By far, the best fitting and most effective mouthguards are those that are fabricated in a dental lab or office. These are fabricated with the use of the patient’s impressions and offer the best fit. In addition, the most effective mouth guards are those that are laminated with a soft inner layer and a hard outer layer.

These are noted to be more effective at absorbing impact. However, these mouth guards require a full dental exam to take into consideration any previous dental injuries. It is also critical to consider the type of sport being played so that the guard is designed appropriately for that specific sport.

Custom appliances can be fabricated using thermal, pressure, vacuum, polymerization, or light-curing systems. The type used is dependent on the material choices, kind of sport, and any other individual characteristics regarding the athlete’s jaw or mouth that need to be considered.

For the best results, a mouth guard should:

• Be made of resilient material and offer long-lasting protection
• Be adapted to the athlete's mouth to ensure accurate fit and adaptation
• Stay in place and provide comfort
• Be odorless and tasteless
• Not interfere with breathing or speech
• Be easy to clean
• Reduce impact from transmitted forces.

By far, the most useful appliances are those that are fabricated with the clinician’s supervision. These will offer the most protection due to the accuracy of fit.