Sports guards in orthodontic treatment.
A patient in fixed appliances needs a guard designed around the brackets, and it protects the lips and cheeks from the appliance as much as it protects the teeth from impact.
Why the usual guard will not do
A conventional custom guard is formed closely to the teeth. Formed over fixed appliances, it either will not seat, locks onto the brackets, or becomes impossible to remove.
It also becomes obsolete quickly, because teeth in active treatment are moving. A guard made to a mid-treatment position stops fitting within weeks.
The design therefore has to accommodate both the appliance and continued movement, which means more space and more resilience than a standard guard.
Soft tissue protection is the larger benefit
For a patient in fixed appliances, the most likely injury in contact sport is not a fractured tooth — it is laceration of the lips and cheeks against the brackets.
A guard that covers the labial surfaces of the appliance prevents that entirely, and it does so at every level of contact rather than only in a significant collision.
This is worth explaining to patients and parents, because the benefit is more immediate and more likely to be experienced than impact protection.
Design
Adequate relief over the brackets so the guard seats without engaging them, with enough space to accommodate tooth movement over the wearing period.
Sufficient labial thickness to protect the soft tissue and absorb impact, and a palatal edge trimmed back so it does not provoke gagging in a patient already coping with an appliance.
The material needs to be resilient enough to be removed over brackets repeatedly without tearing.
Records
An impression or scan capturing the appliance as well as the teeth, with the brackets recorded accurately. Block out or note anything that would lock the guard on.
Tell us the sport, the patient's age, and roughly how long remains in treatment. All three affect the specification.
A guard for a patient with six months of treatment left is built differently from one for a patient with two years.
Replacement during treatment
Expect to remake it. Teeth move, appliances change, and a guard that has stopped seating offers materially less protection than one that fits.
Check the fit at adjustment appointments, and remake when it no longer seats properly. Presenting that as expected rather than as a fault avoids it reading as a failure.
Colour and personalization are worth offering to younger patients. It sounds trivial and it measurably improves the chance the guard is worn.
Coordinating with the orthodontic plan
A guard made mid-treatment has a limited life by definition, and how limited depends on what movement is still to come.
Where major movement remains, it may be better to accept remaking the guard once or twice than to build something so relieved it offers little protection. Where treatment is nearly complete, a guard can be specified closer to the final position.
Tell us which situation applies, and review the fit at adjustment appointments rather than waiting for the patient to report a problem.
What to put on the prescription
Sport guard, the arch, and the fact that the patient is in fixed appliances. The sport, the patient's age, remaining treatment time, and any colour preference.
For patients not in orthodontic treatment, see sports mouthguards.
More in Orthodontic Laboratory
Send a case
Digital scans and conventional impressions are both accepted. Cases move by UPS and Purolator, and Fairmont works with practices throughout British Columbia and across Canada.