Dear Doctors: I just read about these electronic mouthguards that can show if someone has a concussion during contact sports games. Apparently, if you get hit really hard, they will flash and let the coaches know that you need to get out of the game. This seems like a great idea. What took so long?
Dear Reader: You are asking about the news that an international women’s rugby tournament will be introducing the use of an “instrumented” mouthguard that can calibrate the force with which a player is tackled. If that force is powerful enough to cause a head injury, it will trigger a flashing red light within the mouthguard. This, as you say, alerts the coaching staff that the player should exit the game for a medical evaluation.
While contact sports such as rugby and football can be exciting to watch, the repeated tackles and collisions during the game put players at significant risk of head, face and neck injuries. These include concussion, fractures, intracranial bleeds, cerebral contusion, dental and eye injuries, and cervical spine injuries.
Even soccer, in which players use their heads to direct the ball, is coming under new scrutiny. For decades, due in part to cultural attitudes and economic pressures, the issue of head and neck injuries in contact sports flew under the radar.
With the emergence of high-profile cases of chronic traumatic encephalopathy, or CTE, the issue of head injuries in contact sports became a public health concern. CTE is a progressive disease in which repeated blows to the head damage the brain and cause cognitive decline.
Tragically, CTE can be diagnosed only after death, via an autopsy. The awareness of CTE, along with pressure from players, families and the medical community, has led to renewed efforts to protect athletes from playing while injured. That is where the flashing mouthguard enters the picture.
Like a traditional mouthguard, this new so-called “smart” version is made from food-grade thermoplastic that is resilient yet flexible. What makes it different are the tiny motion sensors embedded in the plastic. These sensors use accelerometers to detect the force with which a player is hit head-on and gyroscopes to measure angular and rotational forces.
Because our upper teeth are in a fixed position, they absorb the same impact as the rest of the head. That means the instruments in the mouthguard can provide an accurate picture of what has happened to a player’s head during contact.
The upper limits of an acceptable collision are calibrated using medical studies and biometric and biomechanical data. When one of the smart mouthguards registers contact that exceeds the preestablished limit, it triggers a flashing red light. Due to the difference in the physical size and bone and muscle structures of women and men, the danger zones of the mouthguards are calibrated accordingly.
With this kind of real-time data, players can be pulled from a game even when symptoms are not immediately present. Cumulative hits, another danger of contact sports, can also be tracked. Flashing mouthguards don’t eliminate the risks of contact sports, but they do represent a significant step forward in player safety.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)