Shouldn’t the guard have a strap (to attach to the helmet)?
While straps can be added to a custom guard, they are simply not necessary. Straps are popular with store-bought guards because they are often spit out by necessity (for reasons already mentioned). On the other hand, a custom guard stays put. It’s not removed for talking, breathing, or even drinking water. Accordingly, a strap is not needed.
Straps can even be dangerous with a custom mouth guard. In football, a “face-mask” violation becomes even more worrisome if the strap is grabbed along with the face-mask. In hockey, I’ve seen helmets come off in collisions. A strap could cause trauma to the teeth. I recommend not using a strap.
Do mouth guards reduce concussions?
The short answer is: No. Despite advertising claims and “urban legend,” there is no scientific evidence that mouth guards reduce the incidence of concussions. The primary reason to wear a mouth guard is to protect the teeth and surrounding tissues.
What is the cost?
A pressure-formed, laminated custom mouth guard costs about the same as or less than what you’d spend on multiple boil-and-bite guards. So, yes…the price is higher than a single guard bought at a sporting goods store. But, regardless of the low price of a store-bought guard, it’s worth nothing if it DOES nothing. A stock store-bought guard may last a few weeks to a month (doing nothing, mind you). A custom made guard will easily last a whole season (or more), effectively protecting a player’s teeth. And, since a mouth injury can cause life-long and costly issues, I believe custom mouth guards are an excellent investment and value.
There are few guarantees in life.
Of course, we know that hockey and other contact sports have risks. And, no piece of equipment can guarantee an injury-free season. Using the best equipment available certainly helps. But a chewed-up store-bought mouth guard with half of it (or all of it) hanging outside the player’s mouth is useless and will not help prevent any injuries.
As a dentist and a hockey dad, I would urge you to consider obtaining a properly fitted, pressure-formed athletic mouth guard for your child athlete or for yourself, if you’re an adult playing sports.