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Can a Mouthguard Prevent Concussions?

Published: April 8, 2011
Author: Dr. Mike Williams ( Michael Williams )
Tagged: Concussions, mouthguards, sports

Image: Can a Mouthguard Prevent Concussions?

Mouthguards can reduce the severity of concussions in sports.

What is a brain concussion?

Even with better sports protection it appears that the incidence of sports related concussions is increasing. A concussion is an injury to the brain caused by a severe blow to the head.  The brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull. However, unexpected sudden impacts to the head, chin, or a whiplash type movement can result in brain injury particularly on the opposite of the head as the brain moves through the fluid and bangs up against the hard skull.  Common causes of concussions are fights, falls, car crashes, and bike accidents and high-speed contact sports such as football, boxing, hockey, soccer, skiing, or snowboarding.

Incidence of Concussions

Many more concussions are being reported in the American National Football League (NFL) this season. The League and players are taking head injuries more seriously. According to NFL data obtained by The Associated Press, there were 154 concussions reported in practices or games from the start of the preseason through the eighth week regular season of 2010.  Unlock HQ Video HQ video delivered by Akamai That is an increase of 21 percent over the 127 concussions during the same span in 2009, and a 34 percent jump from the same period of 2008.

The risk of concussion from football is extremely high, especially at the high school level. Some studies say approximately 20% of players suffer concussion or other brain injury during their short high-school careers. The rate at the collegiate level is said to be about one in 20. Rates for hockey players are believed to be similar. Concussion and lasting brain damage is an especially significant risk for boxers and mixed martial arts especially since the “knock out” intent is to produce at lease a temporary concussion. There is currently much debate and negotiations among professional players and owners about the best way to protect the athletes while collegiate and high school organizations are reevaluating their safety programs. The NFL, USA Football and 25 other medical organizations and youth sports entities teamed with the CDC in 2007 on the “Heads Up: Concussion in Youth Sports” campaign. The focus of the national “Heads Up” initiative is to improve prevention, recognition, response and management of concussions across all youth sports. 

According to posts from the NHL Sharks fans the following players have missed time because of a concussion: Boston’s Marc Savard (done for the season). Tough guy Ratis Ivanans of Calgary (got clocked in a fight at the beginning of the season and hasn’t been back). Remember Colorado’s Peter Mueller (out since preseason)? Nashville has been without Matthew Lombardi since Oct. 14. New Jersey could sure use Bryce Salvador on defense (MIA since Oct. 3). Philadelphia’s Ian Laperriere has suffered from post-concussion syndrome since LAST YEAR. Of course, we can’t forget Pittsburgh’s Sidney Crosby. When he’ll return is anyone’s guess. Along with other measures, some are recommending that mouthguards be a mandatory protective device.

Then there’s the tale of Paul Kariya. He’s 11 games shy of 1,000, has 402 goals and 989 points. Last year, he played for St. Louis. But he’s not playing this year. Like Laperriere, he’s suffering from post-concussion syndrome. And while we’re at it, let’s not forget Pat LaFontaine, whose career was cut short by a concussion and its after effects. So concussions are a serious problem with notable athletes but the problem exists on all levels.

Concussion Protection

Yet, we are producing bigger, stronger, faster and quicker superior athletes who by their improved athletic abilities will be more prone to delivering high impact forces. To reduce the incidence of multiple types of injuries including life changing or ending concussions, there is intense focus on changing how the game is taught, played and multiple rule changes are being considered in all levels of sports.  New protective equipment including newly designed helmets and mouthguards are being evaluated. 

Along with other head trauma an impact to the chin can transmit an extreme amount of force directly to the skull resulting in a concussion.  Although some debate exists regarding the benefit of mouthguards in concussion prevention, anecdotal and some manufacture supported studies seem to indicate a protective benefit. In sports such as ice hockey and football, boxing, MMA blows to the underside of the chin are common. These may lead to concussions, as the head of the jaw joint is driven upward and backward by the blow.  Some studies show that a protective mouth guard has been an effective form of protection from the consequences of these blows, because the mouthguard tends to prevent the lower jaw from being forced backward into the skull.

How a Mouthguard can Reduce Concussion Severity

Specially designed mouthguards are said to prevent or lessen the severity of concussions.  When the trauma is received by the jaw the current proposed mechanism of benefits are said to operate as follows: 

The mouthguard will dissipate and absorb the upward and backward force.
Owing to the soft properties of the mouthguard the impact injury is absorbed.  Generally these mouthguards are about 4mm thick. Most of these mouthguards are fabricated from EVA (ethelyne vinyl acetate) which while soft, still maintains stiffness suitable to prevent deformation.

The head and neck muscles are stabilized and strengthened.

The guards must incorporate a uniform and balanced bite position including all teeth when fitted to optimize this feature. This balances the upper head musculature optimizing strength and performance thus reducing the impact forces.

The direct bone-on-bone force is reduced or eliminated.

The somewhat downward and forward position of these mouthguards advances the jaw to a location creating more space in the tempro-mandibular joint.  This additional space reduces the impact force and cushions the joint and jaw collision.

While some claim that the benefits of mouthguards in concussion prevention have not scientifically been proven, it does seem clear that a mouthguard incorporating the above features could certainly reduce the severity of an impact to the lower jaw and thereby reduce the overall impact to the brain.  Everyone agrees that mouthguards reduce dental injuries themselves through their shock absorber features and it seems reasonable to believe that this benefit could reduce concussion severity.

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