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Patterns of Mouthguard Utilization Among Atom and Pee Wee Minor Ice Hockey Players: A Pilot Study

Raaii, Farhang MD*; Vaidya, Nicholas; Vaidya, Katherine; DiBacco, Nunziatina MSN; Les, Clifford DVM, PhD; Sethi, Anil MD*; Vaidya, Rahul MD, CM*

Clinical Journal of Sport Medicine: July 2011 - Volume 21 - Issue 4 - p 320-324
doi: 10.1097/JSM.0b013e31821f5cd7
Original Research
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Objective: To determine if youth hockey players wear their mouthguards properly, and if not, why?

Design: Descriptive cross-sectional study.

Setting: Tecumseh Shoreline Minor Hockey Association, Tecumseh, Ontario, Canada, during the 2007-2008 season.

Participants: Subjects were 180 travel hockey players of the Tecumseh Shoreline Minor Hockey Association at the Atom or Pee Wee level (aged 9-12 y) or their competitors.

Assessment of Risk Factors: Players were asked to complete a survey addressing mouthguard wear under their coach's supervision.

Main Outcome Measures: The type of mouthguard, whether mouthguards were worn at all and worn properly, and the reasons for noncompliance. The incidence of concussion and association to mouthguard-wearing tendencies were also assessed.

Results: Sixty-eight percent [95% confidence interval (CI), 60.4%-74.5%] of subjects always wore their mouthguards, but only 31.7% (95% CI, 25.0%-39.0%) wore them properly during games and 51.1% (95% CI, 43.6%-58.6%) during practice. Custom-made mouthguards were most likely to be worn properly, followed by boil-and-bite and stock-type guards. Younger players wore mouthguards more consistently than older players (P < 0.01). Reasons for not wearing the guard included the following: 43.0% (95% CI, 35.4%-50.4%) of subjects felt it made talking difficult, 27.4% (95% CI, 20.9%-34.3%) felt it uncomfortable, 23.9% (95% CI, 17.9%-30.8%) felt it made breathing difficult, and 12.4% (95% CI, 8.3%-17.9%) thought it did not fit correctly. The incidence of concussion was 17.8%, but the study was underpowered for any association with mouthguard type.

Conclusions: Even when mouthguards are mandated to be worn in a children's travel hockey league, young players self-report that they routinely fail to wear them properly.

From the *Department of Orthopedic Surgery, Detroit Medical Center, Detroit, Michigan; †Tecumseh Shoreline Minor Hockey Association, Tecumseh, Ontario, Canada; and ‡Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, Michigan.

Submitted for publication March 25, 2010; accepted April 12, 2011.

The authors report no conflicts of interest.

Corresponding Author: Rahul Vaidya, MD, CM, FRCSC, Department of Orthopedic Surgery, Detroit Medical Center, 4D4 UHC Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201 (

© 2011 Lippincott Williams & Wilkins, Inc.