Does A Mouth Guard Prevent Concussions?
Overview
Concerns about concussions among athletes continue to capture the attention of doctors and other sporting officials. A global consensus report has been released that provides useful insight concerning concussions and its appropriate diagnosis and treatment. However, this report does not fully answer the perturbing question – Does a mouth guard prevent concussions?
Concussion
Concussion refers to a certain form of brain injury that results from the trauma that is sustained to the head. Injuries that result from the concussion are so dangerous and could potentially end a sporting career. In order to prevent sport-related injuries, it is advisable to wear the proper sporting equipment.
Mouth Guards
Mouth Guards play quite important roles for athletes especially in instances of aggressive contact sporting. The main use of a mouthguard involves protecting the teeth and preventing serious mouth injuries. They can also be used in the prevention of jaw injuries and limited studies have suggested that they can help reduce the risk of concussion.
Argument against this claim
Why mouth guards do not prevent concussions
One of the commonly held myths in the sports medicine field is the premise that wearing a mouth guard can fully aid in the prevention of concussion.
On January 17, 2009, top neurological experts dismissed claims that mouth guards can aid in the prevention of concussion, pointing to evidence that there is no credible research to back this idea.
There has not been any adequate research that links mouth guards to absolute concussion prevention.
Argument for the use of mouth guards as a measure to prevent concussions
Why wearing a mouth guard prevent concussions
Many have advocated that mouth guards can prevent some sport related concussions as it helps in absorbing shock, thus stabilizing the neck and the head and limiting the movement that is caused by a direct hit to the jaw.
So, what’s the primary use of mouth guards?
Mouth guards are mainly used in preventing athletes from lip laceration and loss of teeth. The idea that custom mouth guards can reduce the risk of concussion has been strongly presented (see below) but it is important to note that no mouth guard is able to prevent concussions.
Case Study
The study tracked six high school football teams, totaling 412 players. Half of the players selected their own store-bought mouth guards, and the other half were given custom athletic mouth guards. These mouth guards were customized by taking a mold of the players’ teeth and then fashioning a custom fit mouth guard from the teeth anatomy.
The Numbers
Head Injury Rates Store-Bought = 8.3% Custom-Fit=3.6%
The Results
8.3% of the players over-the-counter mouth guards suffered mild traumatic brain injuries / concussions, whereas only 3.6% of players with custom-fit mouth guards suffered such injuries.
According to the study published in the Clinical Journal of the General Dentistry in a 2014 issue, the study found that high school football players who wear the store-bought mouth guards were twice as susceptible to suffering mild traumatic injuries in comparison to those wearing properly fitted custom mouth guards.
Mouth guard materials have shock absorbing qualities. They are resilient and soft enough to absorb the impact energy and reduce the transmitted forces. Forces from the mandibular impact can be attenuated with a mouthguard, resulting in fewer injuries. Mouth protectors are believed to reduce pressure changes and the bone deformation within the skull in the cadaver model.
The ability of mouth guards to prevent head injuries and concussions falls into the realm of neuromythology rather than hard science. There is not enough convincing and proven evidence to support a full protective effect of the mouth guard in relation to the concussion. However, an absence of proof is not a direct proof of absence.
As it currently stands, mouth guards can possibly aid in the reduction of concussions (specifically custom made mouthguards) but cannot prevent concussion. Still, all athletes are equally susceptible to concussion and should wear the proper sports equipment to downgrade that risk as much as possible.
Head trauma in athletes has been known as a possible consequence of taking part in contact sports for a long time, but recent research has shown that the damage done to the brain may be much worse than previously realized. Given this new understanding, is it time to rethink a career in contact sports?
It’s one of the saddest sights in sport to see a former world-class athlete struggling with traumatic brain injury. There are some athletes who just can’t seem to see the signs and bow out gracefully. Had it not been for a torn ACL, former UFC Welterweight Champion George St. Pierre would be returning to the cage, long after he’d admitted to problems with memory loss and periods of lost time. St. Pierre is just one example among many.
It’s easy to see why they try to prolong their careers. They’ve worked hard to get where they are and are reaping the financial rewards of their success. The same qualities that made them top athletes also makes them want to keep being top athletes until they are forced to retire. It’s also the case that many athletes are from underprivileged backgrounds and may not be suited to any other career. If an athlete with no other viable career prospects has financial commitments, they may feel as though they have no choice but to keep going.
So what are the known conditions associated with contact sports?
Mild Traumatic Brain Injury
First, let’s talk about mild TBI. Despite the name; “mild” TBI can have very serious consequences. Research has shown that mild TBI may be a major factor when it comes to combat veterans experiencing PTSD. It can have many mood altering symptoms. People with mild TBI frequently experience depression. Men with TBI also typically experience lower testosterone levels, which may have a huge impact on an athlete’s ability to compete, risking even further injury. People with mild TBI may also experience memory loss, attention deficit, headaches, mood swings and difficulty problem solving.
Severe TBI
Severe TBI can be devastating. This is what many people know as “punch drunk”. A person with severe TBI may experience slurred speech, difficulty with motor function and may need long-term rehabilitation and care to live a normal life. Severe TBI can be as bad as Alzheimer’s, only rather than taking decades it can happen within a short career in contacts sports. In the worst case scenario, an individual can experience paralysis, a serious degenerative brain condition and even death.
CTE
Kansas City Chief’s linebacker Jovan Belcher’s autopsy has revealed that he had signs of the degenerative brain disease CTE at the time of his suicide (and the murder of his girlfriend) at the age of just 22. The disease is characterized as a progressive death of brain cells due to head trauma. Tangles of tau protein were found throughout Belcher’s hippocampus. We can’t touch on this topic without mentioning the bizarre case of Junior Seau. Chris Borland, another NFL star for the 49ers, has taken the decision to retire at just 24, it may be that he is experiencing the same condition.
Hypoxic Brain Injury
This is when the brain doesn’t get enough oxygen and cannot make use of glucose as a result of cerebral anoxia. When cerebral anoxia occurs the individual can lose consciousness within 15 seconds and experience irreversible hypoxic brain injury as a result. This is type of damage can be experienced by someone who has been choked-out with a rear-naked-choke in MMA, and those who are knocked out.
Lactate Build-up Through Rigorous Exercise
Though glucose is thought of as the main source of energy for the brain, recent research has shown the neurons of mammalian species preferentially metabolises lactate, not glucose during physical activity. The lactate goes into the neurons and into the mitochondria to give the brain energy. However, a build-up of lactate can cause Alzheimer’s-like symptoms, even in young people.
The are also numerous other conditions connected to these types of brain injuries. A possible side effect worth mentioning is a loss of energy, when your brain is in a constant state of repair, your body is having to provide energy for your brain to recover. This may cause your body to lose energy elsewhere. This may mean that normal activity may become difficult, if not impossible.
So, how does brain injury happen and can it be prevented?
The simple answer is the only way to avoid brain injury is to avoid contact sports altogether. However careful one may be, there’s no sure fire way to come out of a career in contact sports totally unscathed. The biggest factor for most is the taking of repeated blows to the head. Head trauma can also occur if someone is frequently tacked to the ground. If you’re someone who is experiencing this on a regular basis, you should definitely consider not pursuing a career in contact sports. Although the scrappy boxer that shows a lot of heart to comeback from a knockdown may be a sporting legend, and may be very entertaining to watch, the damage that’s going on inside his brain is almost incalculable. Nobody thinks brain injury is going to happen to them until it does and when it does it’s often irreversible and your life-outcome may be drastically altered for the worse.
The only way to mitigate the damage outside of not competing; is to know when to quit. That includes knowing when to give yourself time away from the sport as well as knowing when to give up entirely. It’s a very serious issue, one only has to look at recent suicides in the NFL to realize just how serious it is.
Anyone who’s thinking of a career in contact sports should ensure they have a back-up plan, something to fall back on should their plans go awry. Don’t be the person competing for far too long because they don’t know how to do anything else, and definitely don’t be the guy fighting in unlicensed MMA bouts without a doctor on standby and any hope of making a good living out of sport.
Whatever you decide, educate yourself and make sure you fully know the risks before making any decisions which could ruin lives, not only your own, but the lives of people who may be relying on you to stay healthy.
Also, if you’re going to compete, spare no expense & wear the best protective equipment custom mouth guard and high quality helmets especially)
If you’re still set on a career in sport, heed the words of Chris Borland “I just want to live a long, healthy life, and I don’t want to have any neurological diseases or die younger than I would otherwise.”
The Conclusion
Can a mouth guard prevent a concussion? Researchers are careful to note that a direct cause-and-effect correlation cannot be inferred from these data. For example, there is some variation in thickness between store-bought mouth guards and custom athletic mouth guards. Such a difference in thickness could reduce the shock absorbency of the thinner guards. In addition, poor-fitting mouth guards are more likely to come out of place and deteriorate more rapidly due to anatomically atypical wear.
In the end, all that can be said for certain is that wearing a custom-fit mouth guard is likely to reduce the chances of concussion and mild traumatic brain injury.
Getting the Right Equipment
This study is great for demonstrating the importance of proper dental protection. However, it’s important to note one of the more common reasons that players might forego a custom, dentist-made mouth guard: cost.
The price you might pay a dentist for a custom athletic mouth guard is often prohibitive. Typical fees are in the range of $500 for a custom-fit mouth guard, and sometimes more than twice that.
The expense is logical when you consider that a dentist has numerous salaries to pay, as well as general overhead typically associated with running a physical medical office. Fortunately, you have options.
Technological advancements allow for more options. That means athlete safety doesn’t have to break the bank.
In recent years, as the manufacturing technology and materials have become more readily available to non-dentist suppliers, your options as a consumer and patient have expanded greatly.
Online custom dental mouth guard labs are now increasingly common, though a relatively small handful of us would be considered reputable and reliable, offering features like quality guarantees, free shipping, and the like. The best part is that online labs can offer the same material and customization at a fraction of the cost associated with dental offices. We ship the same custom-fitting kit straight to your home, and you mail it right back to the lab. After that, it’s a simple process for the laboratory to fabricate the custom mouth guard and mail it back to you.
When to choose a dentist over an online lab.
What’s the downside of using an online lab? Great question. As with anything, there’s a trade off. For example, if you have pathological dental isses or other mouth conditions that would require frequent adjustments to your mouth guard, then you should probably choose a dentist instead of a mail-order lab. Both can often provide adjustments, but the process is much simpler under the supervision of a licensed dentist or orthodontist.
But if you expect to keep basically the same teeth in basically the same places for a while, then there’s no real benefit to using a local dentist instead of an online lab. Particularly when you consider the cost difference: online labs often charge only a fraction of the typical dentist fees.
Consider your options.
The economics of safety decisions are an unpleasant reality of society. Everyone would agree that safety should always come first in theory. But in reality, few families or individuals can afford the expenses historically associated with professional dental customization. Thankfully, that sad fact is becoming a relic of the past.
Your Opinion
After reading this article, please consider commenting below with your own anecdotal experience. We encourage everyone to make important safety decisions in consultation with physicians and other healthcare practitioners, but your opinions still matter.
When you comment, consider such topics as your own head and neck injuries, as well as your experience with mouth guards. This could include basic mouth guards, boil-and-bite mouth guards, custom mouth guards from a dentist, or custom mouth guards ordered online. If you’ve used any other types of mouth guards, please share!