Mouthguard use in youth ice hockey and the risk of concussion: nested case–control study of 315 cases

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p>Concussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To determine the association between concussion and mouthguard use in youth ice hockey.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Nested case–control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among cases, 236/315 (75%) were wearing a mouthguard at time of injury, while 224/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95% CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95% CI 0.22 to 1.10). No dental injuries were identified in either cohort.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Mouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey.</jats:p></jats:sec>

Association between Sports-Related Concussion and Mouthguard Use among College Sports Players: A Case-Control Study Based on Propensity Score Matching

“…A nested cohort study reported that mouthguard use was associated with reduced odds of SRC [16], which was inconsistent with the previous systematic review. A field survey also revealed that wearing a custom-made, properly fitted mouthguard statistically reduced the incidence of SRC when compared with an over-the-counter mouthguard [14].…”

“…Mouthguards are thought to reduce the risk for SRC because of their shock absorption capability; however, there is mixed evidence that mouthguard use prevents SRC [5][6][7][8][9][10][11][12][13][14][15][16]. A systematic review that analyzed four studies that evaluated the effectiveness of mouthguards in preventing SRCs [9] found the studies reported inconsistent results.…”

‘Injury prevention versus performance’: has the time come to mandate the use of mouthguards in all contact sports?

“…One meta-analysis reported that mouthguard use did not reduce the risk of concussion, 2 while other single-sport studies have shown that mouthguard use reduces the risk of concussion in adults 4 and children. 5 SRC remains a topic of significant interest in contact sports, due to the potential link with the risk of long-term neurodegenerative disease. New mouthguards that monitor Open access head movement with smart ship technology have been proposed as a novel way to screen for and prevent SRC.…”

Padded Headgear does not Reduce the Incidence of Match Concussions in Professional Men’s Rugby Union: A Case-control Study of 417 Cases

“…Concussion is the most common match injury in professional men's rugby union and accounted for 21 % of all injuries in the highest level of rugby in England between 2014/2015 and 2018/2019 [1]. There are a variety of strategies that could be employed to target a reduction in concussion risk in collision sports, including policy and rule changes (e. g., modifying contact [2,3]), injury prevention exercise programmes [4,5], and wearing protective equipment [6]. In relation to protective equipment, rugby union players are allowed to wear padded headgear [7].…”