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

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.