Mouth guards in hockey can reduce concussion risk


Winter weather is getting children out on the rink to play ice hockey, which unfortunately carries a risk of concussion. A new study looks at mouth guards and whether they can reduce the risk of concussive head injury.

Chilly weather outside means that many children are taking to the rink to play ice hockey, a sport that carries a definite risk of concussion. A new study in the British Journal of Sports Medicine looked at whether using mouth guards during play could reduce that risk.1

Researchers used a nested case-control design. Two prospective cohort studies were used to identify cases and controls. Cases were hockey players who were concussed during either a game or practice and controls were players who had an injury during a practice or a game. The players came from 3 age divisions: Pee Wee, children aged 11 to 12 years; Bantam, children aged 13 to 14 years; and Midget, children aged 15 to 17 years. There were 315 cases of concussion and 270 cases of nonconcussion injury.

Mouth guards are effective at reducing risk

At the time of injury, 236 children who became concussed (either physician-diagnosed or therapist-suspected concussion) were wearing a mouth guard and 224 of the children who had nonconcussion injuries were wearing a mouth guard. Any mouth guard use was linked with an adjusted odds ratio (aOR) for concussion of 0.36 (95% confidence interval [CI], 0.17-0.73). When divided into type of mouth guard, researchers found that dental custom-fit mouth guards had a nonsignificant 49% odds of concussion (aOR, 0.51; 95% CI, 0.22-1.10). Meanwhile, off-the-shelf mouth guards were associated with 69% lower odds of concussion (aOR, 0.31; 95% CI, 0.14-0.65). Neither cohort reported dental injuries.

The investigators concluded that using mouth guards during play did reduce the chances of concussion. They stated that wearing a mouth guard should be a requirement for all players in ice hockey leagues for children and adolescents.


1. Chisholm DA, Black AM, Palacios-Derflingher L, et al. Mouthguard use in youth ice hockey and the risk of concussion: nested case–control study of 315 cases. Br J Sports Med. January 14, 2020. Epub ahead of print.

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