The following article was originally published on carolanneblack.com
There aren’t many mouth guards in ultimate. You may see at most two or three per team. Mine is bright blue and people often ask me why I wear it: is it for tooth protection or concussion prevention? The answer is tooth protection, but not because I’m more worried about my teeth than my brain. It’s because that’s what mouth guards do.
Andrea Proulx, a player on Bytown Flatball Club (BFC), Ottawa’s mixed A team, is considering getting a mouth guard. She recently sent me the latest Newsletter from the Sports Information Resource Centre (SIRC), called Sports and Your Smile. Proulx got me thinking more about my mouth guard. I know it’s good for protecting my teeth. I’ve heard that it may protect from concussions and I’ve heard it may not. After doing a little research, I’ve realized why the issue is foggy among athletes – it’s foggy in the literature as well.
Mouth guards and concussions
The human brain sits freely in fluid inside the human skull. When the skull takes an impact, or is jolted, there is nothing to keep the brain from crashing into the inside of the skull. A mouth guard could help protect an athlete from concussion when they are hit in the jaw. The mouth guard could absorb some of the force before it reaches the brain. Sounds great, but studies have yet to show this to be true.
A 2001 review article on mouth guards and concussions states that “although many authors claim that mouth guards offer an effective means of preventing concussion and spinal injuries, the evidence for this statement is limited.” The author also notes that the problem is a lack of evidence. It’s not that there is proof that mouth guards do not prevent concussions; it’s that, so far, we can’t prove that they do. A 2009 review of mouth guards and concussions concurs. They reviewed studies on hockey, football, basketball, and rugby. The result: no evidence ‘exists’ to prove mouth guards prevent concussions.
A 2011 review article on concussion prevention by the use of headgear and mouth guards notes that mouth guards do protect against dental and oral injury. It goes on to state that how mouth guards affect the incidence and severity of concussions is “less clear.” The exception is one study, in which mouth guard use by 1033 NHL players was found to have no effect on the rate of concussions, however, concussion symptoms were much less severe for players who wore mouth guards.
For now, it seems that mouth guards will not protect ultimate players from concussions. It is, however, clear that they help to keep athletes’ mouths and jaws safe.
Mouth guards in ultimate
The American Dental Association (ADA) published an article on mouthguard use in sports that contains a list of sports for which they recommend athletes wear a mouth guard. The obvious sports are listed, but there are some that seem less expected. Topping my unexpected list are bicycling, equestrian events, skiing, soccer, and volleyball. It isn’t only contact sports that put athletes at risk for a mouth or jaw injury.
Health Canada has a webpage on sports and mouth guards. It includes descriptions of the different kinds of mouth guards, should you consider getting one and want help choosing. There is a list of sports, similar to that of the ADA, which includes many non-contact sports. These lists should include ultimate. Health Canada reinforces the low cost of a mouth guard compared to the cost of later dental work to correct for injuries. They also note the pain and suffering experienced by athletes that can easily be prevented by the use of a mouth guard.
A 1998 study found the incidence rates of at least one injury to the face and mouth of high school varsity athletes over the 1996-1997 season were 27.6 percent in soccer, 72.3 percent in wrestling, and 55.4 percent in basketball. During the same season, 10 percent of athletes experienced dental injuries. Of course, ultimate isn’t soccer, wrestling, basketball, or any other sport. But ultimate is too young to have available a slew of studies on mouth guards and concussions and mouth and dental injuries. It is, however, only a hop, skip, and a jump from basketball or soccer. As far as danger to our mouths is concerned, we can learn from these other sports and make smart decisions about ultimate. But are we?
I asked Proulx about BFC’s use of mouth guards and she responded that no one wears one. I got curiouser and asked the same question of Amos Lee, co-captain of Big Fish, Ottawa’s mixed B team. Amos gave me the same response. I even asked Gavin Thompson, who took photos at the Canadian Ultimate Championships in 2012 for a photo of someone with a mouthguard to use for this post. He didn’t have even one.
Why aren’t we wearing mouth guards in ultimate?
The number one reason that players don’t wear mouth guards is that they are not required. After that, the likely reasons are difficulty breathing, doesn’t look good, etc. Few players wear mouth guards Of the varsity players surveyed in the 1998 study discussed earlier in this article, 50 percent reported thinking mouth guards were a good idea, whereas only 6 percent actually used one. I don’t think Ultimate Canada should mandate the use of mouth guards for all players. It should become part of ultimate culture, like our long, baggy shorts and awesome colourful printed jerseys.
There is one slight exception to the low numbers of mouth guards when not required: athletes with a history of oral trauma. These athletes will more frequently choose to wear a mouth guard, despite their peers non-participation.
I wear a bright blue mouth guard to play ultimate; my dentist let me pick the colour. But I do fit into the category of athletes who’ve had a previous injury. I knocked a big chunk off one of my front teeth when I slipped on some ice at 8 years old. It wasn’t a sports injury, but regardless, nothing is as strong as a real tooth: a good bump to the front of my mouth, and I’ll be back at the dentist, once again, after many times, having a new filling put in.
From someone who has lost half her tooth on vacation and had to smile awkwardly for days with her mouth closed, listen up: if you play ultimate, get a mouth guard. Your dentist can make one that’s just right for your mouth. You’ll breathe just fine. You’ll know your mouth is protected. You’ll get to pick whatever colour you want.
It’s definitely slimy and takes up space in my mouth. It pushes my lips out and makes me look funny. The only thing I really like about my mouth guard is that it keeps my teeth in my mouth. And isn’t that enough?