Mouthguard Use in Youth Ice Hockey and the Risk of Concussion and Dental Injuries

Abstract

BackgroundConcussion is the most common injury in youth ice hockey. Mouthguards can play a role in reducing the risk dental injuries; however there is limited evidence evaluating their association with concussion in youth ice hockey.ObjectiveTo assess the association between mouthguard use and risk of concussion and dental trauma in youth ice hockey.DesignNested case-control.SettingYouth ice hockey leagues (elite and non-elite) in Calgary, Canada, where mouthguard use is not mandatory.ParticipantsBaseline and injury data were collected for 11–17 year old players from 2013–2016.Assessment of Risk FactorsMouthguard use at time of injury as reported on Injury Report Forms.Main Outcome MeasurementsCase groups were defined as concussed players (therapist suspected or study physician diagnosed) and those with dental injuries; controls were players who sustained a non-concussion/non-dental injury during a game or practice. Only the first injury sustained within or between seasons was included. Frequency of mouthguard usage between cases and controls was compared. Information on baseline self-reported mouthguard use and type was also collected.ResultsAt baseline, the majority of players self reported always wearing a mouthguard during games 2,156/2,606 (82.7%) and practices 1,853/2,539 (73.0%). No dental injuries were reported during the study period. Amongst concussion cases 147/185 players (79.5%) reported mouthguard use at time of injury, compared with 134/147 controls (91.2%) (unadjusted OR=0.38 95% CI 0.18–0.76). Future analyses will include multivariable logistic regression adjusting for relevant covariates and considering effect modification. The effect of mouthguard type at time of injury, and concordance between mouthguard use at baseline and time of injury will also be examined.ConclusionsThe majority of players self reported always wearing a mouthguard at baseline when there was not mandatory enforcement. Based on preliminary univariate analyses, mouthguard use was associated with reduced odds of concussion.