RT Journal Article
SR Electronic
T1 Mouthguard use in youth ice hockey and the risk of concussion: nested case–control study of 315 cases
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 866
OP 870
DO 10.1136/bjsports-2019-101011
VO 54
IS 14
A1 Dirk A Chisholm
A1 Amanda Marie Black
A1 Luz Palacios-Derflingher
A1 Paul H Eliason
A1 Kathryn J Schneider
A1 Carolyn A Emery
A1 Brent E Hagel
YR 2020
UL http://bjsm.bmj.com/content/54/14/866.abstract
AB Background Concussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question.Objective To determine the association between concussion and mouthguard use in youth ice hockey.Methods Nested case–control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy.Results Among cases, 236/315 (75%) were wearing a mouthguard at time of injury, while 224/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95% CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95% CI 0.22 to 1.10). No dental injuries were identified in either cohort.Conclusion Mouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey.