Does dental insurance cover mouth guards?
A custom mouth guard prescribed to treat teeth grinding (a night guard/occlusal guard) is often covered under a plan's basic or major tier — but athletic sport guards are usually excluded.
What flips the answer
- Covered when
It's a custom occlusal/night guard prescribed to treat grinding or clenching, and your plan covers it under basic or major services within the replacement-frequency limit.
- Not covered when
It's an athletic sports mouth guard, which most plans treat as excluded personal equipment.
- Not covered when
It's an over-the-counter boil-and-bite guard, which isn't submitted to insurance.
'Mouth guard' covers two very different things. A dentist-fabricated occlusal or night guard that treats bruxism (teeth grinding and clenching) is a therapeutic appliance, and many dental plans cover it under basic or major services, paying a share after any waiting period up to the annual maximum.
Custom athletic mouth guards worn for sports are generally treated as preventive personal equipment rather than treatment, and plans commonly exclude them or cover them only for dependent children where a benefit exists. Over-the-counter boil-and-bite guards are not billed to insurance at all.
Even for a covered night guard, plans often limit how often they'll pay for a replacement — for example, once every few years. Whether your guard qualifies, and under which tier, is spelled out in your plan's schedule of benefits.
That's the general answer. Yours is written in your actual policy.
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