{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:15:05Z","timestamp":1765610105792,"version":"3.41.0"},"reference-count":38,"publisher":"National Athletic Trainers' Association","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Current evidence regarding the protective effect of mouthguard use on symptom severity in children and adolescents who sustain sport-related concussions is insufficient to make clinical recommendations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare the association between mouthguard use and symptoms stratified by sex in the first 4 weeks after pediatric sport-related concussion. We hypothesized that mouthguard use would be associated with less severe symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Nine Canadian pediatric emergency departments (EDs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>Children aged 5 to 18 years who were assessed within 48 hours of concussions sustained during a collision or contact sport.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>Injury characteristics were collected using the Acute Concussion Evaluation. The primary outcome measure was symptom score (range = 0\u20136), measured using age-appropriate versions (5\u20137, 8\u201312, or 13\u201318 years) of the Post-Concussion Symptom Inventory. The independent variable was time postconcussion (initial assessment and 1, 2, and 4 weeks).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1019 children (73% male; median [interquartile range] age = 13.43 years [11.01\u201315.27 years]), 42% wore a mouthguard at the time of injury. No significant group-by-sex-by-time interaction was present for symptoms (\\(\\def\\upalpha{\\unicode[Times]{x3B1}}\\)\\(\\def\\upbeta{\\unicode[Times]{x3B2}}\\)\\(\\def\\upgamma{\\unicode[Times]{x3B3}}\\)\\(\\def\\updelta{\\unicode[Times]{x3B4}}\\)\\(\\def\\upvarepsilon{\\unicode[Times]{x3B5}}\\)\\(\\def\\upzeta{\\unicode[Times]{x3B6}}\\)\\(\\def\\upeta{\\unicode[Times]{x3B7}}\\)\\(\\def\\uptheta{\\unicode[Times]{x3B8}}\\)\\(\\def\\upiota{\\unicode[Times]{x3B9}}\\)\\(\\def\\upkappa{\\unicode[Times]{x3BA}}\\)\\(\\def\\uplambda{\\unicode[Times]{x3BB}}\\)\\(\\def\\upmu{\\unicode[Times]{x3BC}}\\)\\(\\def\\upnu{\\unicode[Times]{x3BD}}\\)\\(\\def\\upxi{\\unicode[Times]{x3BE}}\\)\\(\\def\\upomicron{\\unicode[Times]{x3BF}}\\)\\(\\def\\uppi{\\unicode[Times]{x3C0}}\\)\\(\\def\\uprho{\\unicode[Times]{x3C1}}\\)\\(\\def\\upsigma{\\unicode[Times]{x3C3}}\\)\\(\\def\\uptau{\\unicode[Times]{x3C4}}\\)\\(\\def\\upupsilon{\\unicode[Times]{x3C5}}\\)\\(\\def\\upphi{\\unicode[Times]{x3C6}}\\)\\(\\def\\upchi{\\unicode[Times]{x3C7}}\\)\\(\\def\\uppsy{\\unicode[Times]{x3C8}}\\)\\(\\def\\upomega{\\unicode[Times]{x3C9}}\\)\\(\\def\\bialpha{\\boldsymbol{\\alpha}}\\)\\(\\def\\bibeta{\\boldsymbol{\\beta}}\\)\\(\\def\\bigamma{\\boldsymbol{\\gamma}}\\)\\(\\def\\bidelta{\\boldsymbol{\\delta}}\\)\\(\\def\\bivarepsilon{\\boldsymbol{\\varepsilon}}\\)\\(\\def\\bizeta{\\boldsymbol{\\zeta}}\\)\\(\\def\\bieta{\\boldsymbol{\\eta}}\\)\\(\\def\\bitheta{\\boldsymbol{\\theta}}\\)\\(\\def\\biiota{\\boldsymbol{\\iota}}\\)\\(\\def\\bikappa{\\boldsymbol{\\kappa}}\\)\\(\\def\\bilambda{\\boldsymbol{\\lambda}}\\)\\(\\def\\bimu{\\boldsymbol{\\mu}}\\)\\(\\def\\binu{\\boldsymbol{\\nu}}\\)\\(\\def\\bixi{\\boldsymbol{\\xi}}\\)\\(\\def\\biomicron{\\boldsymbol{\\micron}}\\)\\(\\def\\bipi{\\boldsymbol{\\pi}}\\)\\(\\def\\birho{\\boldsymbol{\\rho}}\\)\\(\\def\\bisigma{\\boldsymbol{\\sigma}}\\)\\(\\def\\bitau{\\boldsymbol{\\tau}}\\)\\(\\def\\biupsilon{\\boldsymbol{\\upsilon}}\\)\\(\\def\\biphi{\\boldsymbol{\\phi}}\\)\\(\\def\\bichi{\\boldsymbol{\\chi}}\\)\\(\\def\\bipsy{\\boldsymbol{\\psy}}\\)\\(\\def\\biomega{\\boldsymbol{\\omega}}\\)\\(\\def\\bupalpha{\\bf{\\alpha}}\\)\\(\\def\\bupbeta{\\bf{\\beta}}\\)\\(\\def\\bupgamma{\\bf{\\gamma}}\\)\\(\\def\\bupdelta{\\bf{\\delta}}\\)\\(\\def\\bupvarepsilon{\\bf{\\varepsilon}}\\)\\(\\def\\bupzeta{\\bf{\\zeta}}\\)\\(\\def\\bupeta{\\bf{\\eta}}\\)\\(\\def\\buptheta{\\bf{\\theta}}\\)\\(\\def\\bupiota{\\bf{\\iota}}\\)\\(\\def\\bupkappa{\\bf{\\kappa}}\\)\\(\\def\\buplambda{\\bf{\\lambda}}\\)\\(\\def\\bupmu{\\bf{\\mu}}\\)\\(\\def\\bupnu{\\bf{\\nu}}\\)\\(\\def\\bupxi{\\bf{\\xi}}\\)\\(\\def\\bupomicron{\\bf{\\micron}}\\)\\(\\def\\buppi{\\bf{\\pi}}\\)\\(\\def\\buprho{\\bf{\\rho}}\\)\\(\\def\\bupsigma{\\bf{\\sigma}}\\)\\(\\def\\buptau{\\bf{\\tau}}\\)\\(\\def\\bupupsilon{\\bf{\\upsilon}}\\)\\(\\def\\bupphi{\\bf{\\phi}}\\)\\(\\def\\bupchi{\\bf{\\chi}}\\)\\(\\def\\buppsy{\\bf{\\psy}}\\)\\(\\def\\bupomega{\\bf{\\omega}}\\)\\(\\def\\bGamma{\\bf{\\Gamma}}\\)\\(\\def\\bDelta{\\bf{\\Delta}}\\)\\(\\def\\bTheta{\\bf{\\Theta}}\\)\\(\\def\\bLambda{\\bf{\\Lambda}}\\)\\(\\def\\bXi{\\bf{\\Xi}}\\)\\(\\def\\bPi{\\bf{\\Pi}}\\)\\(\\def\\bSigma{\\bf{\\Sigma}}\\)\\(\\def\\bPhi{\\bf{\\Phi}}\\)\\(\\def\\bPsi{\\bf{\\Psi}}\\)\\(\\def\\bOmega{\\bf{\\Omega}}\\)\\({\\rm{\\chi }}_3^2\\) = 0.27; P = .965). Male mouthguard users reported similar symptom scores in the ED (difference in Post-Concussion Symptom Inventory \u0394 scores [diff] = \u22120.07; 95% CI = \u22120.23, 0.09) and at weeks 1 (diff = \u22120.02; 95% CI = \u22120.18, 0.14), 2 (diff = \u22120.03; 95% CI = \u22120.19, 0.13), and 4 (diff = \u22120.13; 95% CI = \u22120.29, 0.04) compared with males who did not wear a mouthguard. Female mouthguard users described minimally higher symptom scores at week 1 compared with non-mouthguard users (diff = 0.29; 95% CI = 0.01, 0.56). In the ED, symptom scores were not different for females who wore a mouthguard and those who did not (diff = 0.22; 95% CI = \u22120.04, 0.48) or at weeks 2 (diff = 0.22; 95% CI = \u22120.06, 0.51) or 4 (diff = 0.08; 95% CI = \u22120.20, 0.36).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Wearing a mouthguard at the time of injury was not associated with reduced acute or subacute symptoms after sport-related concussion in either males or females who were treated in the ED compared with those who did not wear a mouthguard. Athletes are still encouraged to wear mouthguards during sports because overwhelming evidence supports their use in preventing dental injuries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-0393.20","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:58:33Z","timestamp":1618448313000},"page":"1188-1196","source":"Crossref","is-referenced-by-count":4,"title":["Sex-Based Differences in Symptoms With Mouthguard Use After Pediatric Sport-Related Concussion"],"prefix":"10.4085","volume":"56","author":[{"given":"Jacqueline","family":"van Ierssel","sequence":"first","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9e-Anne","family":"Ledoux","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada"},{"name":"University of Ottawa, Faculty of Medicine, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Tang","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada"},{"name":"University of Ottawa, Faculty of Medicine, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"2021110920054733100_i1062-6050-56-11-1188-b01","doi-asserted-by":"crossref","unstructured":"Bryan\n              MA,\n            \n            \n              Rowhani-Rahbar\n              A,\n            \n            \n              Comstock\n              RD,\n            \n            \n              Rivara\n              F;\n            \n          \n          Seattle Sports Concussion Research Collaborative. 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