Short Answer: Silicone for a mouth guard and Gold for a night guard
Long Answer: This question comes up occasionally because there is more and more public awareness about the dangers of plastics. Most people know about Bisphenol A (BPA) which is a chemical used in the production of plastics. It can be found lining soda cans, plastic wrap, canned food and even in the thermal paper of sales receipts (which is readily absorbed through your skin when you handle them). It was banned from use in all children’s products in 2012 due to concerns about health effects. But companies soon started substituting BPA with a different compound called Bisphenol S (BPS). Many scientist believe BPS is even more potent and potentially more toxic than BPA. I really couldn’t make this up!
The marketing departments of these manufactures get to slap a big and proud “BPA-Free” label on their products but fail to mention what new chemicals they substituted in its place. Additionally, it also doesn’t mean your only concern should be BPA or BPS. There are other chemicals found in some plastics like Phthalates, Vinyl Chloride, Dioxins and Styrenes. Suffice it to say, I believe that no matter what a manufacturer claims, plastics are generally not to be trusted and they should be avoided when it is practical and reasonable. I have personally gone to great lengths to avoid contacting these chemicals, from getting a stainless steel blender, having the butcher put meat in my own glass container, not touching store sales receipts with my bare fingers and having absolutely no canned-anything in my house. That is just a short list of everything I have done 🙂 Am I a little crazy? Maybe. But I really believe plastic is not a good thing.
ATHLETIC MOUTH GUARD
So what is a patient to do if they need an athletic mouth guard? 99% of all these products are made of some plastic. Typically, athletic mouth-guards are soft and are made of a variety of plastics and usually some kind of copolyester. It is both impractical and not beneficial to make an athletic mouth guard from a rigid material, which is why it must be relatively thick and somewhat soft. In my own research, I have found that silicone is an exceptionally safe and effective alternative to traditional plastics. I use it in situations where I require a soft and pliable material. For example, I use a silicone spatula, baking sheet and reusable sealable bags, all made from 100% silicone. You can do your own research, but suffice it to say, I believe silicone is the only safe material out there that behaves like typical plastic. The good news is that you can have athletic mouth guards made from silicone, and that would be my preferred material for making one.
As for a night guard designed to protect from bruxism (tooth grinding), that is a whole different situation. I do not recommend anything soft for addressing bruxism, because a poorly adjusted soft night guard has the potential to cause jaw joint issues (TMD) and can also lead to an increase in grinding during the night. I will leave the issue of night guards for another post, but the bottom line is that a night guard should be rigid. Typically, dentists make hard night guards from acrylics, and usually (MMA) Methyl Methacrylate, Urethane Methacrylate, Stearyl Acrylate and others. These materials do work very well and I make night guards using them for my patients today. That is because most people are not as health obsessed as I am and all these materials have been evaluated by the FDA and other health governing bodies like the American Chemistry Council. They have been found to be safe, so I cannot honestly say that I am sure a hard night guard made of plastic will harm you in any way. Also, since the majority of hard night guards are acrylic-based, you can rest assured they have no BPA or BPS in them. That doesn’t mean other harmful chemicals are not present, but at least you can know there is no BPA/BPS in any of them. With few exceptions, no modern dental material has BPA in it and all dental materials made in a lab have been evaluated by the Food and Drug Administration. http://www.ada.org/en/member-center/oral-health-topics/bisphenol-a
When in doubt, ask your dentist for the “MSDS” (Material Safety Data Sheet) for whatever product the lab is making your night guard from. Most will provide it and you can verify what is being used. There are some states where dental labs are not required to disclose the materials being used, so your situation may be different.
Despite any reassurances, if you are deeply concerned, then the best alternative I have found is to make a device out of gold (or gold alloy). You can also read here to find out why I think gold is safe. Unfortunately, it is not cheap to make a gold night guard. A typical well-adjusted hard night guard made of plastic would cost you about $500 at a dental office. An equivalent gold night guard could run in the $3,000-$4,000 range, and most dentists would look at you funny if you even asked about it. You would have to be pretty concerned to justify such an expense. On the other hand, a gold night guard could potentially last a lifetime, as opposed to a plastic one which requires replacement every 5 years or so. And you would rest assured (pun intended) that the product you have sitting in your mouth for 1/3 of your life has no potentially harmful chemicals. I personally think it’s worth it, but then again, I admit to being a little weird.
The bottom line is this: If you need an athletic mouth guard, I would recommend having one made of 100% silicone with no added coloring or scents, etc.. If you need a night guard, I would always recommend a well adjusted hard one. And if you could afford it, the safest material to make it from is clearly gold.