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Should football players wear custom fitted mouthguards? Results from a group randomised controlled trial
  1. C Finch1,
  2. R Braham2,
  3. A McIntosh3,
  4. P McCrory4,
  5. R Wolfe2
  1. 1NSW Injury Risk Management Research Centre, University of New South Wales, Sydney, NSW, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
  3. 3School of Safety Science, University of New South Wales, Sydney, NSW, Australia
  4. 4Centre for Health, Exercise and Sports Medicine & the Brain Research Institute, University of Melbourne, Melbourne, Australia
  1. Correspondence to:
 Professor C Finch
 NSW Injury Risk Management Research Centre, University of New South Wales, Sydney, NSW, Australia 2052;


Objective: Head/orofacial (H/O) injuries are common in Australian rules football. Mouthguards are widely promoted to prevent these injuries, in spite of the lack of formal evidence for their effectiveness.

Design: The Australian football injury prevention project was a cluster randomized controlled trial to evaluate the effectiveness of mouthguards for preventing H/O injuries in these players.

Setting and subjects: Twenty three teams (301 players) were recruited from the largest community football league in Australia.

Intervention: Teams were randomly allocated to either the MG: custom made mouthguard or C: control (usual mouthguard behaviours) study arm.

Main outcome measures: All injuries, participation in training and games, and mouthguard use were monitored over the 2001 playing season. Injury rates were calculated as the number of injuries per 1000 person hours of playing time. Adjusted incidence rate ratios were obtained from Poisson regression models.

Results: Players in both study arms wore mouthguards, though it is unlikely that many controls wore custom made ones. Wearing rates were higher during games than training. The overall rate of H/O injury was 2.7 injuries per 1000 exposure hours. The rate of H/O injury was higher during games than training. The adjusted H/O injury incidence rate ratio was 0.56 (95% CI 0.32 to 0.97) for MG versus C during games and training, combined.

Conclusions: There was a significant protective effect of custom made mouthguards, relative to usual mouthguard use, during games. However, the control players still wore mouthguards throughout the majority of games and this could have diluted the effect.

  • EVA, ethylene vinyl acetate
  • H/O, head/orofacial
  • IRR, incidence rate ratio
  • PDC, primary data collector
  • RCT, randomized controlled trial
  • football injury
  • randomised controlled trial
  • mouthguards
  • head/orofacial injury

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  • R Braham is now at the School of Human Movement and Exercise Science, University of Western Australia