Why Are Some Athletes More Prone to Concussion Than Others?

Paula Duffy

More than a year ago I wrote a piece about a simple mouth guard which prevented concussions when worn by athletes. I asked why the NFL wasn't all over it, testing it, buying it and making it part of their equipment.

The mouth guard was developed and is sold by a dentist named Gerald Maher who for many years has been the dentist for the New England Patriots. As Patriots players got the hang of the device they raved about it, (testimonials on Maher's company's website) especially players who had already suffered heard trauma.

As those Patriots players like Matt Cassel and Mike Vrabel moved about the league they brought their mouth guards with them and members of their new teams were introduced to the device. But this was mere anecdotal evidence and the NFL said it needed peer reviewed studies, in which it never seemed to be interested enough to put into motion.

The Maher mouth guard doesn't prevent all concussions. It works specifically with the lower jaw but its success rate, until recently all anecdotal, is eyebrow raising if not astounding.

And then a few weeks ago, a study was published on Dr. Maher's device. Its study subjects were high school age football players and according to a statement filed with the House Judiciary Committee by Maher's company, Mahercor Laboratories, LLC it validates the company's methods of examining a player's jaw and fitting a device to help prevent concussion from direct blows.

Two weeks ago, that same committee, chaired by Representative John Conyers, (D-MI) heard testimony from NFL executives, former players, wives of former players and medical professionals. The topic was what the league will do with recent study results that found its retired players are 19 times more likely than the average person who never played football to be diagnosed with a memory disorder.

The league now has data it can't ignore any longer. But since the study didn't prove a direct causal link between concussions on the field of play and the condition of the brains of ex-NFL players, it doesn't want to admit anything and says it needs to study the problem in more detail.

In the meantime, concussions occur weekly on every team, some more newsworthy than others.
and time slips away. All the Judiciary Committee did was to give the league its chance to insist that it was working on the problem therefore government intervention isn't necessary.

Some conservative members of the committee used that time to talk about their disdain for poking Congress' nose into a private workplace, even if worker safety is a factor. Funny how OSHA doesn't seem to apply to football players.

Mahercor has an advocate in Senator John Kerry (D MA) as well as endorsements from the ADA, the current president of the AFL-CIO, and a board member of Blue Cross/Blue Shield. It has the study results published in the The Academy of Sports Dentistry's Referring Journal, the Journal of Dental Traumatology,

I have no relationship with Mahercor and write as a journalist and observer. In the year since I began following this story, the concussion problems for the NFL have not only continued, but data about brain damage to former players as young as their mid-thirties is very disturbing.

I think it's time to take some relief where the league can find it right now. As I said, the Mahercor mouth guard isn't a cure for all head trauma. But it's a great start and it seems odd that the league doesn't use its two-minute drill to get some relief where it exists right now.

The league also is paying attention to tests being done on mouth guards to see whether they could play a role in helping prevent concussions. The NFL's Aiello said the league has not ruled out making use of mouth guards mandatory.

Dave Halstead, who is testing helmets for the NFL, is scheduled to testify at a congressional hearing at Detroit's Wayne State University School of Medicine on Monday, the House Judiciary Committee's second recent look at football head injuries has produce research on mouth guards in relation to concussion.

http://www.compendiumlive.com/article.php?id=2907

Mahercor guards and splints

Dr. Gerald Maher, a Massachusetts

dentist who specializes in TMJ and

facial pain, was one of the first to

explore how an athletic mouthpiece

can affect performance and protection.

As the team dentist for the New

England Patriots, his primary goal

was to reduce the number of concussions

the players suffered.

He concluded that 64 percent of

adults have misaligned mandibles

where the condyles do not sit on

the cartilage discs; and, if someone

suffers a blow to the jaw in this position,

the condyles are more likely to

be driven into the base of the skull,

causing a concussion.

The Maher guards and splints

(www.mahercorlabs.com) are

designed so that the opposing teeth

are seated in a centric relation position

so that the condyles are in alignment

with the discs. These discs

will then act as shock absorbers to

cushion the impact of the condyles

on the skull.

In addition, because of the thickness

of the appliance, the condyles

are moved from a position where

they are resting directly against the

articular disc — or even against the

fossa in the case of patients with

internal derangements where the

disc is displaced, usually anteriorly

— to a position farther away from

the fossa on the articular eminence.

This would mean that it would

take a greater force to drive the condyles

into the skull.

Earlier this year, Maher, along

with Drs. G. Dave Singh and Ray

Padilla, published a preliminary

study that suggests a customized

mandibular orthotic may decrease

the incidence of concussions. The

study, however, did not attempt to

explain the mechanism of protection.

While Mahercor Laboratories

does not market their line of mouthpieces

and mouthguards for their

performance-enhancing effects and

doesn’t claim to have specific studies

to substantiate these benefits, some

of the athletes that have been outfitted

with their mouthpieces claim to

have noticed a significant increase

in strength, balance and speed.

They attribute this effect to the

full-body benefits of a properly, CRpositioned

mandible and point to a

1995 paper by Dr. Harold Gelb that

favors the premise that jaw repositioning

can enhance appendage

muscular strength and athletic performance.

The Maher splint design is a Gelb

splint or MORA (mandibular orthopedic

repositioning appliance). It

is not designed to offer soft tissue

protection, but Maher’s line also

includes upper full coverage mouthguards.

The Maher appliances may be

fabricated by dentists who are skilled

in capturing a CR bite by ordering it

through Mahercor Laboratories or,

more recently, Space Maintainers

Laboratory.

The laboratory fees range from

$75 for a custom mouthguard to

$175 for their protective splint, with

a recommend a retail price range of

$175 to $250 for the mouthguard and

$300 to $450 for the splint.

www.mahercor.com

 http://www.mahercorlabs.com/pdf/Dental_Traumatology%20Publication.pdf