Mouthguards and Dental Safety

By 4Football Staff · September 29, 2026 · 10 min read

Why football players wear mouthguards, how stock, boil-and-bite and custom types differ, how to fit and clean one, and what to do in the first minutes after a dental injury.

Picture a hypothetical eighth-grader in the third quarter of a rec league game. He is breaking down to make a tackle when a teammate's knee catches him in the mouth. His mouthguard is hanging from his facemask, where he clipped it because it makes his words sound strange. When he spits into his hand, one of his front teeth is in it.

Dentists and sports medicine groups have heard that story, in different forms, many times. The mouthguard is among the cheapest and simplest pieces of protective equipment in football, and it is also among the most often worn wrong, chewed up or left in a bag. This article explains what a mouthguard does and does not do, how the main types compare, how to fit and care for one, and what families and coaches should do in the first minutes after a dental injury.

It is general education, not dental or medical advice. Your dentist and your athletic trainer know the individual player and should guide specific choices.

What a mouthguard protects

A mouthguard is a flexible, shaped cover that fits over the teeth, usually the upper ones. In football it does several jobs:

It cushions the teeth. A hit to the face can chip, crack or loosen teeth. The mouthguard spreads the force over a wider area and keeps teeth from hitting each other directly.
It protects the lips and cheeks. Without a barrier, the soft tissue of the lips and cheeks can be cut against the teeth or the braces behind them.
It softens blows to the lower jaw. A mouthguard helps absorb some of the force of an upward blow to the chin that might otherwise slam the jaws together.
It protects the tongue. A bitten tongue is a common injury when a player takes a hit while his mouth is open.

What a mouthguard does not do is prevent concussion. Dental organizations recommend mouthguards for contact sports mainly to protect the mouth, teeth and jaw. Researchers have studied whether mouthguards reduce concussion risk, and the evidence has not established that they do. A player should wear a mouthguard because it protects the teeth and mouth, and not because it makes a hit to the head safe. For more on what does and does not help, see our article on helmet technology and standards.

What the rules require

Football is one of the sports where mouthguards are required rather than recommended at most organized levels. The National Federation of State High School Associations (NFHS) has required mouthguards in football for many decades, and NCAA football rules also require them. Many youth leagues, Pop Warner-style programs and other organizations have the same rule.

The specific requirements are written in each rule book and can change. They commonly cover:

That the mouthguard covers the upper teeth
That it is worn in the mouth during all plays, including practice if the league says so
Rules on color, since visible colors help officials see that a player has one in
Whether a strap or tether may be attached to the helmet or facemask
Whether a player with braces needs a certain kind of protector

A player who is not wearing a required mouthguard can be told to leave the field and fix it before the next play. Check the rule book for your level, or ask your coach or league for a copy. Our article on uniform and equipment rules gives a wider view of what officials check before a game.

The three types

Type	How it is made	Typical advantages	Typical drawbacks
Stock	Preformed and sold ready to wear	Cheapest and easiest to find	Poor fit, bulky, can make breathing and talking harder, often held in place by clenching
Boil-and-bite	Softened in hot water, then shaped to the teeth by biting	Better fit than stock, widely available and moderate in cost	Fit depends on the molding, may be thin in places, can wear out quickly
Custom-made	Made by a dentist or a lab from an impression or scan of the teeth	Best fit and comfort, easier to talk and breathe, can be tailored for braces	Costs the most and needs a dentist visit; growing children may outgrow it

Dental organizations generally rank the custom mouthguard first, the boil-and-bite second and the stock mouthguard last, with the reminder that any mouthguard that a player actually wears is better than none. A mouthguard that does not fit well tends to be chewed, removed or left behind, and that defeats its purpose.

Families have to balance cost and use. For a child who is still losing baby teeth and growing new ones, a custom guard may not last the season, so a well-molded boil-and-bite is often a sensible choice. A teenager or adult with a stable set of teeth, or a player with orthodontic hardware, may benefit more from a custom guard. A dentist can offer advice for an individual mouth.

How to mold a boil-and-bite mouthguard

Instructions vary by brand, so the package directions always come first. The steps usually look like this:

Start with clean teeth and a clean guard. Brush first, rinse the new guard in cool water and check the package for the right size.
Soften the guard as directed. Many brands call for dipping the guard in hot water for a set number of seconds. Too long can warp the material, and too short leaves it stiff. A few brands avoid boiling altogether, so follow the label.
Let it cool briefly before putting it in. Test the temperature against the skin of the hand or the cheek. A guard that is too hot can burn the mouth.
Place it over the upper teeth and bite gently. Bite to press the teeth into the material, then use fingers and tongue to press the material around the teeth and gums. Many instructions suggest sucking in to create a seal.
Cool it as directed. Cold water sets the shape.
Check the fit. It should be snug without being painful and should stay in place without clenching.
Redo it if needed. Many brands allow a limited number of remoldings, as the package says.

Younger children may need a parent or coach to help. It is much easier to mold the guard correctly the first time than to fix it halfway through the season.

Braces, retainers and changing teeth

Players with orthodontic appliances face extra risk, because a blow to the mouth can drive braces into the lips and cheeks. Orthodontists generally recommend a guard that is made for braces, and they may suggest a custom or specially designed orthodontic mouthguard. Boil-and-bite guards are sometimes molded onto braces in ways that can interfere with tooth movement, so ask the orthodontist before choosing one. Removable retainers and aligners should not be worn under a mouthguard unless the orthodontist says so.

Children between about six and twelve years old are losing baby teeth and growing permanent ones, so the shape of their mouths changes quickly. A mouthguard that fit well in August may be loose by midseason. Check it regularly and replace or remold it when it no longer fits.

Care, cleaning and replacement

A mouthguard goes into a mouth, often under sweaty conditions, so hygiene matters.

Rinse before and after use. Cool water, or a gentle brush with toothpaste or mild soap, removes debris.
Avoid hot water and hot places. Heat can warp a mouthguard. Do not leave it in a car or on a hot dashboard.
Store it in a ventilated hard case. A case with air holes lets it dry and protects it. A sealed bag can encourage bacteria.
Do not share it. A mouthguard is as personal as a toothbrush.
Do not chew it. Chewing weakens the material and shortens its life.
Check it often. Replace it if it has holes, tears, thin spots, rough edges or a fit that has changed.
Bring it to dental visits. Dentists can inspect it and clean or adjust it.

As a rule, expect to replace a mouthguard at least once a season, and more often for a player who chews or grinds. Dentists often recommend inspecting the guard before every season and replacing it when it shows wear.

Common mistakes

Hanging it from the facemask. A mouthguard outside the mouth protects nothing.
Trimming it to be more comfortable. Cutting a guard changes its protection. If it feels bulky, ask a dentist.
Wearing it only in games. Dental injuries happen in practice too, and practice includes drills with contact.
Using one that does not fit. A loose guard can come out on impact.
Choosing the wrong size. Youth and adult sizes are not interchangeable.
Forgetting it altogether. A spare in the equipment bag solves this.
Using a mouthguard that has been chewed to pieces. A thin guard offers little cushion.

Coaches can make the right habit automatic. A team that checks mouthguards at the start of each practice, the way it checks helmets, leaves little room for a missing guard.

If a dental injury happens

Any serious injury to the face, mouth or jaw is a medical situation. The first priority is the player's overall condition, including the head and neck. A player who has been knocked unconscious, is confused, has neck pain or cannot move normally needs emergency care before anyone worries about a tooth. Our article on tackling technique and safe contact covers how technique reduces many of these hits.

Once the player is stable, the following is widely taught first aid for dental injuries. It is general education, and the dentist or emergency department has the final say.

A tooth is knocked out

Find the tooth and pick it up by the crown, the white chewing part, not the root.
If it is dirty, rinse it gently with milk or a saline solution or, if nothing else is available, briefly with water. Do not scrub it and do not remove tissue fragments from the root.
For a permanent tooth, dentists often recommend trying to place it back in its socket right away, facing the right direction, and having the player gently bite on a piece of gauze or a clean cloth. This is best done by someone trained.
If it cannot be reinserted, keep the tooth moist. A cup of milk or a tooth-preservation solution from a first aid kit is better than plain water. Do not wrap it in tissue or let it dry out.
Get to a dentist or emergency department immediately. The chances of saving a knocked-out permanent tooth are best when it is replaced quickly, often within an hour.
Do not try to reinsert a baby tooth. A dentist will decide what to do.

A tooth is chipped or cracked

Save any fragments in milk or saline, rinse the mouth with water and call a dentist the same day. A sharp edge should be looked at even when it does not hurt.

A tooth is loosened or moved out of place

Do not force it back. Have the player bite gently on gauze and see a dentist at once.

Cuts to lips, cheeks or tongue

Apply gentle pressure with a clean cloth or gauze. Bleeding that does not stop after several minutes, deep cuts, or a cut that goes through the lip need professional care.

Signs of a broken jaw

Pain when opening or closing the mouth, a bite that feels wrong, swelling, numbness or a visible deformity call for emergency care.

Teams should keep a basic dental kit in the first aid bag, including gauze, a small container with a tight lid and a tooth-preservation solution or milk, and should have a plan for contacting a dentist or emergency department. Include this in the written emergency plan.

Cost, availability and choosing a plan

A stock mouthguard is the least expensive, and a custom guard costs the most. Prices vary by region and provider, and some dental insurance plans or school programs help with custom guards. Some programs offer group fittings, and dentists in some communities donate custom mouthguards to local teams. Ask your league, school or dentist.

If your child plays recreationally, the Play section can help you find leagues in your area. For school teams, our high school directory lists programs, and you can ask the coach what equipment is provided and what the family must buy. College programs, listed in our college section, usually provide mouthguards through team staff.

The short version

A mouthguard protects teeth, lips, cheeks and jaw, but there is no proof that it prevents concussion.
Football rules at most organized levels require a mouthguard, and the details are in the rule book for your level.
Custom guards fit best, boil-and-bite guards are a good middle choice, and stock guards fit worst, but any worn mouthguard beats none.
Players with braces should ask the orthodontist about a guard made for orthodontic appliances.
Rinse the guard, store it in a ventilated case, keep it away from heat, and replace it when it wears or no longer fits.
Wear it in practice and games, and in the mouth where it belongs.
In a dental emergency, handle a knocked-out permanent tooth by the crown, keep it moist and get to a dentist right away.

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