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Comparison of Mouth Guard Designs and Concussion Prevention in Contact Sports: A Multicenter Randomized Controlled Trial

Barbic, David BSc (Hon), MSc*; Pater, Joseph MD; Brison, Robert J MD, MPH

Clinical Journal of Sport Medicine: September 2005 - Volume 15 - Issue 5 - p 294-298
doi: 10.1097/01.jsm.0000171883.74056.21
Original Research

Objectives: To compare the effectiveness of the WIPSS mouth guard to other currently used mouth guards in the prevention of concussion injuries in athletes participating in varsity football and rugby.

Design: Multicenter, cluster-randomized, controlled trial comparing the WIPSS Brain-Pad mouth guard against the standard use mouth guard of choice. Teams were monitored by their respective athletic therapist, trainer, or sports physician for 1 playing season to diagnose and record incident concussion injuries and dental trauma. Concussion symptoms were also recorded at the time of injury.

Setting: Five Ontario universities.

Participants: University male football (394) and university male (129) and female (123) rugby athletes reporting to 2003 fall training camps.

Main Outcome Measurements: The primary end point was the incidence of any diagnosed concussion events during the 2003 playing season as defined by the American Academy of Neurology Concussion Guidelines. Secondary endpoints included the incidence of dental trauma events and observed concussion symptoms.

Results: There was no significant difference in the number of concussions observed between the intervention and control arms of this trial (P = 0.79; odds ratio, 1.06, in favor of controls; 95% CI, 0.51, ≪1.61). No dental trauma events occurred. The 5 most common symptoms experienced by concussed athletes were dizziness, general headache, nausea, loss of visual focus, and personality changes.

Conclusions: In this study, concussion rates were not significantly different for varsity football and rugby players who wore the WIPSS Brain-Pad mouth guard compared with other types of mouth guards.

From the *Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada; †Clinical Trials Division, Cancer Institute, Queen's University, Kingston, Ontario, Canada; and the ‡Department of Emergency Medicine, Queen's University, Ontario, Canada.

Received for publication August 2004; accepted May 2005.

Supported by a Graduate Student Scholarship from the Ontario Neurotrauma Foundation.

Reprints: David Barbic, BSc (Hon), MSc, 2165 Gibraltar Rd., RR#6, Kingston, ON K7L 4V3, Canada (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.