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Mouthguards decrease brain injury in men's lacrosse
Executive summary
Available reporting shows mixed evidence on whether mouthguards reduce brain injury (concussion) risk in men's lacrosse: a systematic review found only a modest, non‑statistically significant effect on concussion incidence (summary RR 1.25, 95% CI 0.90–1.74) [1], while some case‑control and smaller studies report an association between mouthguard use and fewer sports‑related concussions (odds ratio ~0.10 in one college study) [2]. Industry and vendor pieces, as well as some advocacy pages, commonly state that mouthguards can absorb shock or stabilize the jaw and therefore may lower concussion severity, but clinical trial evidence remains limited or contested across the coverage [3] [4] [5] [6].
1. What the systematic evidence says — weak and inconclusive
The most rigorous source in the set, a systematic review and meta‑analysis, concluded that data from five cohort studies showed only a modest influence of mouthguards on concussion incidence (summary RR 1.25; 95% CI 0.90–1.74), a result the authors framed as insufficient to claim clear concussion prevention benefits but supportive of mouthguards for orofacial protection [1].
2. Individual studies and case‑control signals — some suggest benefit
A college‑level case‑control study using propensity score matching found a strong negative association between frequency of mouthguard use and sports‑related concussion (odds ratio 0.10; 95% CI 0.01–0.91), which the authors presented as suggesting mouthguards may offer benefit, while also noting study limitations and need for caution in interpretation [2].
3. Mechanisms invoked — plausible but not proven in trials
Commercial and review pieces describe plausible mechanisms — shock absorption, energy dispersion, and jaw stabilization that might reduce transmission of force to the skull — and argue custom fitted guards outperform stock models; these mechanistic claims underpin claims that mouthguards “may” reduce concussion risk, but such explanations are presented more as theory or preliminary evidence than settled fact in the available materials [4] [3] [5] [6].
4. Industry and vendor messaging — stronger claims than the studies
Manufacturer and retail sites often present mouthguards as actively reducing concussion risk or severity and promote features like fit and material for that purpose [7] [8] [9]. These claims are inconsistent with the cautious tone of the systematic review and some academic sources; readers should note the commercial incentives behind stronger safety claims [7] [8].
5. Official safety positions and practice — mandated for dental protection, not concussion certainty
Governing and educational materials (for example, USA Lacrosse guidance) emphasize mouthguards principally for preventing orofacial injuries and recommend properly fitted guards, while acknowledging the evidence on concussion mitigation needs more investigation [10]. Some rule summaries and popular articles still list mouthguards alongside helmets and pads as “essential” safety gear, sometimes implying concussion reduction without citing robust trial data [11] [12].
6. Conflicting interpretations — why opinions diverge
Differences arise because cohort and case‑control studies can show associations but are vulnerable to bias; the meta‑analysis combined limited cohorts and found only a modest, non‑significant pooled effect [1]. Single studies can produce strong associations [2], and mechanistic/biomechanical work and vendor testing sometimes show promising effects on force transfer [4] [9]. These different evidence types lead researchers to be cautious while vendors and some commentators present more definitive claims [4] [9] [6].
7. Practical takeaway for men’s lacrosse players and programs
Based on current reporting, mouthguards should be considered essential for dental and orofacial protection; any concussion‑prevention benefit is plausible but not proven conclusively in randomized clinical trials [1] [6]. Programs seeking to reduce brain injuries should rely primarily on established concussion prevention measures (helmets, rule enforcement, coaching on safe play) and view mouthguards as a recommended adjunct that may help but is not a guaranteed concussion shield [11] [10].
8. Gaps and next steps — what reporting says is needed
Available sources call for higher‑quality studies, including prospective trials or better‑controlled cohort research, to measure whether specific mouthguard designs (custom fit, thickness, material) materially change concussion incidence or severity; until then, recommendations should distinguish dental protection (well supported) from concussion prevention (still uncertain) [1] [6] [4].
Limitations: This analysis uses only the supplied sources. If you want, I can pull and summarize recent peer‑reviewed trials, biomechanical studies, or governing‑body position statements beyond these items to expand on the evidence base.