Are mouth guards important for concussion prevention?

Mouth guards are worn in many contact sports with the main goal of protecting the mouth, teeth, and jaw, and literature has shown them to be very effective. Though they were initially designed to prevent dental and facial trauma, researchers are now wondering if they can serve another purpose, to prevent concussion.  In this blog we will explore this topic and discuss the reasons mouthguards are so important for certain contact sports.

There is a theory that mouthguards can help prevent a traumatic brain injury (concussion). “It is thought that mouth guards may reduce the severity of the concussion by absorbing some of the forces from an impact to the face. They primarily reduce the force being transferred to the base of the skull.”  When a mouthguard is worn correctly, it pulls the mandible (jaw bone) forward and creates a space between the jaw bone and the skull. “An upward blow to the head through the mandible,” should have more difficulty radiating to the skull if there is a space between the mandible and skull.  Though this theory makes sense, in studies thus far, mouthguards have not been shown to reduce the incidence of concussion.  Though unproven, research is continuing to be conducted to determine if “custom fitted mouth guards might be more effective at measurably absorbing the force of impact.”

So, if we aren’t yet convinced that mouthguards will help prevent a concussion, why do we recommend them?  Though they may not prevent a concussion, it makes sense that they could theoretically decrease a hard impact to the jaw from radiating to the skull and lessen the blow.  More importantly, mouthguards help prevent trauma to the teeth and face.  A hard hit to the mouth without a mouthguard could lead chipped or broken teeth which could further injure the lips or gums.  Additionally, a proper filling mouthguard helps protect the jaw and the temporomandibular joint (TMJ).  

Since mouthguards aren’t one of the proven answers to concussion prevention, we need to consider additional ways to keep our children’s’ brains safe.  Of course, wearing a properly fitting helmet is helpful in sports such as football, ice hockey, skiing, snowboarding, and cycling.  Additionally, “encouraging neck strengthening exercises and minimizing high-risk impacts may provide a more fruitful avenue to reduce concussions in sports.”  Lastly, and of utmost importance is “improving coach and player education about proper concussion management,” since despite personal protective equipment, concussions will continue to exist.  Parents, coaches, athletic trainers, school nurses, and primary care providers all have a role in teaching children and teens the symptoms of concussion and the importance of stopping play in the event these symptoms occur after a head injury. 

 

References:

Patel, D.R., Fidrocki, D., & Parachuri, V. (2017). Sport-related concussions in adolescent athletes: a critical public health problem for which prevention remains an elusive goal.  Translational Pediatrics, 6(3): 114–120. 

Winters, J.E. (2001).  Commentary: Role of Properly Fitted Mouthguards in Prevention of Sport-Related Concussion Journal of Athletic Training.  National Athletic Trainers’ Association, 36(3):339–341.

Daneshvar, D.H., Baughb, C.M., Nowinskic, C.J., McKeec, A.C. , Stern, R.A., & Cantu, R.C. (2011). Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sport-Related Concussions.

Clin Sports Med. 30(1): 145–163. doi:10.1016/j.csm.2010.09.006. 

Author
Emily and Amber CPNP's at SportsSafe

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