Port City Ortho explains how athletes can stay active while protecting their orthodontic treatment.
QUICK ANSWER: Yes. Braces and clear aligners are not a reason to sit out a season, and no sport is off limits during orthodontic treatment. What changes is the equipment. Athletes in braces need a mouthguard built to fit over brackets, worn at practice and in games. Athletes in clear aligners should take the aligners out for contact sports, store them in their case, and wear a standard mouthguard instead. The American Dental Association reports that mouthguard users are between 82 and 93 percent less likely to suffer injuries to the teeth, mouth, and jaw.
Key Takeaways
- Braces do not disqualify an athlete from a sport. The mouthguard has to change, not the season.
- A standard boil-and-bite guard is the wrong tool. Teeth in braces keep moving. An orthodontic mouthguard has a taller channel built for brackets.
- Aligners come out for contact sports. They go in their case, never a pocket or a napkin.
- Some sports require a guard by rule. The National Federation of State High School Associations (NFHS) requires them in football, field hockey, ice hockey, lacrosse, and for wrestlers in braces. Basketball and soccer do not, and still send us plenty of loose brackets.
An elbow comes out of nowhere in a Tuesday night rec basketball game. A field hockey ball skips off the turf. Two players go for the same header, and only one sees it coming.
Any of those can end with a parent on a sideline holding a loose bracket in a napkin, wondering whether the season just got complicated.
We have been answering that question in Wilmington for more than 25 years. Today, Dr. Bill Gierie and Dr. Steven Hancock proudly carry forward a legacy shaped by Dr. Gregory Richardson and Dr. Joe Jamison, whose years of service helped make Port City Ortho what it is today. As a locally owned, independent practice, our decisions are made right here by doctors who know and care for this community. Across our Mayfaire, Shipyard, and Southport offices, we have cared for generations of local families through every stage of life.
Here is the short version we give parents at the chair. The sport is almost never the problem. The gap between the first practice and the first mouthguard is.
What Actually Changes When an Athlete Has Braces
Braces do not make an athlete more likely to get hit. They change what a hit does.
An athlete in braces has hardware sitting right where the inside of the lip rests. An impact that would have left a bruised lip instead presses that lip into brackets, and the cut takes longer to heal than the bracket takes to fix.
That is the whole risk, and it is manageable. The American Association of Orthodontists is direct about it: wearing a mouthguard with braces is not only possible but strongly recommended.
One request, then. Do not treat the mouthguard as game-day equipment. Most of the repairs we see start at practice, because that is where the repetitions are.
Do You Need a Mouthguard With Braces?
Yes, in any sport where contact with a person, a ball, a stick, or the floor is possible. That is a wider list than most families expect.
The numbers are unusually clear for a piece of safety equipment. The American Dental Association reports that mouthguard users are 82 to 93 percent less likely to suffer injuries to the teeth, mouth, and jaw, and that athletes who skip one carry more than twice the risk. In one study of college basketball players, dental injury rates were five times lower among those wearing custom-fitted guards.
The American Academy of Pediatric Dentistry estimates the lifetime cost of a single knocked-out tooth in a teenage athlete can reach that figure. A mouthguard costs a fraction of one office visit.
None of this is meant to worry anyone. Serious dental injuries in youth sports are uncommon, and close to fully preventable.
What Kind of Mouthguard Works With Braces?
An orthodontic mouthguard, meaning one specifically made to fit over brackets. A standard boil-and-bite guard from the sporting goods aisle is the wrong tool during treatment, and it's worth understanding why.
A boil-and-bite guard molds tightly around the teeth as they sit that day. Teeth in braces move every few weeks. A guard molded in August fits a mouth that will not exist in October, and one hardened around brackets can pull on them when you take it out.
An orthodontic mouthguard solves this with a taller channel and softer material. It fits over the hardware rather than around each tooth, so it keeps working as treatment progresses.
| Mouthguard type | Works over braces? | What to know |
|---|---|---|
| Stock, ready-made | Loosely | The American Dental Association calls it the least effective type: generic design, improper fit, inadequate retention. Better than nothing on the day you forgot the real one. |
| Standard boil-and-bite | Not recommended | Molds to tooth positions the day it is formed. Can grip brackets, and stops fitting after an adjustment. The one most families buy by mistake. |
| Orthodontic, over-brace | Yes | Taller channel and softer material built for brackets and moving teeth. Sold at sporting goods stores and pharmacies. This is what we point our patients toward. |
| Custom-made | Yes, with planning | Best fit and retention. The American Academy of Pediatric Dentistry notes block-out methods can build in room for future movement. Usually the better choice once braces come off, and a retainer takes over. |
We do not fabricate custom guards during active treatment, and that is deliberate: a custom guard made today is fitted to a mouth we are actively changing. Buy the orthodontic version and bring it to your next adjustment. Our guide to back-to-school braces prep covers the rest of the fall checklist.
BEFORE THE FIRST PRACTICE: Buy an orthodontic mouthguard, not a boil-and-bite. Buy two, because one will go missing in a gym bag by week three. Name on the case in marker. Rinse in cold water, keep it out of a hot car, store it in a vented case.
Can You Play Sports With Clear Aligners?
Yes, and the rule is simple: no contact. For contact sports, take the clear aligners out and wear a mouthguard instead. For running, swimming, cycling, or lifting, leave them in and count that time toward wear.
The American Association of Orthodontists gives the same guidance. An aligner is a thin tray built to move teeth gently over two weeks, not to absorb an impact.
The tradeoff is wear time. Most plans call for 20 to 22 hours a day, so a practice plus a game is a real subtraction. The fix is a habit: trays go back in at the final whistle, not on the ride home.
WHERE THE ALIGNERS GO: In their case, in the bag, every time. Not a pocket, where they get crushed. Not a napkin on the bench, where they get thrown away. Replacing a lost tray costs time, and lost time lengthens treatment.
Which Sports Actually Require a Mouthguard?
Five, by rule at the high school level. The National Federation of State High School Associations (NFHS) requires mouthguards in football, field hockey, ice hockey, lacrosse, and in wrestling for any wrestler wearing braces. North Carolina high school teams compete under NFHS playing rules.
The required list is a floor, not a recommendation. The American Dental Association also recommends a guard for boxing, rugby, baseball, gymnastics, skateboarding, skiing, and volleyball.
Look at what is missing. Basketball and soccer require nothing, and between them they account for a steady share of the emergency repairs we handle every winter and spring.
Whether your athlete suits up for Ashley, Hoggard, Laney, or New Hanover, plays for the Cougars at South Brunswick High School in Southport, or is nine years old in a Saturday rec league, the answer does not change.
Youth leagues are where mouthguards are most often skipped because the collisions may seem less serious. If your child has not yet had an orthodontic evaluation, we would love to meet them and help you understand whether treatment may be needed. If they play sports, we will also help your family protect their smile and confidently navigate athletics throughout orthodontic treatment.
What To Do When Something Breaks During a Game
Come out of play and look at it. The American Association of Orthodontists puts this plainly: never play through damaged orthodontic hardware, because it can cause serious injury.
LOOSE BRACKET: Still on the wire? Cover it with orthodontic wax. Off completely? Bag it and bring it in. Call your office the next business day.
POKING WIRE: Cover the end with wax. If the wax isn't holding, a clean pencil eraser can push the wire flat against the tooth. Do not cut a wire at home.
LOST OR CRACKED ALIGNER: Move back to the previous tray and call us. Do not skip ahead, and do not go without a tray in, because teeth start drifting within a day.
KNOCKED-OUT PERMANENT TOOTH: A true emergency. Pick the tooth up by the crown, never the root. Do not scrub it. Keep it moist in milk and get to a dentist immediately.
Keep a kit in the sports bag: wax, a toothbrush, floss picks, a spare mouthguard, the aligner case. Our travel checklist for braces wearers covers the same kit for tournaments.
Not sure the mouthguard in the bag is the right one?
Bring it to your next adjustment, and we will check the fit against the brackets. Not in treatment yet, with a season coming? A complimentary consultation is the place to start.
Mayfaire 910.256.8590, Shipyard 910.452.7988, Southport 910.457.0020.
SCHEDULE HERERooted Here, and Here for Every Season
Port City Ortho is locally owned, and we are proud to call this community home. The decisions we make are guided by doctors and team members who live, work, and raise their families here; people who understand the busy school days, sports practices, and family schedules you are balancing.
More than 550 families have shared five-star reviews of their experiences with us. Some first came through our doors as teenagers and now bring their own children for their first visit. There is no greater compliment than hearing that a family found us because a friend or neighbor recommended us from the sidelines of a soccer game. Whether this is your family’s first visit or you have known us for years, you will always be warmly welcomed here.
Why Families Choose Port City Ortho
- Proudly rooted in the Cape Fear community. Because Port City Ortho is locally owned and independent, your care is guided by doctors who live here, know our families, and are personally invested in the community we share.
- Local families trust us. Families across Wilmington and Southport have shared more than 550 five-star Google reviews, and we are sincerely thankful for every patient who has trusted our team with their smile.
- Three offices, 25 years, one community. Mayfaire, Shipyard, and Southport mean a repair visit rarely costs an athlete a whole afternoon. We have watched local athletes go through braces, through seasons, and often through their own children's braces.
- Aligner expertise at the highest level. A Diamond Plus Invisalign provider, in the top one percent nationally. Dr. Gierie has served on Align Technology's Invisalign Global Scientific Advisory Board as one of seven members worldwide.
- University-trained doctors. Dr. Gierie teaches at the University of North Carolina, and Dr. Hancock earned his Doctor of Dental Surgery there with highest distinction.
FINAL ANSWER: Play the season. In more than 25 years here, we have never told a healthy athlete to give up a sport because of orthodontic treatment. Get an orthodontic mouthguard before the first practice rather than after the first injury; take aligners out for contact, and put them straight into the case, and come off the field when hardware breaks. The thing most likely to cost your athlete playing time is not the braces. It is a mouthguard that never made it into the bag.
Your smile is your signature. Trust Port City Ortho to craft your masterpiece.
Starting treatment before a season, or already halfway through one? Consultations are complimentary, and we see patients of every age across Wilmington, Southport, and the Cape Fear communities. Same locally owned team, three offices, more than 25 years of serving our neighbors.
Frequently Asked Questions
A few more of the questions families ask us most once a season is underway.
Can you wear a regular boil-and-bite mouthguard with braces?
We do not recommend it. A standard boil-and-bite guard molds tightly to the teeth as they sit on the day it is formed, so it can lock onto brackets, and it stops fitting after an adjustment moves those teeth. An orthodontic mouthguard has a taller channel and softer material built for brackets.
What should you do if a bracket comes loose during a game?
Come out of play and look at it. If the bracket is still on the wire, cover it with orthodontic wax and call our office the next business day. If it came off completely, save it and bring it in. Don't keep playing on damaged hardware, because a loose bracket or wire can cut your cheek.
Where should clear aligners go during a game?
In their case, in the bag, every single time. Aligners wrapped in a napkin get thrown away, and aligners in a pocket get crushed. A replacement tray costs time and can set treatment back, so the case habit matters more than almost anything else we tell aligner athletes.
Sources
- American Dental Association. "Athletic Mouth Protectors (Mouthguards)," ADA Oral Health Topics. https://www.ada.org/resources/ada-library/oral-health-topics/athletic-mouth-protectors-mouthguards
- American Association of Orthodontists. "Mouthguards." https://aaoinfo.org/treatments/mouth-guards/
- American Association of Orthodontists. "Oral Health Tips for Athletes from the Orthodontic Experts." https://aaoinfo.org/whats-trending/oral-health-tips-for-athletes/
- National Federation of State High School Associations. "Position Statement and Recommendations for Mouthguard Use in Sports," October 2018. https://assets.nfhs.org/umbraco/media/1014750/position-statement-and-recommendations-for-mouthguard-use-in-sports-october-2018-final.pdf
- American Academy of Pediatric Dentistry. "Policy on Prevention of Sports-Related Orofacial Injuries," revised 2023. https://www.aapd.org/media/policies_guidelines/p_sports.pdf
Medical disclaimer: This article provides general educational information. Individual orthodontic needs differ, and appliance type, treatment stage, and sport all affect what protection is appropriate. For a diagnosis or a recommendation specific to your athlete, including guidance on any dental injury, please see a qualified orthodontist or dentist in person.
