Football players wear mouthguards to protect their teeth, gums, jaw, and the soft tissue inside their mouths from the repeated high-force collisions that define the sport. The protection is dramatic: players who wear mouthguards are 82% to 93% less likely to suffer dental and facial injuries than those who don’t.
How Mouthguards Protect Your Mouth
A mouthguard works by absorbing and spreading out the force of an impact across a wider area. Instead of a hit concentrating all its energy on a single tooth or one point along the jawbone, the guard redistributes that force across the entire dental arch. This raises the threshold of force needed to actually crack or knock out a tooth. It also reduces the energy transmitted to the jaw joints and the bony structures around the mouth.
Without a mouthguard, the most common injuries are cracked teeth (coronal fractures) and teeth getting completely knocked out (avulsions). A 2019 meta-analysis found that dental trauma affected roughly 48% to 59% of athletes who didn’t use a mouthguard, compared to just 7.5% to 7.75% of those who did. That gap is enormous, especially for a piece of equipment that costs anywhere from a few dollars to a couple hundred.
Beyond teeth, the guard creates a barrier between your teeth and the soft tissue inside your mouth. When your jaw snaps shut from an upward blow to the chin, a mouthguard prevents your teeth from slicing into your tongue, lips, or inner cheeks. It also cushions the jaw joints (the temporomandibular joints on either side of your skull), which can be damaged when impact forces travel up through the lower jaw.
Do Mouthguards Prevent Concussions?
This is one of the most common claims about mouthguards, and the short answer is: probably not. While mouthguards do reduce head acceleration slightly during impacts, that reduction alone doesn’t translate into fewer concussions. The current scientific evidence shows little impact on concussion prevention, with the data described as inconsistent and unclear by researchers reviewing the topic. Mouthguards are excellent at protecting your face and mouth, but they shouldn’t be relied on as concussion protection.
Three Types and How They Compare
There are three basic categories of mouthguard, and the differences matter more than you might expect.
- Stock mouthguards come pre-formed in standard sizes. They’re cheap and available at any sporting goods store, but they fit poorly, can make breathing and speaking difficult, and offer the least protection.
- Boil-and-bite mouthguards are the most popular type in football. You soften them in hot water, then bite down to mold them roughly to your teeth. They offer a decent fit at a low price, typically under $30. These are the type most commonly studied in the research.
- Custom-made mouthguards are fabricated by a dentist from an impression or scan of your teeth. They fit precisely, stay in place better, and have a significant advantage when it comes to breathing and performance.
A study evaluating 168 mouthguards across eight different designs found that most types didn’t significantly interfere with speaking, breathing, or saliva flow. The major exception was one poorly designed stock model that caused problems across the board. In general, better fit means fewer complaints.
The Breathing and Performance Tradeoff
One reason some players resist wearing mouthguards is the feeling that it restricts airflow. There’s some truth to this, but it depends heavily on the type. A meta-analysis comparing athletic performance with and without mouthguards found that wearing one slightly reduced maximum oxygen uptake and ventilation overall. However, when researchers looked at custom-made mouthguards separately, there was no significant effect on either measure. The performance penalty applies mainly to stock and boil-and-bite designs that don’t fit well and partially obstruct the airway.
Some research has even suggested that a well-designed mouthguard can widen the airway opening at the back of the throat, potentially improving endurance performance and reducing lactic acid buildup. That finding is still debated, but it underscores the point: a properly fitted mouthguard shouldn’t hurt your breathing, and a cheap ill-fitting one might.
What the Rules Require
The NCAA mandates that all football players wear intraoral mouthguards, and they must be brightly colored so officials can spot whether a player is complying. The bright color requirement exists because enforcement has historically been lax. A survey of college football officials found that 96% said they would issue a warning for a mouthguard violation rather than charging a timeout, which is the actual prescribed penalty. In practice, this means some players get away with wearing their mouthguard dangling from their facemask rather than in their mouth.
The NFL does not mandate mouthguard use for all players, though many wear them voluntarily. Skill position players who take frequent hits, especially running backs, wide receivers, and quarterbacks, tend to wear them more consistently. Linemen sometimes skip them, citing communication difficulties at the line of scrimmage, though custom-fitted options have largely solved that problem.
Getting the Right Fit
If you’re playing any level of football, the single most important factor is fit. A mouthguard that’s uncomfortable won’t stay in your mouth, and one that’s not in your mouth can’t protect you. For recreational or youth football, a quality boil-and-bite guard from a reputable brand is a reasonable starting point. For anyone playing competitively at the high school level or above, a custom-made guard is worth the investment. It protects better, breathes better, and you’re far more likely to actually keep it in during play.
Mouthguards also wear out. The material loses its elasticity over time, especially with repeated clenching during games. Most dentists recommend replacing a boil-and-bite guard each season and having a custom guard checked annually for fit and wear.