Monday, September 11, 2017

Custom Mouth Guards - what does it mean?



Many sports either require a mouth guard, or while not required in others - it is often a very good idea!  One option to meet this need is a custom mouth guard.  While taking an impression for a custom mouth guard is a quick process, it may be an overwhelming new experience for some patients.  We continue our standard pediatric treatment techniques outlined by Amber in our April blog entry and make sure we explain the process through Show, Tell, Do.  Knowing what to expect should help ease any apprehension a patient may have, and choosing the thermoplastic material color for final mouth guard is a great way to start the half-hour appointment.  

The first step in creating your child's custom mouth guard is dry fitting the tray to be used in molding process.  We have a variety of sizes to ensure the best fit and the most comfortable process.  Once the appropriate size tray has been fit, dustless Jeltrate alginate powder is mixed with water to create the flexible, paste-like impression material.  There is a slight minty flavor and scent similar to toothpaste.  A small spatula is used to fill the impression tray before inserting it into the patient's mouth upper palate.  The upper lip will be lifted to ensure the tray is properly placed and not too far back to prevent gagging.

Your child's provider with hold the tray against upper palate until the alginate sets.  This only takes about 30-50 seconds.  Your child will need to hold still during the setting process so that consistent pressure can be maintained to ensure an accurate impression.  Once the tray and impression have been removed, no alginate is left on the teeth. For our patients with braces, wax will be placed over the orthodontic appliances prior to taking the impression to ensure no alginate becomes lodged.  The impression is inspected for imperfections caused by air bubbles, the tray not seated high enough on the upper gigival tissue above teeth, or movement during the setting process.  Sometimes an impression will need to be retaken, but not very often.

Below is a slide show of the full process - starring our own Dr. Scholl and her assistant Michelle!




In our lab, the impression is used to create a hard model of the teeth that will be used to make the final mouth guard.  Powdered dental stone is mixed with water and poured into the impression, still in the tray, to make a model of the upper teeth.  The dental vibration machine settles the dental stone into the details of the impression and reduces bubbles to create a smooth model.  The model has been poured, jiggled, and takes a few hours to dry before it can be removed from the tray and impression is disposed of.

The stone model must be smoothed on our model trimmer, a wet disc sander to reduce dust from the dental stone.  Once the model is trimmed and smooth, it is placed in the vacuum forming machine (the model used in this portion of the slide show is of Dr. Scholl's son).  The top section is the heat source that melts the thermoplastic sheet that was selected at the beginning of the impression process.  You can see the blue material Dr. Scholl's son chose clamped below the heat source.  The heat will cause it to soften to a drooping state at which the heat source is quickly moved to the side and the clamped thermoplastic can be slid down over the model.  The vacuum suction is engaged and the thermoplastic is sucked around the model to form the final mouth guard.  The plastic cools for a minute before it can be removed and the excess material is trimmed for a comfortable fit.


Store bought mouth guards certainly offer protection against dental trauma if they are formed correctly, but an accurate, professional impression of your child's teeth is the best protection they have with minimal additional investment over store bought options.  To schedule your athlete's impression, please call our Scheduling Coordinator at 607-4197 or inquire at your next oral health visit!

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