Mouthguard use may reduce dentofacial injuries in field hockey players

Data sourcesPubMed, Embase, OvidSP, Web of Science, Cochrane and CINAHL databases were searched up to February 2015 with no language restrictions.Study selectionTwo review authors independently assessed tiles and abstracts of the retrieved case-control, cohorts and cross-sectional studies. For the studies to have been included in the meta-analysis, they must have included the total number of hockey players reporting at least one dentofacial injury, the total number of these injuries compared with other types of injuries and quantitative data on characteristics of dentofacial injuries. Recreational and competitive elite level were included.Data extraction and synthesisThe included studies fell into three categories, related to dentofacial injury, mouthguard use or both, and their quality was assessed using the Newcastle-Ottawa Scale (NOS). A random effects model was used to calculate the overall effect size when appropriate; if not, then pooled prevalence was reported. Binary variables were used in order to express the results as Mantel-Haenszel pooled prevalence odds ratios (OR) with 95% confidence intervals (CI) and a p-value of the overall effect. To compare the between-studies differences, a χ² test was used. The heterogeneity across the studies was evaluated using the I².ResultsEleven studies were included: six related to dentofacial injury, one related to mouthguard use and four to both. The numbers of field hockey players who presented at least one dentofacial injury was 12.7% (95% CI 8.5% to 17.0%) and 45.2% (95% CI 39.3% to 51.0%) in junior/senior players and elite players, respectively. There were no significant differences with respect to sex. After 2000, 84.5% (95% CI 69.3% to 99.7%) of players regularly wore mouthguards, whereas only 31.4% (95% CI 22.7% to 40.1%) wore mouthguards previous to 2000. The mouthguards were commonly depicted as unnecessary and uncomfortable by players.ConclusionsDentofacial trauma poses a serious problem in field hockey, but a considerable number of players still do not regularly wear mouthguards. The likelihood is that if mouthguard usage were higher, fewer dentofacial injuries would occur during field hockey games and in training.Source of fundingNone declared.