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With an increase in sporting activities comes an increase in orofacial injuries. A properly fitted mouthguard has been shown to provide protection against orofacial injuries and trauma to the teeth and supporting tissues such as the lips, cheeks, and tongue. However, because it is not mandatory that all athletes (amateur and professional) wear a mouthguard, many do not for reasons such as fit, comfort, social stigma, and speaking constraints. Athletes prefer mouthguards to be comfortable, soft, and resilient, which is characteristic of a custom-fitted mouthguard. This article will review reasons athletes prefer not to wear mouthguards and advantages of a custom-made mouthguard, as well as describe a process to fabricate a custom-made mouthguard.