Thank you. My disclosures. The prevalence of concussion and the potential for TBI and long-term mental health issues continues to be a concern, especially in contact sports. Prior studies have either claimed or disputed the role of mouth guard protection in reducing the incident rate of concussions. Other than investigating concussion rate, however, no long-term studies have specifically compared the type of mouth guard protection on the severity of concussion. Therefore, we decided to take a retrospective look as part of our established ongoing comprehensive injury surveillance program. 40 universities were evaluated over 16 seasons across all FBS conferences. Mouth guard type were divided into two groups, dentist-fitted versus self-fitted. The main outcome of interest was concussion severity. We also looked at possible influences such as prior history of concussion, head impact location and type of playing service. Concussion definition was based on the existing agreement statement at that time, whether it was 2005 or the present time. As you can see here, there's the definition. Concussion severity classification has changed over the last 30 years from first, second, and third degree to McCrory's simple and complex, and now brief and prolonged recovery. We chose brief recovery, seven to 10 days of time loss versus prolonged recovery of greater than 10 days time loss. Data was expressed as incident rate for 10-team games, multivariate analysis with Wilkes-Lambda criteria and post-hoc analyses were used where appropriate. Significance was set a priori at the P less than 0.05 level. Results 2,332 games resulting in 9,563 total injuries. Of these, 708 concussions were diagnosed. There were 589 what we call simple or brief recovery concussions, 119 complex or prolonged recovery concussions. The 652 of these concussions were attributed to player to player and 56 player to surface impact. Multivariate analysis revealed or indicated a significant main effect by concussion severity between the mouth guard groups. As you can see on the red columns here, we found a significantly lower incidence of complex or prolonged recovery concussions among athletes who wore the dentist fitted mouth piece versus the self-fitted. When looking at mouth guard type by possible influence, we found no significant difference between mouth guard group by prior concussion injury history or head impact location. 73% of the cases involved players with no history of concussion, 78% of the cases involved frontal and temporal regions. There was no significant difference in player to player between mouth guard groups nor surface to impact diagnoses. However, due to the perceived speed and hardness of artificial turf, we decided to look at the type of playing surface among the over 2,300 games, 1,150 were heavyweight artificial turf fields and we had 1,182 natural grass surfaces. Artificial turf was diagnosed with 26 concussions, five basically, five complex prolonged natural grass, similar 30 concussions, seven complex or prolonged diagnoses. Findings reflected a lower and less severe incidence of concussions on both surfaces than often perceived. As with any injury surveillance system, there are numerous limitations. We stuck here strictly to the concussions. We're unable to receive any information on dental or TMJ integrity, neurocognitive functional testing, behavioral indices such as high risk behavior or anxiety among the athletes. We weren't able to receive any helmet or mouth guard age type and maintenance, variations in type of impact velocities, trauma to medical attention timeframes, variability in concussion diagnostics between the 40 universities or any unknown congenital or developmental factors among the athletes. The strengths were a multi-team longitudinal approach with adequate sample size, minimal variation skill level using perspective validated methods with an extensive ATC network. In conclusion, we found a significant decrease in severity of concussion with dentist fitted mouth guards. This may reflect more optimal fit and fabrication, translating less severity and more expedient return to play. Hopefully findings may lead to conversation. Further research is one variable to reconsider. Although findings are only generalizable to this level of competition, further research is warranted at the high school and youth level where over 90% of the mouth guards are self-fitted. Thank you.

concussions

mental health issues

contact sports

mouth guards

dentist-fitted mouth guards