sport, the teeth should be cleaned and the aligner reinserted. Talk to Liverpool Orthodontics about your specific treatment options if sports participation is a significant consideration in your treatment planning.

Sport-by-Sport Risk Assessment

What to Do If a Bracket Is Hit During Sport

If a blow occurs to the face during sport, check immediately whether:

• The lips and cheeks are cut. If lacerations are significant, seek appropriate medical attention
• Any brackets have come loose or detached. A bracket hanging from the archwire should be carefully removed and brought to the orthodontic appointment
• The archwire has bent or a wire end is protruding and poking the soft tissue. Orthodontic wax (available from the practice) can be used to cover a sharp wire end as a temporary measure until an appointment can be arranged

Contact Liverpool Orthodontics promptly if any component of the appliance has been damaged. A broken bracket or bent archwire left unrepaired can affect treatment progress and cause ongoing soft tissue irritation.

Frequently Asked Questions

Do I need to give up contact sport during orthodontic treatment?

Generally no. Most orthodontic patients can continue participating in contact sport with appropriate mouthguard protection. The specific considerations depend on the sport and the appliance type. Your orthodontist can advise on whether any specific modifications to your training or sport participation are needed for your particular treatment plan.

Can I wear my usual mouthguard with braces?

No. Standard mouthguards are not designed for use with fixed braces and can cause damage to the appliance and ineffective protection. A specific orthodontic mouthguard, either a boil-and-bite design made for braces or a custom-fabricated option, is needed for safe sports participation with fixed braces.

How long can I leave a knocked-off bracket before seeing the orthodontist?

A knocked-off or loose bracket should be seen at Liverpool Orthodontics as soon as possible. While a single loose bracket is not a dental emergency, leaving it unattended for more than a few days can affect treatment progress. Call Liverpool Orthodontics to arrange an appointment at the earliest available time.