The Same Fall, Two Different Outcomes

Quick answer: A properly made mouthguard is the single most effective thing you can do to prevent dental injuries in sport. Custom-made ones fit, stay in, and are actually worn — which is the whole point, because the ones people take out and leave in a bag protect nothing.

The call

Two boys, thirteen, same class, same match on the court in RBS Gimmel. They collided going for the same ball and both went down hard, face first.

We saw both of them that afternoon.

Boy one was not wearing a mouthguard. Fractured upper central incisor through enamel and dentine with pulp exposure, a chipped lateral incisor, and a lip laceration needing sutures. He needed emergency pulp treatment that evening, a composite build-up, and he is now committed to monitoring that tooth for the next decade. It may still need a root canal.

Boy two was wearing a custom mouthguard. Bruised lip, sore jaw, no dental injury at all. We checked him thoroughly and sent him home.

His mother had had it made eighteen months earlier after his older brother lost a tooth. She said, more than once, that she had felt slightly ridiculous insisting on it.

What we found

The mouthguard itself told the story. It had a visible impact mark across the front — a compressed, whitened area where the material had absorbed and spread the force.

That is the mechanism, and it is worth understanding because it explains why fit matters so much. A mouthguard does three things: it cushions the direct blow, it spreads the force across all the teeth and the underlying bone rather than concentrating it on one or two, and it separates the jaws so that a blow to the chin does not slam the lower teeth into the uppers or drive the condyle into the skull base.

All three depend on the guard being thick enough in the right places and staying put on impact.

Custom-made guards are formed on a model of the mouth from a proper impression or scan, in layered pressure-laminated material, with controlled thickness where it matters. They stay in place, they allow speech and breathing, and — the decisive factor — children actually wear them.

Boil-and-bite guards from a sports shop are better than nothing. They are also usually too thin at the front after being bitten into, bulky where they should not be, and loose enough that they fall out or get taken out. A guard in a kitbag has a protective value of zero.

The cost comparison is not close. A custom mouthguard costs a small fraction of treating a single fractured front tooth, and that treatment is not a one-off — a tooth injured at thirteen typically needs work repeatedly across a lifetime.

What we did

For boy two: nothing beyond a check and a new mouthguard, since the old one had done its job and was showing wear. Guards need replacing every one to two seasons in a growing child, because they outgrow them.

For boy one: the whole trauma protocol, and a custom mouthguard once his tooth was restored. Injured teeth are more vulnerable to the next impact, not less.

Over the following month, seven boys from that class came in for mouthguards. We took the impressions in one afternoon.

What to do if this happens to you

1. Get a custom mouthguard for any contact or collision sport — basketball, football, hockey, martial arts, skateboarding.
2. Replace it every one to two years in a growing child, or when it no longer fits.
3. Wear it in training too, not just matches. Most injuries happen in casual play.
4. Check it fits after orthodontic changes. Braces need a specific design.
5. Rinse it after use, store it in a ventilated box, and keep it out of hot cars.
6. Bring it to check-ups so it can be assessed for wear.

Child playing contact sport? Ramat Beit Shemesh Urgent Dental Care makes custom mouthguards in a single visit. 055-985-8845 · WhatsApp https://wa.me/972559858845 · Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.