Behavior & Development • Jan 21, 2016

Protecting your child’s smile: When are mouthguards needed?


My daughter’s teacher pulled me aside as I was coming for pick-up to tell me that she had fallen on the playground and hit her mouth. I was met by a crying child with blood covering her face, hands and coat.  What the teachers thought was just a split lip turned out to be fractured front teeth along with bruising and cuts to her gums. Thankfully they were all baby teeth!  But after this dental trauma I had concerns about sending her out on to the soccer field for her game that weekend…what if she got hit in the mouth?  Making her wear a mouthguard seemed like an obvious answer, but she is only 4 years old!  Turns out, they make mouthguards sized for kids of all ages. As a sports medicine physician, I am a huge advocate for mouthguard wear because it goes a long way in preventing dental trauma to both baby and adult teeth. They can also protect kids that have dental hardware, like braces.

There are three kinds of mouthguards:

  • Custom Fitted—made by your dentist to fit your child’s mouth. They are more expensive but will fit perfectly
  • Boil and bite—available for purchase at sporting goods stores or drug stores. You place them in hot water and then shape them to fit the mouth.
  • Stock—very inexpensive and are pre-molded

So how can you get your child to wear a mouth guard?  My 4 year loves the color purple, so getting her to wear a bright purple mouthguard wasn’t too difficult. Many mouthguards can be customized for team colors, and dentists can even put logos or mascots on the guard. If color isn’t enough to encourage your child to wear a mouthguard regularly, several companies have developed flavored mouthguards. They come in a wide range of flavors, from bubblegum to strawberry. The taste is subtle, but seems to last – and may encourage a wary kid to sport one for his or her activities.

Caring for a mouthguard is relatively easy. Mouthguards should be rinsed with soap and warm water after each use. Many come with straps that can be attached to helmets so that they don’t get lost. Others come with a carrying case that can be placed in a gym bag ready for its next use. Now, what happens if your child isn’t wearing their mouthguard and they get hit with an elbow or a ball in the mouth?

Types of Dental Trauma and What You Should Do If This Happens:

  1. Knocked out tooth—If an adult tooth is knocked out, the tooth should be rinsed briefly with cold water to remove any dirt or debris. Then, if possible, the tooth should be put back into its place until the athlete can see a dentist. If you can’t put the tooth back in, place it in a cup of milk or into a special liquid for teeth that some trainers may keep with them (i.e. Hanks balanced salt solution). If it is a baby tooth (primary tooth) that is knocked out, DO NOT put it back in. Just call the dentist to have them take a look. Usually baby teeth are left out.
  2. Tooth fracture—If a tooth has been broken, it is best to try and find the piece of tooth that has been broken off and take it to the dentist as soon as possible. Little chips are not emergent, and can be taken care over the few days after the injury.
  3. Tooth pushed in to gums (intrusion)—Sometimes after getting hit, a tooth won’t fall out, but will get pushed up in to the gums. If this happens, you should seek dental attention right away. A primary tooth that is pushed up into the gums can damage an adult tooth that is waiting in the gums emerge.

It is always best to call your dentist or primary care doctor if you have dental trauma to discuss. But, if you can get your child to wear a mouthguard when he or she is playing sports, you just might be able to avoid a trip to the dentist or the emergency room!

For more information on young athletes and other sports injuries visit

For more information on building first aid kits which may be helpful in a dental trauma (and might include the tooth saving liquid mentioned above) visit