The Best Mouthguard for Hockey: What the Research Says (2026)

Q: What's the best mouthguard for a hockey player?

A custom-fitted mouthguard with at least 3 mm of posterior thickness, manufactured from real dental impressions. The 2023 BJSM meta-analysis of 192 studies found mouthguards in collision sports were associated with a 26% reduction in concussion incidence (IRR 0.74, 95% CI 0.64-0.89). The 2014 Winters & DeMont RCT showed custom mouthguards specifically had a 2.3× lower concussion rate than over-the-counter alternatives in HS football — the same fit-quality differential applies to hockey. NeuroGuard+ is engineered to those specifications and works with both half-shield and full-cage facial protection.

Q: Half-shield vs full-cage — does the mouthguard choice change?

The 2009 Benson BJSM systematic review found 'evidence is provided to suggest that full facial protection in ice hockey may reduce concussion severity, as measured by time loss from competition.' So full-cage is associated with reduced concussion severity (not necessarily incidence). Mouthguards address a different mechanism — jaw stabilization and force dissipation — and the protective effect applies whether the player wears a half-shield or full-cage. For youth hockey leagues that mandate full-cage, the mouthguard is the additional protective layer addressing the failure mode the cage doesn't. For older players in half-shield leagues, the mouthguard is even more important because the face mask isn't catching as much force.

Q: Bodychecking rule changes did 58% — why bother with equipment?

Because they're complementary, not substitutes. The 2023 BJSM meta-analysis found bodychecking policy changes in hockey were associated with a 58% reduction in concussions — the largest single intervention effect size in the meta-analysis. But policy changes only apply at the league/level/age-group scale. They don't help an individual player wearing inadequate equipment in a contact moment that still happens. Equipment + rule changes + neuromuscular training + neck strength is the multi-layer approach the research supports. Pulling out any layer under-protects.

Q: What about the 1,033-NHL-player study?

The 2009 study cited in the Daneshvar 2011 review found mouthguard non-wearers had a relative risk of concussion 1.42× higher than wearers (95% CI 0.90-2.25) — but the wide confidence interval crossed 1.0 so it wasn't statistically significant for incidence. However, symptom severity was significantly worse without mouthguards (P<0.01) — the same finding the broader Benson 2009 BJSM review reported about full facial protection in hockey. So the older NHL study supports a severity-reducing effect of mouthguards in hockey specifically, even if the older incidence finding wasn't conclusive on its own. The 2023 meta-analysis's pooled 26% incidence reduction in collision sports updates the older picture.

Q: What about women's hockey vs men's hockey?

Different rule sets, different stick-contact dynamics, different concussion patterns. Women's hockey doesn't allow bodychecking, so the 58% bodychecking-policy effect from the meta-analysis doesn't apply directly. But concussion incidence in women's hockey is real (often from incidental contact, sticks, falls) and the mouthguard mechanism — jaw stabilization, force dissipation, airway maintenance — applies regardless of how the contact happens. Custom mouthguards are recommended for both men's and women's hockey at all competitive levels.

Hockey has the most aggressive concussion-prevention research of any contact sport — and the data has shifted fast in the last decade. Bodychecking policy changes alone reduced concussions 58%¹. Custom mouthguards added a separate 26% reduction on top¹. Full facial protection reduced concussion severity in older studies². None of these substitute for each other — they stack. Here's how to pick the mouthguard layer.

Why hockey concussion research is some of the deepest in sports medicine

Hockey has been a research priority for sports concussion for two decades, partly because the NHL drives funding and visibility, and partly because the game has multiple distinct concussion-causing mechanisms — bodychecking, fighting, falls onto ice, errant sticks, puck impact. That depth shows up in the 2023 BJSM meta-analysis¹, which broke out hockey-specific findings explicitly:

Bodychecking policy changes: 58% concussion reduction (IRR 0.42, 95% CI 0.33-0.53)
Mouthguards in collision sports (including hockey): 26% reduction (IRR 0.74, 95% CI 0.64-0.89)

The 2009 Benson BJSM systematic review of 51 studies² documented that "full facial protection in ice hockey may reduce concussion severity, as measured by time loss from competition." The 2011 Daneshvar review³ reported a 1,033-NHL-player study where mouthguard non-wearers had concussion relative risk 1.42 (95% CI 0.90-2.25) — non-significant for incidence on its own, but significantly worse for symptom severity (P<0.01).

So the hockey-specific story has three pillars: rule changes (huge effect), facial protection (severity reduction), and mouthguards (incidence reduction). All three contribute. None substitute. Hockey programs that take only one are leaving meaningful protection on the table.

Bodychecking and the 58% number

The single largest concussion-prevention intervention documented in the 2023 BJSM meta-analysis is hockey bodychecking policy change¹. When youth and amateur leagues raised the age at which bodychecking was permitted (typically from age 11-12 to age 13-14), concussion rates in the affected age groups dropped by 58% (IRR 0.42, 95% CI 0.33-0.53). That's a meaningfully larger effect size than any equipment intervention.

What this means for an individual hockey parent: the age and rule context of your kid's league is the single biggest concussion-risk variable. If your league has updated bodychecking rules in the last 10 years, you're already getting most of the protective effect that's available. The mouthguard layer adds on top of that — not as a substitute for the rule changes, but as a separate layer addressing a different failure mode.

For older players in leagues that allow bodychecking, the equipment layers (mouthguards, helmets, facial protection, neck strengthening) become more important because the rule-level protection is no longer doing the heavy lifting.

The mouthguard layer in hockey specifically

The 2014 Winters & DeMont RCT was a high school football study⁴, but the fit-quality differential it documented (3.6% vs 8.3% concussion rate, custom vs OTC) generalizes to hockey for the same biomechanical reason: hockey hits transmit force through the jaw and cervical chain to the skull, just like football hits do. The same posterior-thickness threshold (≥3 mm) and the same custom-fit requirement that produced the protective effect in football should produce a similar effect in hockey, where the mechanism is identical.

The 2023 BJSM meta-analysis pooled hockey-specific studies into the 26% mouthguard effect for collision sports overall¹. That number is hockey-inclusive even though the most-cited single trial is football.

What's different in hockey: face mask interaction. Custom mouthguards need to be designed to fit comfortably alongside half-shield and full-cage face protection — bulky retail mouthguards often don't, which is part of why hockey players have notoriously poor mouthguard compliance at older ages when half-shields become permitted. NG+ is fitted from impressions and sized to the athlete's actual mandible, which means it stays in place under a face mask without bulking out the player's profile. Compliance and fit are the practical variables that determine whether the protective effect actually shows up on the ice.

Half-shield vs full-cage and how the mouthguard fits in

Most US youth hockey leagues mandate full-cage face protection through age 17 or 18, then transition to half-shield at the junior, college, or pro level. The 2009 Benson BJSM systematic review found that full facial protection in hockey was associated with reduced concussion severity (time loss from competition), though not necessarily reduced incidence². So full-cage helps once a concussion happens; it doesn't necessarily prevent the concussion from happening in the first place.

The mouthguard addresses a different layer: jaw stabilization and force dissipation regardless of what's happening at the face shell. A custom mouthguard works behind both half-shield and full-cage protection — the jaw is the jaw and the cervical chain is the cervical chain.

For a player transitioning from full-cage to half-shield (typical at age 18 in most US leagues), the mouthguard layer becomes more important, not less. The face mask is no longer catching as much force, so the internal biomechanics (jaw, neck, posture) are doing more work. NG+ at the half-shield age is a category upgrade, not a status-quo equipment item.

Women's hockey: different rules, same biomechanics

Women's hockey doesn't allow bodychecking at any organized level — which means the 58% rule-change effect from the 2023 BJSM meta-analysis¹ doesn't apply directly to women's programs because the rule was never permitting bodychecking. But concussion incidence in women's hockey is still real (incidental contact, stick collisions, falls onto ice, accidental skate-to-head impact), and the underlying biomechanics — force transmitted through the jaw and cervical chain to the brain — are identical between men's and women's hockey.

The mouthguard mechanism applies regardless of how contact happens. A custom mouthguard with the same posterior thickness specification, the same custom-fit workflow, and the same jaw-stabilization design produces the same protective effect in women's hockey as in men's hockey. The 2014 Winters & DeMont RCT and the broader 26% mouthguard meta-analytic effect generalize to women's hockey on the biomechanics, even though the most-cited trials are male-population studies.

Women's hockey programs at the youth, high school, college, and pro levels should equip athletes with custom mouthguards for the same reasons men's programs should — and the protective research applies in the same way.

Evidence at a glance

Hockey-specific peer-reviewed findings, with sample sizes and qualifying language preserved.

Outcome	Effect	Source
Bodychecking policy changes (youth hockey)	58% concussion reduction (IRR 0.42)¹	Eliason 2023 meta-analysis
Mouthguards in collision sports (incl. hockey)	26% reduction (IRR 0.74)¹	Eliason 2023 — 192 studies pooled
Full facial protection in ice hockey	Reduced concussion severity (time loss)²	Benson 2009 BJSM systematic review
NHL mouthguard non-wearers (incidence)	RR 1.42 (95% CI 0.90-2.25, NS)³	1,033 NHL athletes; reported in Daneshvar 2011
NHL mouthguard non-wearers (severity)	Significantly worse symptom severity (P<0.01)³	1,033 NHL athletes; reported in Daneshvar 2011
Custom vs OTC mouthguards (HS football, generalizes)	3.6% vs 8.3% concussion rate (p=0.0423)⁴	Winters & DeMont 2014
Neck strength (per 1-lb increase)	5% reduction in concussion odds⁵	Collins 2014 — N=6,704 HS athletes

For hockey coaches and team programs

If you're equipping a youth or high school hockey roster, the protective stack the research supports is:

Rule compliance. Make sure your league's bodychecking policy is current — the 58% reduction in the meta-analysis¹ is from raising the age of permitted bodychecking. If your league hasn't updated, push for it.
Custom mouthguards across the roster. The 26% incidence-reduction effect from the meta-analysis applies. NG+ team-ordering workflow makes per-athlete economics work at program scale.
Full-cage facial protection where age-appropriate (severity reduction per Benson 2009²).
Neck strengthening protocols (5% concussion-odds reduction per pound per Collins 2014⁵).
Concussion management protocols with qualified medical personnel at games.

For the team-ordering workflow, see NG+ team ordering. For the evaluation framework, see our buyer's checklist.

What we won't claim

NeuroGuard+ does not "prevent" concussions in hockey. We will never put that word on this site. Hockey is a fast, contact-heavy sport and concussions happen at every level regardless of equipment. What we will say:

Custom mouthguards in collision sports (including hockey) are associated with a 26% reduction in concussion incidence per the 2023 BJSM meta-analysis¹
The protective mechanism (jaw stabilization, force dissipation, airway maintenance) applies regardless of whether the contact comes from a bodycheck, a stick, a fall, or a puck
NG+ is one strong layer in a multi-layer hockey concussion-protection stack that also includes rule compliance, full-cage protection where age-appropriate, neck strengthening, and concussion management protocols
Equipment alone — including any single mouthguard — does not eliminate concussion risk in hockey

Bottom line

For a hockey player at any level, the best mouthguard is the same one that's best for any collision-sport athlete: a custom-fitted, pressure-laminated mouthguard with at least 3 mm of posterior thickness, manufactured from real dental impressions, that holds dimensions across a season of contact. The hockey-specific context — bodychecking rules, half-shield vs full-cage, women's vs men's — changes the surrounding protective stack, but doesn't change which mouthguard the research supports.

Combine it with rule compliance, age-appropriate facial protection, neck strengthening, and concussion management protocols. That's the multi-layer stack the research keeps pointing to. NG+ is engineered to slot into hockey programs at every level.

For the deeper mechanism story, see How Mouthguards Reduce Concussion Risk. For the comparison-vs-retail story, see Custom vs Boil-and-Bite. For the buyer's framework, see our checklist. For the football-specific page, see Best Mouthguard for Youth Football.

FAQs

What's the best mouthguard for a hockey player?

A custom-fitted mouthguard with at least 3 mm of posterior thickness, manufactured from real dental impressions. The 2023 BJSM meta-analysis of 192 studies found mouthguards in collision sports were associated with a 26% reduction in concussion incidence¹. The 2014 Winters & DeMont RCT showed custom mouthguards specifically had a 2.3× lower concussion rate than over-the-counter alternatives in HS football⁴ — the same fit-quality differential applies to hockey. NeuroGuard+ is engineered to those specifications and works with both half-shield and full-cage facial protection.

Half-shield vs full-cage — does the mouthguard choice change?

The 2009 Benson BJSM systematic review² found "evidence is provided to suggest that full facial protection in ice hockey may reduce concussion severity, as measured by time loss from competition." So full-cage is associated with reduced concussion severity (not necessarily incidence). Mouthguards address a different mechanism — jaw stabilization and force dissipation — and the protective effect applies whether the player wears a half-shield or full-cage. For older players in half-shield leagues, the mouthguard is even more important because the face mask isn't catching as much force.

Bodychecking rule changes did 58% — why bother with equipment?

Because they're complementary, not substitutes. The 2023 BJSM meta-analysis¹ found bodychecking policy changes in hockey were associated with a 58% reduction in concussions — the largest single intervention effect size in the meta-analysis. But policy changes only apply at the league/level/age-group scale. They don't help an individual player wearing inadequate equipment in a contact moment that still happens. Equipment + rule changes + neuromuscular training + neck strength is the multi-layer approach the research supports.

What about the 1,033-NHL-player study?

The 2009 study cited in the Daneshvar 2011 review³ found mouthguard non-wearers had a relative risk of concussion 1.42× higher than wearers (95% CI 0.90-2.25) — but the wide confidence interval crossed 1.0 so it wasn't statistically significant for incidence. However, symptom severity was significantly worse without mouthguards (P<0.01) — the same finding the broader Benson 2009 BJSM review reported about full facial protection in hockey². The 2023 meta-analysis's pooled 26% incidence reduction in collision sports updates the older picture¹.

What about women's hockey vs men's hockey?

Different rule sets, different stick-contact dynamics, different concussion patterns. Women's hockey doesn't allow bodychecking, so the 58% bodychecking-policy effect from the meta-analysis doesn't apply directly. But concussion incidence in women's hockey is real (often from incidental contact, sticks, falls) and the mouthguard mechanism — jaw stabilization, force dissipation, airway maintenance — applies regardless of how the contact happens. Custom mouthguards are recommended for both men's and women's hockey at all competitive levels.

References

1.Eliason PH, Galarneau JM, Kolstad AT, et al. Prevention strategies and modifiable risk factors for sport-related concussions and head impacts: a systematic review and meta-analysis. British Journal of Sports Medicine. 2023;57(12):749-761. doi:10.1136/bjsports-2022-106656
2.Benson BW, Hamilton GM, Meeuwisse WH, McCrory P, Dvorak J. Is protective equipment useful in preventing concussion? A systematic review of the literature. British Journal of Sports Medicine. 2009;43(Suppl 1):i56-i67. doi:10.1136/bjsm.2009.058271
3.Daneshvar DH, Baugh CM, Nowinski CJ, McKee AC, Stern RA, Cantu RC. Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sport-Related Concussions. Clinics in Sports Medicine. 2011 Jan;30(1):145-163. doi:10.1016/j.csm.2010.09.006
4.Winters JE Sr, DeMont R. Role of mouthguards in reducing mild traumatic brain injury/concussion incidence in high school football athletes. General Dentistry. 2014 May/Jun;62(3):34-38. Academy of General Dentistry
5.Collins CL, Fletcher EN, Fields SK, et al. Neck strength: a protective factor reducing risk for concussion in high school sports. Journal of Primary Prevention. 2014;35(5):309-319. PMID: 24930131