Mouthguards reduce injury risk in tackle football
Executive summary
Mouthguards clearly cut orofacial and dental injuries in football—multiple reviews and organisations (ADA, NFHS) report significant reductions in dental trauma when properly fitted mouthguards are used [1] [2]. Evidence for a protective effect against concussions is mixed: some reviews and studies find inconsistent or inconclusive links between mouthguard use and lower concussion rates, while new technologies (instrumented mouthguards) aim to measure impacts but do not establish prevention efficacy yet [1] [3].
1. Mouthguards prevent dental and facial injuries—strong consensus
Clinical reviews and position statements converge: mouthguards reduce the incidence and severity of sports-related orofacial injuries, and governing bodies mandate or recommend them in many contact sports. The ADA’s guidance cites consistent reductions in dental trauma with mouthguard use [1], and the NFHS notes mandatory use in football, ice hockey, lacrosse and other sports, citing multiple studies showing fewer orofacial injuries with properly fitted devices [2]. Historical analyses also document dramatic declines in dental injuries after widespread adoption of mouthguards [4] [5].
2. Concussion prevention: the research is mixed, not settled
Despite clear dental benefits, available reviews say evidence that mouthguards lower concussion risk is inconsistent. The ADA review highlights conflicting studies—some showing no concussion difference and others showing divergent results by mouthguard type—so there is no uniform finding that mouthguards prevent concussions [1]. Older systematic reviews explicitly examined concussion outcomes alongside dental outcomes but did not reach a definitive protective conclusion for brain injury [4].
3. Why the evidence diverges: mechanism, measurement and study design issues
Experts point to three reasons for inconsistent concussion findings. First, mouthguards are designed to protect teeth and distribute local forces—there’s biological plausibility for reduced jaw-related forces but not a clear mechanism for preventing brain acceleration from helmet-to-helmet impacts [6] [7]. Second, concussion studies vary in populations, mouthguard types (stock, boil-and-bite, custom), fit quality and reporting, producing mixed results across high-school and college samples [1] [8]. Third, measurement limitations—concussion diagnosis variability and limited impact data—complicate causal claims; that is one reason instrumented mouthguards (iMGs) are being developed to quantify head acceleration events more precisely [3].
4. Instrumented mouthguards: new data, not yet proof of prevention
Instrumented mouthguards embed sensors to monitor head acceleration events in real time, improving measurement of impacts and potentially informing prevention strategies [3]. The mini-review describes iMGs as a promising tool for monitoring and quantifying impacts in contact sports, but available reporting does not claim iMGs themselves reduce concussion incidence—rather they improve data collection that may guide future interventions [3].
5. Practical takeaways for players, coaches and parents
For immediate, evidence-based risk reduction, mandating and enforcing properly fitted mouthguards prevents dental and facial injuries and is standard practice in many sports [2] [1]. Stakeholders should not assume mouthguards reliably prevent concussions; that remains unproven in the literature and varies by study and mouthguard type [1] [4]. Where concussion prevention is the goal, complementary measures—helmet design, rule changes, guardian caps and coaching to reduce head contact—are the interventions more directly linked to lowering head impacts (p1_s10; available sources do not mention specific comparative efficacy numbers).
6. Commercial claims vs. the literature: watch for overreach
Manufacturers and retailers often state mouthguards “reduce concussion risk” or “absorb shock to the skull” [9] [10]. Those marketing claims exceed what the peer-reviewed summaries and position statements support: industry copy may assert secondary benefits, but systematic and organisational reviews emphasise dental protection as the proven outcome and describe concussion effects as mixed or inconclusive [1] [4].
7. What reporting still does not say or resolve
Available sources do not provide definitive, quantified estimates that mouthguards reduce concussion incidence by a specific percentage across football levels, nor do they settle whether custom mouthguards perform better than over-the-counter models for concussion prevention—the literature contains conflicting findings [1] [8]. Longitudinal randomized trials tying mouthguard type and fit to concussion outcomes remain lacking in the cited material [4] [3].
Conclusion: In football, mouthguards are essential and demonstrably effective for preventing oral and facial injuries; their role in preventing concussions remains uncertain. Instrumented mouthguards promise better impact measurement, but current reporting frames them as data tools rather than proven protective devices [1] [3].