Incidence of cerebral concussions associated with type of mouthguard used in college football

Controversy exists among sports dentists as to whether or not a 'custom made' mouthguard is more effective in reducing the incidence of cerebral concussion than the boil-and-bite 'non-custom made' mouthguard. While members on each side remain steadfast in their opinion, not a single epidemiological study has been conducted to investigate the effect of type of mouthguard worn on the incidence of cerebral concussion. The aim of this study was to determine if there was a difference between the type of mouthguard worn and the incidence of cerebral concussions among National Collegiate Athletic Association (NCAA) Division I-A football players. During the 15-week 2001 college football season, trainers entered, via an interactive web site, weekly data for each game and practice sessions for the preceding week. Eighty-seven (76%) out of a possible 114 Division I teams participated. A total of 506 297 athletic exposures were recorded; 369 brain concussions were reported. The incidence of cerebral concussions per 1000 exposures was 0.73. Utilizing a risk ratio with a 95% confidence interval, no statistical difference occurred in the incidence of cerebral concussions between football players wearing custom made versus non-custom made mouthguards (0.990,1.750). In this study, there was no advantage of wearing a custom made mouthguard over a boil-and-bite mouthguard to reduce the risk of cerebral concussion in football players.