Ringside Doctors Discuss Mouthguards and Concussion Reduction in Combat Sports

The Association of Ringside Physicians (“ARP”) recently published a position statement about the use of mouthguards in combat sports. They noted their view that “mouth guards should be used in all high- and intermediate-risk sports, including contact and combat sports, to aid in the prevention of orofacial trauma“.

In terms of the type of mouth guards they noted “APR does not endorse over-the-counter “stock” or boil-and-bite mouth guards. Custom mouth guards provide more complete coverage of teeth and molars, ft more comfortably, remain in place better, have fewer side effects, and do not degrade athletic performance. Effective education on appropriate mouth guard use should be provided to all athletes participating in these sports

They went on to discuss the impact of mouthguards on concussions and whether they do anything to reduce them.

In short the ARP noted that mouth guard use has not been conclusively proven to reduce the incidence of concussion in contact sport and that further research is needed to determine if mouth guards have a significant effect on preventing sport concussion, and whether the type of mouth guard used is important in this regard.

In theorizing as to why mouth guards may have some impact on concussion reduction the physicians noted as follows:

Theoretically a properly ftted athletic mouth
guard may reduce the severity of concussions by
the following mechanisms:

  1. Direct dissipation and/or absorption of force
    of an upward blow to the jaw. Forces from
    mandibular impact would be attenuated with
    a mouth guard, resulting in fewer injuries. It
    has been shown that mouth protectors reduced pressure changes and bone deformation within the skull in a cadaver model. The amplitude of the intracranial pressure after
    a blow to the chin when wearing a mouth
    guard may be decreased by 50%
  2. Increased separation of the head of the condyle and glenoid fossa. When a properly fitted and balanced custom mouth guard is in place there is a forward/downward movement of the jaw, thus opening the space between the glenoid fossa and the condylar head. This may reduce the opportunity for the condylar head to directly impact the glenoid fossa after an upward blow to the jaw, thus reducing the impact and acceleration forces to the entire temporal region
  3. Increased head stabilization by activating and strengthening neck muscles. Activation of head and neck muscles at the time of impact will decrease the rotational forces on the skull, leading to less harmful movement of the brain inside the skull. Research has suggested that being able to clench down on a mouth guard may activate muscles of the head and neck thus stabilizing the head. Some have suggested that this effect might be in place whether or not the athlete sees the impact coming.

The full position statement can be found here:

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