Can a Mouthguard Prevent a Concussion?

Long-time readers of this blog know I have a special interest in concussion prevention. Foul ball impacts to the face are an occupational hazard for an umpire. Unfortunately, umpiring is more hobby than occupation for the amateur umpire and a nasty concussion on the field can adversely affect your day job and your personal life.

Over the years several individuals have advocated that umpires should wear mouthguards as an added layer of protection to prevent concussions. The basic argument is that an impact to the chin will force the jawbone into the skull and concuss the brain.

Here at Midwest Ump we (why, yes. I do have a mouse in my pocket) appreciate these well-meaning folks, but it begs the question: it is true? We (the mouse and I) did a little investigating to find out.

There appears to be quite a bit of controversy concerning the matter. There is also a fair amount of posturing from dentists and neurosurgeons. A number of dentists claim that mouth guards can prevent (or at least reduce the effect of) concussions. The Florida Dental Association even published a slick flier on the “Top Ten Reasons to wear a mouthguard” featuring NFL quarterback Mark Brunnell which claims that concussions can "be significantly reduced by properly fitting mouthguards."

A study published in the journal Dental Traumatology in 2009 showed fewer concussions occurred over three seasons in all but one of the 28 high school football players who used mouthguards. However, one of the authors of this study was the president of a company that teaches dentists how to make the medically corrective mouthguards with instructive DVDs. So this study smells a wee bit biased.

Sports doctors and neurosurgeons (who apparently think dentists aren’t real doctors) counter that there is no research evidence to support this claim. A more recent study published in the medical journal Neurosurgery by researchers from the University of Toronto, showed that mouthguards have limited or no benefit in reducing concussions in rugby players. This finding was also supported by previous research by the University of Calgary. Lead researcher Dr. Michael Cusimano says “A large number of players, coaches and referees believe that equipment such as mouth guards and headgears may prevent brain injuries in rugby. . . Our study was the first to summarize what did and what did not work. Equipment such as headgear and mouth guards are ineffective at preventing neurological injuries, but other strategies, such as education and rule changes, have been shown to be effective.”

While mouthguards have been found to be effective in preventing dental trauma, there has been no clear evidence that mouthguards will prevent or reduce concussive effects. On the other hand, there is no clear evidence that a mouthguard won’t help prevent a concussion. The New England Patriots are wearing mouthguards and dentists in the NFL and NHL are making custom mouthguards for players. Also, at least one MLB umpire (Andy Fletcher) has worn a mouthguard to avoid concussive effects. Until we know conclusively what works to prevent concussions, the mouse in my pocket tells me, "Do what works for you." A mouthguard can't hurt and could possibly help.