Queenstown is not a gentle town. Between the bike park, the ski fields, the rugby and hockey seasons and a general local enthusiasm for going fast downhill, we see a lot of damaged front teeth.
Almost all of it is preventable, and the prevention is unglamorous: a piece of moulded plastic that costs a small fraction of what fixing the damage does.
What a knocked-out front tooth actually costs
This is the comparison worth having in your head.
If a front tooth is lost and cannot be replanted, replacing it properly usually means an implant - an assessment, the placement, several months of healing, then a crown. It is one of the more expensive things in dentistry, and it is not a one-off: the crown on top will need replacing at some stage in your life.
The alternative is a bridge, which means preparing the healthy teeth either side, or a denture. None of these are as good as the tooth you were born with.
A custom mouthguard costs a small fraction of any of that, and it lasts seasons.
Why boil-and-bite guards underperform
You can buy a guard from any sports shop, drop it in hot water and bite into it. It is better than nothing. It is also a long way from what a fitted guard does.
The problem is retention and thickness. A shop-bought guard is a uniform sheet of material shaped roughly to your mouth. It tends to be too thin where you need protection most - over the front teeth - and it does not stay put reliably, so people push it out with their tongue, chew on it, or take it out to talk and forget to put it back.
A custom guard is made from an impression of your teeth, so it clips into place and stays there. The thickness is built up where the impact lands. And because it fits and you can talk in it, you actually keep it in.
Who should be wearing one
Rugby is the obvious one, and most clubs require it. But the sports where we see the worst dental injuries are not always the contact sports.
- Mountain biking and downhill - handlebars and front teeth are at a similar height
- Skateboarding and scootering
- Hockey, at every level
- Basketball and netball - elbows, mostly
- Skiing and snowboarding, particularly in the park
- Boxing and martial arts
- Anyone who has already had a front tooth repaired - a restored tooth is more vulnerable, not less
Children and teenagers
Adult front teeth come through around seven to nine and then have to last eighty years. A knock at ten has consequences for a very long time.
Growing mouths do mean a guard needs remaking every year or two as the teeth change, which people sometimes use as a reason to buy the cheap one. That logic runs the wrong way - the years when the mouth is changing are exactly the years the teeth are most exposed and most valuable to protect.
Getting one made
It takes two short appointments. We take an impression of your teeth, the guard is made to it, and you come back to check the fit. You can choose the colour, which matters more to eleven-year-olds than you would think and is a genuinely good reason they will wear it.
Bring it to your check-ups and we will look at whether it still fits - particularly for kids, and particularly if it has been chewed.
One thing a sports guard is not
A sports mouthguard is not a night guard, and the two are not interchangeable. A sports guard absorbs a single large impact. A night guard resists sustained grinding force for hours at a time, and is made from harder material.
Wearing a soft sports guard overnight can actually encourage more clenching, because the springy surface gives the jaw something to work against. If you grind your teeth, that is a different appointment and a different device.
General information, not a diagnosis. Written and reviewed by Dr Adrian Paul, BDS (Otago), principal dentist at Lakeside Dental Practice, Queenstown. If something is worrying you, see a dentist.
