Do mouthguards prevent concussion?

One of the most commonly held myths in sports medicine is the premise that wearing a mouthguard will prevent concussion. The origins of this contention are obscure, but an evidence based review of the scientific support for this concept has not been previously published. Mouthguards or “gum shields” were originally developed in 1890 by Woolf Krause, a London dentist, as a means of protecting boxers from lip lacerations. Such injuries were a common and often disabling accompaniment of boxing contests in that era.1–3 These gum shields were originally made from gutta percha and were held in place by clenching the teeth. Philip Krause, his son, who was both a dentist and amateur boxer, subsequently refined the design of the gum shield and made them from vella rubber.1 In the United States, the first mouthguard was probably manufactured by Thomas Carlos, a Chicago dentist, in 1916.1, 4 By the 1930s, mouthguards were part of the standard boxers' equipment and have remained so since that time. Jack Dempsey and Gene Tunney, before the second world war, were probably the last of the heavyweight champions to fight without a mouthpiece. There are several distinct types of mouthguard. The simplest are the stock mouthguards, which may be purchased from sporting goods stores. The second type are the mouth formed or boil and bite guards, which are heated and immediately worn by the athlete allowing some adaptation to the dentition to occur. The more complex mouthguards are custom made …