Can You Wear a Mouthguard Over Invisalign or Braces?
Clinically reviewed by Dr. Abinaash Kaur, DDS, RCDSO, on 2026-08-27. Dr. Kaur is a general dentist in Toronto (Bloor West Village) registered with the Royal College of Dental Surgeons of Ontario.
Over braces, yes, as long as it's a mouthguard built for braces and not the one from the bin at the sports store. Over Invisalign, no. The aligners come out, the mouthguard goes in, and the aligners go back once the game is over.
Fall sports start back up around Bloor West Village in a few weeks, and this question shows up every year in the same shape. A parent signed a kid up for hockey or rugby in the spring, the braces went on in July, and nobody put the two together until the first practice.
The two halves of that question aren't the same question. One of them has a randomized trial sitting behind it. The other has nothing at all, and I'll show you exactly what I mean by nothing.
Why can't a kid in braces just use a regular mouthguard?
Brackets and wires take up room. A stock guard is moulded to a smooth arch, so it either won't seat properly or it presses down onto the hardware.
There's a second problem that's easier to miss. Teeth in active treatment are moving on purpose. A guard shaped tightly around where the teeth sit in September is a worse fit by November, which is the opposite of what you want from protective gear.
A braces guard solves both by leaving space on purpose. When researchers built and impact-tested three braces-specific designs, the one that worked best created a buffer space between the guard and the appliance and added a hard insert, and it beat the other two designs on the strain reaching the teeth (Journal of Dental Sciences via PubMed Central).
Space is the feature. It isn't a manufacturing flaw.
Which kind holds up best over braces?
A lab study put seven braces mouthguards through impact testing on a model fitted with a fixed appliance, firing hockey balls, cricket balls and steel balls at them. Only the three custom-made guards and one mouth-formed brand stayed put. The other three were knocked out of position by the impacts (European Journal of Orthodontics via PubMed Central).
A guard that shifts on impact isn't protecting anything.
The same research group then ran a randomized trial on real kids. Twenty-four patients in braces, median age 13, most of them playing rugby or field hockey, wore three types of guard in turn and rated each one. Custom-made and mouth-formed guards both beat the prefabricated one on comfort, stability, breathing and the urge to chew it. Asked to pick a favourite at the end, the patients chose the custom guard (European Journal of Orthodontics via PubMed Central).
A 2025 review pooling nine studies of athletes generally landed in the same place, with custom guards rating better than self-adapted ones for fit, speech and breathing (Quintessence International via PubMed).
Here's the practical read. A custom guard is the better product, and a decent boil-and-bite made specifically for braces is a real option rather than a consolation prize. The one to skip is the cheap prefabricated guard, and the evidence points the same way whichever study you pick up.
Does a mouthguard still work with a bracket in the way?
Yes. A study modelling a front-tooth impact on a computer found that adding a mouthguard cut the stress reaching the tooth by roughly 88% with metal brackets and 89% with ceramic ones, and the guard helped regardless of bracket type (Brazilian Dental Journal via PubMed).
Two honest caveats belong with those numbers. It's a computer simulation and not a group of children, so treat it as mechanism rather than proof. The same study also found ceramic brackets pushed higher stresses into the enamel than metal ones did, which is worth raising with your orthodontist if your child plays a contact sport and is choosing between them.
What about Invisalign? Do you wear the guard over the aligners?
No. Take the aligners out and wear the mouthguard on its own.
Aligners are thin plastic built to move teeth gradually. They aren't built to absorb a stick or an elbow, and nothing about the material suggests they would be. Stacking a mouthguard on top also means the guard is fitted to a layer of plastic rather than to teeth, so it seats worse than it would on its own.
Now the part I promised. I searched the medical literature for research on wearing a mouthguard with clear aligners, and there isn't any. Not thin evidence. None. There are more than 700 published papers mentioning Invisalign and more than 800 on mouthguards, and the overlap between those two piles is empty (PubMed).
So take what I just told you as clinical reasoning from someone who has watched this play out for years, and not as a finding from a trial. Anyone who tells you the research supports one approach here is describing research that doesn't exist.
The worry parents raise is wear time, since aligners need to be in for most of the day to keep the plan on track. A ninety-minute game isn't what derails treatment. Forgetting to put them back in afterward is.
Wrap them in a napkin on the bench and they go in the trash with the napkin. I've replaced more aligners lost that way than lost any other way. Our guide to retainers after Invisalign covers the same habit on the other side of treatment, and if you're still weighing the two appliances, we compare them in Invisalign versus braces.
Why is the braces year also the riskiest year?
The bite problem that sends a lot of kids to orthodontics is itself one of the strongest predictors of a broken front tooth. Did you know about this? Most parents don't, and it changes how seriously you take the guard.
Children with an overjet greater than 5 mm, meaning upper front teeth that sit well ahead of the lower ones, have about twice the odds of a traumatic dental injury compared with children whose overjet is smaller (British Dental Journal via PubMed Central). Worldwide, roughly 21% of these injuries are attributable to a large overjet (British Dental Journal via PubMed Central).
The background rate isn't small either. Dental trauma affects around 10% to 12% of UK children at ages 12 and 15, and just over 15% of people worldwide once the adult teeth are in, with up to 18% of 12-year-olds affected (British Dental Journal via PubMed Central).
So the child in braces is often in braces because of the exact feature that raises the risk. The appliance didn't create that risk. It arrived alongside it.
Correcting the overjet early does appear to help, cutting incisor trauma from 25.5% to 14.2% across four trials, though the authors are careful to note the effect varied widely between studies and the evidence carries a high risk of bias (British Dental Journal via PubMed Central). That's a conversation with your orthodontist about timing, not a reason to rush anyone into treatment.
Does a mouthguard prevent injuries?
It reduces damage. It doesn't make a mouth bulletproof, and I'd rather say so plainly than oversell a piece of plastic.
A survey of 1,213 field hockey players found that 20% of Dutch players and 29% of international players had suffered a mouth or tooth injury during their career, and that was with 95% and 88% of them wearing mouthguards. There was no statistical link between wearing one and whether an injury ended up needing treatment (Journal of Clinical and Experimental Dentistry via PubMed Central). The authors concluded that the guards in use may not offer enough protection against the forces in that sport.
Read that as an argument for a better guard, not for no guard. The Canadian Dental Association's position is straightforward: "Wear a mouthguard if you are participating in sports or recreational activities to reduce the chances of damage to your teeth, lips, cheek and tongue" (Canadian Dental Association).
A guard also protects the soft tissue, which matters more with braces than without. Lips and cheeks meeting brackets at speed is its own kind of injury, and it never shows up in tooth-fracture statistics at all.
What do you do if a tooth gets knocked out anyway?
Move fast, and don't let the tooth dry out.
If it's an adult tooth, the Canadian Dental Association says a dentist may be able to put it back, and that "if you can get help within 10 minutes, there is a fair chance that the tooth will take root again" (Canadian Dental Association). If you can't reseat it, or there's any chance it gets swallowed, put it in a container of cold milk and bring it with you (Canadian Dental Association).
Milk, not water, and not a dry tissue. We walk through the rest of the triage in our emergency dentist guide, and it's worth reading before the season rather than during it.
One more thing worth folding into the same appointment. If your child grinds at night, the appliance for that is a different one with a different job, and we cover it in our post on night guards for grinding. A sports mouthguard won't do that work, and a night guard won't survive a hockey game.
Frequently Asked Questions
Q: Can you wear a mouthguard with braces? Yes, and it should be one made for braces. Orthodontic guards are built with extra room so they sit over brackets and still fit while teeth are moving. In impact testing of seven braces guards, only the three custom-made ones and a single mouth-formed brand stayed in place after impact (European Journal of Orthodontics via PubMed Central).
Q: Can you wear a mouthguard over Invisalign aligners? Take the aligners out and wear the mouthguard alone. Aligners are thin plastic meant to move teeth, not to absorb impact, and a guard fitted over them seats on plastic instead of on teeth. There's no published research on the combination, so this is clinical judgement rather than a trial result.
Q: Will taking my aligners out for a game slow my treatment down? A single game won't. Aligners need to be in for most of the day, so the risk is forgetting to put them back in afterward rather than the hour they spent in the case. Put them back on the way home and keep the case with the sports bag.
Q: Is a custom mouthguard worth it over a boil-and-bite? For most kids in braces, yes. In a randomized trial of patients in fixed appliances, custom and mouth-formed guards both outperformed a prefabricated guard on comfort, stability and breathing, and patients preferred the custom one overall (European Journal of Orthodontics via PubMed Central). A braces-specific boil-and-bite is a reasonable middle option. The cheap prefabricated guard is the one to skip.
Q: Does a mouthguard still protect teeth that have brackets bonded to them? Yes. A computer model of a front-tooth impact found a mouthguard cut the stress reaching the tooth by roughly 88% with metal brackets and 89% with ceramic ones (Brazilian Dental Journal via PubMed). That's a simulation rather than a clinical trial, so read it as mechanism.
Q: My child's front teeth stick out. Does that change anything? It raises the stakes. An overjet greater than 5 mm roughly doubles the odds of a traumatic dental injury, and about 21% of these injuries worldwide are attributable to a large overjet (British Dental Journal via PubMed Central). A guard matters more for that child, not less, and the timing is worth raising with your orthodontist.
Q: Do we need a new guard partway through treatment? Often, yes. Teeth move throughout treatment, so a guard that fit in September can loosen by the winter. Bring it to a routine visit and we'll check the fit rather than guessing at it. Our back to school dental checkup post covers what else is worth folding into that appointment.
Reviewed by Dr. Abinaash Kaur, B.Sc., DDS (University of Toronto Faculty of Dentistry), who has practised general and family dentistry in Bloor West Village for about 25 years. This article is general oral health information, not a diagnosis or a substitute for an examination.
Starting a season with braces or aligners and not sure what your child should be wearing? Bring the sports bag to the next visit and we'll check the fit, tell you whether a custom guard is worth it for the sport they play, and sort out the timing with your orthodontic plan. We're at 750 Annette Street in Bloor West Village, serving the Junction, High Park, and Baby Point. Book a visit with The Village Dentist and we'll take it from there.
