Patterns of mouthguard utilization among atom and pee wee minor ice hockey players: a pilot study

To determine if youth hockey players wear their mouthguards properly, and if not, why?

Descriptive cross-sectional study.

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

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.

Players were asked to complete a survey addressing mouthguard wear under their coach's supervision.

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.

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.

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.