Inside Dental Assisting
July/Aug 2012
Volume 8, Issue 4

Enhance Patient Services through Custom Mouthguards

New technology has improved the benefits and lowered the costs

Roger P. Levin, DDS

Offering new services is an excellent way to grow the practice and attract new patients, especially in a slower economy. The challenge is finding those services that not only enhance patient care and generate additional revenue but also can be easily incorporated into the practice’s current systems.

Dentistry has for a long time been a traditional field that has mainly provided a finite set of services. When a disruptive change such as a recession takes place, it becomes imperative that practices look at all growth opportunities, including service expansion. For dental practices, it makes sense to stay close to the core mission of promoting and maintaining excellent oral health. Selling vitamins or weight-loss products through the hygiene department is not a reasonable strategy because it does not support the practice’s core mission. These types of products are generally too far afield from dentistry.

One of the best opportunities for service expansion today is offering custom mouthguards. The reasons for providing this service are ample:

New technology has improved the benefit of a custom mouthguard for patients and lowered the cost of providing it to them.

• Mouthguards are close to the core business of dentistry.
• Millions of children each year need mouthguards to protect their teeth.
• Custom mouthguards are a quality dental service.
• As children grow, they will need mouthguards replaced, which creates a recurring service.
• Many adults need mouthguards as well.
• Mouthguards can be a source of word-of-mouth referrals and represent a new revenue source that requires little doctor time.
• Mouthguards promote good will with patients and parents.

Incorporating Mouthguards into the Practice

Mouthguards are not a traditional part of most dental practices, but in this author’s opinion they certainly should be. Think about tooth whitening and cosmetic dentistry. While there was a time when many oral healthcare practitioners were skeptical about these services, they have now become mainstream. As a profession, dentistry has expanded beyond simply “fixing teeth” (functionality) and moved into areas that promote dental esthetics, implants, and other services.

Mouthguards have both a functional and esthetic component because they protect a person’s teeth and smile. In addition to providing a needed service to patient athletes, offering mouthguards is a way to build good will with patients and parents.

Two Types of Mouthguards

The most popular mouthguard is the “boil-and-bite” variety available at retail outlets. Though relatively inexpensive, these products do not offer the same degree of protection as a custom mouthguard, which is created from an impression of the patient’s mouth taken at the dental practice.

Many practitioners resist offering products or services that compete with similar items available at retail outlets. The reasoning goes along these lines: “Why should I expend my energy when a cheaper version is available at the megastore?”

As the recognized dental expert, doctors should always offer patients ideal treatment, whether it is recommending dental implants versus dentures or custom mouthguards rather than over-the-counter brands. Educating patients about all available options allows them to make the best oral health choice for their unique situation.

When properly educated about the advantages of custom mouthguards (ie, better fit, better protection, longer lasting), many patients and parents will opt for greater protection. Dental teams can motivate patients about the benefits of this new service.

Outstanding Patient Care

Unlike many practice services, custom mouthguards can be easily integrated into practice operations. There is no inventory or storage involved because once the impression is taken, the custom mouthguard is then created at the dental lab. In most cases, the dental assistant can take the impression.

With the popularity of youth athletics, adding custom mouthguards to dental services makes sense for a number of reasons:

• Outstanding patient care—Oral healthcare practitioners pride themselves on offering the highest quality of care, and custom mouthguards are a great way to protect patients’ teeth and smiles.
• Exceptional customer service—The best practices exceed patient expectations at every opportunity. Instead of patients’ settling for a lower quality mouthguard or visiting another dental practice for such a service, make it easy and convenient for them to obtain a state-of-the-art mouthguard.
• Practice growth—Depending on patient demographics, custom mouthguards represent a strong opportunity to increase practice production without generating additional overhead.

Dental practices have an excellent opportunity to help patients protect their teeth and oral health by dispensing custom mouthguards. With the growing popularity of youth sports, providing custom guards can prevent mouth injuries and oral trauma. In addition, this service not only builds good will, but can also increase practice production. It is genuinely a situation that benefits patients and the practice.

Performance Enhancing Mouthguards: Science or Fiction?

Understandably, there are many in the dental profession—as well as the world of athletics—that question the validity of claims about performance enhancing mouthguards. Some argue that the enhanced performance some athletes realize is actually the result of a placebo effect.

However, while William Balanoff, DDS, MS, admits that the history of performance appliances is weak, he says that studies published in 2009 in the peer-reviewed literature include a placebo-controlled, double-blind study that proves the performance enhancement from the use of particular mouthguards wasn’t a placebo effect, but actually a quantitative effect on performance enhancement.

According to Jay Turkbas, senior vice president at Shock Doctor, performance-enhancing mouthguards are a type of mandibular orthopedic repositioning appliance (MORA) that are designed to adjust the gap in the mandibular jaw joint to create a balanced and relaxed strength-enhancing benefit when an athlete is clenching. Shock Doctor markets four mouthguards that are MORAs, he says.

Turkbas cautions that current tests that show large strength gains are likely not to have a deep enough scientific protocol. In order to better understand the MORA effect, more research should be undertaken to ensure there are no biases in these tests, he says.

Emilio Canal, Jr, DDS, past president, Academy of Sports Dentistry, has had experience with providing the different types of performance enhancement mouthwear. He believes that these appliances are setting the patient’s occlusion, or bite, in a better position for performance at optimum capacity or abilities.

“With the mouthguards that I have delivered to some of the athletes at the professional and amateur levels, some have experienced increased strength and speed, but it varies percentage-wise,” Canal observes. “There aren’t sufficient independent studies to really say that performance enhancement is going to occur with the use of this appliance. Some companies do say that some athletes will not benefit. I believe the reason why they will not benefit is because they already have an ideal occlusion, so they are in the ideal position to achieve the optimum result from their bodies.”


DiMatteo AM. Sports dentistry. Inside Dentistry. 2010;6(2):102-110.

About the Authors

Roger P. Levin, DDS
Founder and CEO
Levin Group in Owings
Mills, Maryland

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