Why Are Some Athletes More Prone to Concussion Than Others?
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.
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
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
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.
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