Introduction:

In the fast-paced world of sports, athletes face a myriad of risks, including injuries like concussions. While helmets and pads are commonly associated with protecting athletes, another often overlooked piece of equipment plays a crucial role in sports safety: the mouthguard. In this article, we'll delve into the vital role mouthguards play in preventing concussions and enhancing overall safety in sports.

Understanding Concussions:

Before diving into the specifics of mouthguards, it's essential to understand what concussions are and how they occur. Concussions are mild traumatic brain injuries typically caused by a blow or jolt to the head. In sports, these injuries can result from collisions, falls, or impacts with equipment or other players. The consequences of concussions can range from mild symptoms like headaches and dizziness to more severe issues such as memory loss and cognitive impairment.

The Role of Mouthguards:

While mouthguards are primarily recognized for protecting the teeth and mouth, their benefits extend far beyond dental safety. Properly fitted mouthguards serve as shock absorbers, effectively dispersing the force of impacts and thereby reducing the risk of concussions. When athletes endure blows to the jaw or head, mouthguards play a crucial role in cushioning the impact, thereby diminishing the transmission of force to the brain. Research has indicated a noteworthy 28% reduction in concussion rates across all levels of ice hockey with the use of mouthguards, see the study here. The evidence supporting mouthguard use spans various sports, although much of the research has focused on ice hockey. However, the findings can be applied to other sports, particularly at the youth level. Therefore, given the clear data, mandating mouthguards for youth ice hockey is a logical step toward enhancing safety in sports.

“Research has indicated a noteworthy 28% reduction in concussion rates across all levels of ice hockey with the use of mouth guards.”

Types of Mouthguards:

Historically there are three main types of mouthguards: stock mouthguards, boil-and-bite mouthguards, and custom-made mouthguards. Stock mouthguards are pre-formed and come ready to wear but offer limited protection and often have a poor fit. Boil-and-bite mouthguards can be customized by softening them in hot water and then biting down to mold them to the shape of the wearer's mouth, providing better fit and protection. Custom-made mouthguards, typically fabricated by dental professionals, offer the highest level of customization and protection, as they are tailored to the individual athlete's mouth.

How Mouthguards Help Prevent Concussions:

Shock Absorption: Mouthguards absorb and dissipate the force of impacts, reducing the risk of concussions by minimizing the transmission of force to the brain.
Stabilization: Mouthguards help stabilize the jaw and prevent it from slamming shut during impacts, which can lessen the severity of concussions.
Protection Against Jaw Injuries: By cushioning the jaw, mouthguards also help prevent injuries to the temporomandibular joint (TMJ), which may indirectly reduce the risk of concussions.

The Importance of Proper Fit:

One of the critical factors influencing the effectiveness of mouthguards in concussion prevention is proper fit. Ill-fitting mouthguards can be uncomfortable, impede breathing and speech, and offer inadequate protection. Athletes should ensure their mouthguards fit snugly and comfortably, covering all teeth and providing cushioning for the jaws.

A new breed of mouthguards - The Smart Concussion Mouthguard:

Smart concussion mouthguards integrate sensor technology and data analytics to deliver real-time monitoring of impacts sustained during sports activities. These innovative devices are engineered to detect and quantify the force, frequency, and location of impacts to the head, thereby providing valuable insights into potential concussive events, while still retaining the traditional benefits of a mouthguard. Notably, two prominent organizations leading in this field are Prevent Biometrics and HIT IQ. Prevent Biometrics appears to cater directly to teams, while HIT IQ offers its product directly to patients, albeit currently limited to Australia to the best of my knowledge at the time of this post, with an intra-oral scan required to be completed at a dental clinic.

Key Features and Functionality:

Impact Sensors: Smart mouthguards are equipped with miniature sensors capable of detecting and recording the magnitude and direction of impacts. These sensors can differentiate between routine collisions and high-impact events that may pose a risk of concussion.
Real-time Monitoring: By wirelessly transmitting data to a companion app or sideline monitoring system, smart mouthguards enable coaches, trainers, and medical personnel to monitor athletes' head impacts in real-time. This instantaneous feedback allows for prompt assessment and intervention in the event of a potentially concussive impact.
Concussion Risk Assessment: Through sophisticated algorithms and machine learning techniques, smart mouthguards can analyze impact data to assess an athlete's risk of concussion. By considering factors such as impact magnitude, frequency, and cumulative exposure, these devices can provide personalized risk assessments tailored to individual athletes.
Alerting Mechanisms: In cases where a significant impact is detected, smart mouthguards can trigger immediate alerts to coaches or medical staff, prompting them to evaluate the athlete for signs of concussion. This rapid notification enables timely intervention and reduces the likelihood of undetected head injuries.

Pros & Cons of Smart Mouthguards:

Pros:

Real-time Monitoring: Smart concussion mouthguards provide real-time monitoring of head impacts, allowing coaches, trainers, and medical personnel to promptly assess the severity of potential concussions and intervene as necessary.
Data-driven Insights: These mouthguards collect detailed data on the magnitude, frequency, and location of head impacts, providing valuable insights into an athlete's risk of concussion and overall exposure to head trauma over time.
Early Detection of Concussions: By detecting and analyzing impacts as they occur, smart mouthguards can help identify concussive events early, enabling timely intervention and reducing the likelihood of undetected head injuries.
Enhanced Safety: The real-time monitoring and risk assessment capabilities of smart mouthguards contribute to overall athlete safety by minimizing the risk of undetected concussions and facilitating timely medical intervention.

Cons:

Cost: Smart concussion mouthguards can be expensive compared to traditional mouthguards, making them less accessible for athletes and sports organizations with limited budgets.
Complexity: The technology involved in smart mouthguards adds complexity to their use, requiring proper setup, calibration, and maintenance. Training may be needed for coaches, trainers, and medical personnel to effectively utilize the data provided by these devices.
False Positives/Negatives: Like any concussion assessment tool, smart mouthguards may generate false positives or false negatives, leading to unnecessary concern or potentially overlooking a true concussion.
Privacy Concerns: The collection and storage of sensitive health data by smart mouthguards raise privacy concerns, particularly regarding data security and unauthorized access to athlete information.

Conclusion:

In the realm of sports safety, mouthguards are indispensable tools for protecting athletes from a range of injuries, including concussions. Functioning as shock absorbers and stabilizers, properly fitted mouthguards play a vital role in minimizing the risk of concussions and enhancing overall safety on the field or court. Athletes and sports organizations must prioritize the use of quality mouthguards, mandating their usage at all levels of youth sports.

Moreover, smart concussion mouthguards represent a significant advancement in sports safety technology. By offering real-time monitoring, risk assessment, and injury management capabilities, these devices have the potential to revolutionize concussion management and elevate athlete safety. However, current limitations such as high cost and complexity hinder widespread adoption, particularly in elementary, high school, and non-premiere collegiate programs.

From my experience, top-tier collegiate programs and professional sports teams, or families prioritizing safety and possessing the financial means, are the demographics most likely to afford and effectively manage this technology. While the technology holds great promise, its widespread adoption may be hindered until costs decrease and usability improves to a point where it can be easily managed by coaches or athletic trainers without additional personnel. Until then, the full potential of smart mouthguards may remain unrealized on a large scale.

References:

• Patricios, J. S., Schneider, K. J., Dvorak, J., Ahmed, O. H., Blauwet, C., Cantu, R. C., Davis, G. A., Echemendia, R. J., Makdissi, M., McNamee, M., Broglio, S., Emery, C. A., Feddermann-Demont, N., Fuller, G. W., Giza, C. C., Guskiewicz, K. M., Hainline, B., Iverson, G. L., Kutcher, J. S., … Meeuwisse, W. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695–711. https://doi.org/10.1136/bjsports-2023-106898

The Crucial Role of Mouthguards in Sports Safety – How Do They Help Concussions?