Your First Line of Defense: Unpacking Mouthguards, Concussions, and Options for Hockey Players
In the chaotic symphony of a hockey game – sticks clashing, pucks flying, bodies colliding – one small, often overlooked piece of equipment stands as a crucial guardian: the mouthguard. More than just a piece of rubber, a properly fitted mouthguard is your first line of defense against devastating dental injuries and plays a role, albeit debated, in the larger conversation around concussion prevention.
The Primary Purpose: Dental & Orofacial Protection
The most universally accepted and undeniable benefit of wearing a mouthguard in hockey is its ability to significantly reduce the risk and severity of orofacial and dental injuries. This includes:
Protecting Teeth: Mouthguards act as a cushion, absorbing and distributing the force of impacts from errant sticks, pucks, or direct contact, preventing chipped, fractured, or knocked-out teeth. Without one, the cost of dental repair can be astronomically high.
Safeguarding Soft Tissues: They create a barrier between your teeth and the delicate soft tissues of your mouth – your lips, cheeks, and tongue – preventing lacerations when your jaw is forcibly closed or impacted.
Preventing Jaw Fractures: By cushioning the upper and lower jaws, mouthguards can help absorb and dissipate impact forces, reducing the likelihood of jawbone fractures.
The Concussion Connection: A More Nuanced Discussion
While mouthguards are unequivocally effective at preventing dental injuries, their role in reducing the likelihood or severity of concussions is a more complex and debated topic in sports medicine.
The Theory: The proposed mechanism is that a mouthguard helps to absorb some of the shock and energy from a blow to the jaw, preventing the lower jaw from ramming into the skull or dissipating forces that could otherwise transmit to the brain, thus reducing brain acceleration and potential injury.
The Evidence:
Mixed Results: Research studies have yielded mixed results. Some studies have suggested a modest influence or a statistically non-significant trend towards a protective effect, with mouthguard users potentially having a lower risk of concussion. For example, some research indicates a lower incidence of sports-related concussions among more frequent mouthguard users.
More Research Needed: Major dental and sports medicine organizations, like the American Dental Association (ADA) and the NFHS Sports Medicine Advisory Committee (SMAC), strongly recommend mouthguards for dental protection but state that further rigorous research is required to definitively confirm their effectiveness in significantly reducing concussion risk or severity. They emphasize that while some biomechanical studies suggest a protective role by reducing forces to the head, clinical studies haven't consistently proven this.
Focus on Dental First: It's important to remember that even if the concussion-prevention link isn't fully established, the undisputed benefit of preventing costly and painful dental injuries alone makes mouthguard use essential.
Regardless of the ongoing concussion debate, the consensus remains: wearing a properly fitted mouthguard is a crucial safety measure for any hockey player.
Types and Styles of Mouthguards for Hockey Players:
When choosing a mouthguard, especially for hockey, fit, comfort, and the level of protection are paramount.
Stock Mouthguards (Ready-to-Wear):
Description: These are pre-formed, off-the-shelf mouthguards that come in various sizes (e.g., small, medium, large). They are the most affordable option.
Pros: Inexpensive, immediately available.
Cons: Offer the least protection and comfort. They often require the player to clench their jaw to keep them in place, which can impede breathing and speaking, and their bulky nature can be distracting. They do not provide a custom fit.
Hockey Use: Generally not recommended for competitive hockey due to poor fit and limited protection.
Boil-and-Bite Mouthguards:
Description: Made from a thermoplastic material that becomes pliable when heated in hot water. The user then places it in their mouth and bites down, molding it to their teeth.
Pros: More affordable than custom options, readily available, and offer a better fit than stock mouthguards. They provide decent protection for general use.
Cons: While moldable, they rarely achieve a truly precise fit. They can still be somewhat bulky, and if not molded correctly, can be uncomfortable, impede breathing/speaking, and may not stay securely in place. The fit can degrade over time with chewing.
Hockey Use: A popular choice for recreational and developing players, offering a good balance of cost and protection. Brands like Shock Doctor and SISU are popular in this category, offering various models with different thicknesses and features (e.g., gel-fit, low-profile).
Custom-Fitted Mouthguards (Professional/Dental):
Description: These are fabricated by a dentist or orthodontist from a precise impression of the player's teeth.
Pros:
Superior Fit: Offers the most precise, snug, and comfortable fit, virtually becoming part of the mouth.
Optimal Protection: Custom-made to absorb and distribute impact forces most effectively across the entire dental arch.
Enhanced Performance: Allows for clear breathing and speaking, which is critical for communication on the ice and maintaining endurance. The secure fit means no need to clench.
Durability: Made from high-quality materials that are more durable than boil-and-bite options.
Cons: Most expensive option. Requires a dental visit.
Hockey Use: Strongly recommended for all competitive hockey players, from youth to professional levels, as they provide the highest level of protection and comfort, enabling players to focus entirely on the game. Many NHL players use custom-molded mouthguards.
Key Considerations for Hockey Players:
Fit is King: Regardless of the type, a mouthguard must fit securely and comfortably. An ill-fitting mouthguard is ineffective, distracting, and often ends up being chewed on or spit out.
Mandatory Use: Many hockey leagues (especially youth and high school) mandate the use of mouthguards, often specifying a colored (non-clear) mouthpiece for visibility.
Care and Maintenance: Always store your mouthguard in its case when not in use. Clean it regularly with cool water and mild soap or a mouthguard cleaner to prevent bacterial buildup.
Replacement: Mouthguards should be replaced annually or sooner if they show signs of wear, tear, or a compromised fit. For growing athletes, a new impression may be needed more frequently.
While the debate about concussion prevention continues, the evidence for mouthguards' role in protecting against devastating dental and orofacial injuries in hockey is overwhelming. Investing in a properly fitted mouthguard is a smart, essential decision for any player stepping onto the ice.
