{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:29:10Z","timestamp":1788416950790,"version":"build-2803163510"},"reference-count":44,"publisher":"BMJ","issue":"14","funder":[{"DOI":"10.13039\/501100000145","name":"Alberta Innovates - Health Solutions","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000145","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Markin Undergraduate Research Program in Health and Wellness Research"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003965","name":"International Olympic Committee","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003965","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2019,12,16]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Concussion is the most common injury in youth ice hockey. Whether mouthguard use lowers the odds of concussion remains an unanswered question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the association between concussion and mouthguard use in youth ice hockey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nested case\u2013control design. Cases and controls were identified from two prospective cohort studies using valid injury surveillance methods. Cases were players concussed during a game or practice; controls were players who sustained a non-concussion injury during a game or practice. The primary exposure was mouthguard use at time of injury; mouthguard type (dental custom fit or off the shelf) was a secondary exposure. Physician-diagnosed or therapist-suspected concussion was the primary outcome. Dental injury was a secondary outcome. Multilevel logistic regression with random effect at a team level was used to obtain ORs for the mouthguard effect, adjusted for level of play, age group, position, concussion history, mechanism of injury, cohort, session type and body checking policy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among cases, 236\/315 (75%) were wearing a mouthguard at time of injury, while 224\/270 (83%) controls were wearing a mouthguard at time of injury. Any mouthguard use was associated with an adjusted OR for concussion of 0.36 (95% CI 0.17 to 0.73). Off-the-shelf mouthguards were associated with a 69% lower odds of concussion (adjusted OR: 0.31; 95%\u2009CI 0.14 to 0.65). Dental custom-fit mouthguards were associated with a non-significant 49% lower odds of concussion (adjusted OR: 0.51; 95%\u2009CI 0.22 to 1.10). No dental injuries were identified in either cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mouthguard use was associated with lower odds of concussion. Players should be required to wear mouthguards in youth ice hockey.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2019-101011","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T22:24:42Z","timestamp":1579040682000},"page":"866-870","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Mouthguard use in youth ice hockey and the risk of concussion: nested case\u2013control study of 315 cases"],"prefix":"10.1136","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7185-0625","authenticated-orcid":false,"given":"Dirk A","family":"Chisholm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5668-9706","authenticated-orcid":false,"given":"Amanda Marie","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz","family":"Palacios-Derflingher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H","family":"Eliason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn J","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9499-6691","authenticated-orcid":false,"given":"Carolyn A","family":"Emery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5530-0639","authenticated-orcid":false,"given":"Brent E","family":"Hagel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"2024101109552032000_54.14.866.1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506290061"},{"key":"2024101109552032000_54.14.866.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-9657.2009.00808.x"},{"key":"2024101109552032000_54.14.866.3","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1097\/JSM.0b013e31821f5cd7","article-title":"Patterns of mouthguard utilization among atom and pee Wee minor ice hockey players: a pilot study","volume":"21","author":"Raaii","year":"2011","journal-title":"Clin J Sport Med"},{"key":"2024101109552032000_54.14.866.4","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200205001-01739"},{"key":"2024101109552032000_54.14.866.5","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyh346"},{"key":"2024101109552032000_54.14.866.6","first-page":"209","article-title":"Oral trauma in adolescent athletes: a study of mouth protectors","volume":"11","author":"McNutt","year":"1989","journal-title":"Pediatr Dent"},{"key":"2024101109552032000_54.14.866.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2010.09.006"},{"key":"2024101109552032000_54.14.866.8","first-page":"299","article-title":"Intra-Oral Mouth-Guard in sport related oro-facial injuries: prevention is better than cure!","volume":"8","author":"Mantri","year":"2014","journal-title":"J Clin Diagnostic Res"},{"key":"2024101109552032000_54.14.866.9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jebdp.2012.03.021","article-title":"Mouthguards reduce orofacial injury during sport activities, but may not reduce concussion","volume":"12","author":"Mascarenhas","year":"2012","journal-title":"J Evid Based Dent Pract"},{"key":"2024101109552032000_54.14.866.10","doi-asserted-by":"publisher","DOI":"10.1046\/j.0960-7439.2001.00304.x"},{"key":"2024101109552032000_54.14.866.11","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s40279-014-0167-9","article-title":"Factors affecting sports-related orofacial injuries and the importance of mouthguards","volume":"44","author":"Tuna","year":"2014","journal-title":"Sports Med"},{"key":"2024101109552032000_54.14.866.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097452"},{"key":"2024101109552032000_54.14.866.13","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.35.2.81"},{"key":"2024101109552032000_54.14.866.14","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e31816a1c9a"},{"key":"2024101109552032000_54.14.866.15","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2004.006882"},{"key":"2024101109552032000_54.14.866.16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.21.2.5"},{"key":"2024101109552032000_54.14.866.17","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509341032"},{"key":"2024101109552032000_54.14.866.18","unstructured":"Momsen KM . Association between the incidence of cerebral concussions and dental injuries and mouthguard usage among NCAA Div. I men's ice hockey players [MA]. University of North Carolina at Chapel Hill, 2003."},{"key":"2024101109552032000_54.14.866.19","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1964.0290"},{"key":"2024101109552032000_54.14.866.20","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514541926"},{"key":"2024101109552032000_54.14.866.21","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000171883.74056.21"},{"key":"2024101109552032000_54.14.866.22","first-page":"34","article-title":"Role of mouthguards in reducing mild traumatic brain injury\/concussion incidence in high school football athletes","volume":"62","author":"Winters","year":"2014","journal-title":"Gen Dent"},{"key":"2024101109552032000_54.14.866.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-4469.2004.00259.x"},{"key":"2024101109552032000_54.14.866.24","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092734"},{"key":"2024101109552032000_54.14.866.25","unstructured":"Nichols C . 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