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PHOTO BY USA Hockey Magazine Archives T he first generation of mouth guards in the 1930s were worn exclusively by boxers to protect their mouths, teeth and jaws. Today, mouth guards are worn by athletes playing a variety of sports to protect them from orofacial injuries as well as concussions. Mouth guards reduce the risk and severity of orofacial injuries, but it is also believed that a well-fit mouth guard may help prevent concussions. A recent study of youth hockey players reported that off-the-shelf mouth guards lowered the odds of sustaining a concussion by 69 percent. Another study of 195 collegiate athletes in contact/collision sports other than ice hockey suggested mouth guard use may offer benefit in preventing sports related concussions. The available evidence supports the use of a mouth guard for all youth hockey players. USA Hockey Rule 304 states that "All players, including goalkeepers, in the 12 and under through youth 18 and under (including high school) age clas- sifications are required to wear a colored (non-clear) internal mouthpiece that covers all remaining teeth of one jaw, customarily the upper. It is strongly recommended, that in all age classifications, every player should wear a mouthpiece form fitted by a dentist." Despite strong recommendations and this clearly stated rule, mouth guard compliance is poor and rule enforcement is inconsistent. An unpublished survey of high school hockey players revealed that only 50 percent of players wear a mouth guard during games. When asked about mouth guard compliance and perceived effi- cacy in collegiate athletes, 93 percent of the NCCA athletic trainers surveyed said they valued the mouth guard's role in the prevention of injury. However, only 63 percent of the players consistently wore a mouth guard during games. The NCAA and USA Hockey mouth guard requirement at these lev- els of participation may not be adequately emphasized by coaches, par- ents and athletic trainers or consistently penalized by game officials. Available Evidence Supports Use Of Mouth Guard By All Hockey Players /// by Jeff Lamb, Aynsley M. Smith, David A. Krause, Logan Breu and Michael J. Stuart There is plenty of available evidence to support the use of a mouth guard for all youth hockey players. OPEN OPEN AND SHUT SHUT CASE CASE 36 // NOVEMBER/DECEMBER 2020 USAHOCKEYMAGAZINE.COM