Should football players wear custom fitted mouthguards? Results from a group randomised controlled trial.

New South Wales Injury Risk Management Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
Injury Prevention (Impact Factor: 1.94). 09/2005; 11(4):242-6. DOI: 10.1136/ip.2004.006882
Source: PubMed

ABSTRACT Head/orofacial (H/O) injuries are common in Australian rules football. Mouthguards are widely promoted to prevent these injuries, in spite of the lack of formal evidence for their effectiveness.
The Australian football injury prevention project was a cluster randomized controlled trial to evaluate the effectiveness of mouthguards for preventing H/O injuries in these players. Setting and
Twenty three teams (301 players) were recruited from the largest community football league in Australia.
Teams were randomly allocated to either the MG: custom made mouthguard or C: control (usual mouthguard behaviours) study arm.
All injuries, participation in training and games, and mouthguard use were monitored over the 2001 playing season. Injury rates were calculated as the number of injuries per 1000 person hours of playing time. Adjusted incidence rate ratios were obtained from Poisson regression models.
Players in both study arms wore mouthguards, though it is unlikely that many controls wore custom made ones. Wearing rates were higher during games than training. The overall rate of H/O injury was 2.7 injuries per 1000 exposure hours. The rate of H/O injury was higher during games than training. The adjusted H/O injury incidence rate ratio was 0.56 (95% CI 0.32 to 0.97) for MG versus C during games and training, combined.
There was a significant protective effect of custom made mouthguards, relative to usual mouthguard use, during games. However, the control players still wore mouthguards throughout the majority of games and this could have diluted the effect.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective : To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background : An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations : The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.
    Journal of athletic training 03/2014; 49(2). DOI:10.4085/1062-6050-49.1.07 · 1.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: American Flag football (AFF) is a version of American Football that has become very popular worldwide, but lacks high quality research into the epidemiology of injuries. To characterize the epidemiology of injuries in post-high school male and female athletes in the rapidly growing international sport of contact flag football. Prospective injury-observational study. Kraft Stadium, Jerusalem, Israel. 1 492 players,consisting of men (n=1 252, mean age, 20.49±5.11) and women (n=240, mean age, 21.32±8.95 years), participated in 1028 games over a 2-season period (2007-2009). All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel and followed up by a more detailed phone injury surveillance questionnaire. One hundred sixty-three injuries were reported, comprising 1 533 776 athletic exposures (AEs). The incidence rate was 0.11 [95% confidence interval (CI), 0.09-0.12] per 1000 AEs, and incidence proportion was 10.66% (95% CI, 9.10-12.22). Seventy-six percent of the injuries were extrinsic in nature. Thirty percent of the injuries were to the fingers, thumb, and wrist, 17% to the knee, 17% to the head/face, 13% to the ankle, and 11% to the shoulder. Contact flag football results in a significant amount of moderate to severe injuries. These data may be used in the development of a formal American flag football injury database and in the development and implementation of a high-quality, randomized, prospective injury prevention study. This study should include the enforcement of the no-pocket rule, appropriate headgear, self-fitting mouth guards, the use of ankle braces, and changing the blocking rules of the game.
    British journal of sports medicine 04/2014; 48(7):616. DOI:10.1136/bjsports-2014-093494.152 · 3.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: AimsTo assess rugby players' preferences for using a mouthguard and to determine the factors contributing to the use and discontinuation of a mouthguard.MethodsA cross-sectional study was conducted in two rugby tournaments from 2009 to 2010. Samples were selected by convenience sampling. Participants were required to complete a self-administered questionnaire, which inquired about awareness and pattern of mouthguard use, as well as reasons if discontinued.ResultsCompleted questionnaires were returned by 456 participants, with an estimated response rate of 77.8%. All participants were male (mean age = 22.73, SD = 3.98). Median duration of playing was 6 years, and median frequency was 6 h per week. Overall mouthguard use was low (31.1%, n = 142), especially for custom-fitted mouthguard (1.8%, n = 8), followed by stock mouthguard (7.7%, n = 35). Boil-and-bite type was most commonly used (21.1%, n = 96). Of those who wore a mouthguard before, only 28% continued using it. The discontinuation rate for each type was as follows: stock, 57.1% (P = 0.032); boil-and-bite, 80.2% (P = 0.002); and custom, 37.5% (P = 0.04). Age was a significant factor for mouthguard use (P = 0.007, OR = 1.10, 95% CI = 1.03–1.17). Breathing disturbance (OR = 3.36, 95% CI = 1.17–9.72) and general discomfort (OR = 3.71, 95% CI = 1.68–8.20) were significant factors in discontinuing mouthguard use.Conclusions The use of mouthguard was low among rugby players. Custom-made was the least worn type, possibly due to limited availability. The use of mouthguard increased slightly with age but was discouraged by breathing interference and general discomfort. Therefore, preventive effort should focus on early education and reinforcement, as well as on the improvement of wearability and accessibility.
    Dental Traumatology 05/2014; DOI:10.1111/edt.12114 · 1.21 Impact Factor

Full-text (2 Sources)

Available from
May 22, 2014