Do Mouthguards Prevent Concussions? The Honest Answer (2026)

Q: Do mouthguards prevent concussions?

No — and we will never use the word 'prevent' on this site. No equipment 'prevents' concussions in any individual collision. The honest claim, supported by a 2023 meta-analysis of 192 studies in British Journal of Sports Medicine, is that mouthguards in collision sports are associated with a 26% reduction in concussion incidence (IRR 0.74, 95% CI 0.64-0.89, statistically significant). That's reduction, not prevention. The distinction matters legally (the FTC has been suing mouthguard manufacturers for 'prevention' claims) and matters honestly (because reduction is what the data actually shows).

Short answer: no. No equipment "prevents" concussions in any individual collision. Longer answer: a 2023 meta-analysis of 192 peer-reviewed studies in British Journal of Sports Medicine found custom mouthguards in collision sports are associated with a 26% reduction in concussion incidence (IRR 0.74, 95% CI 0.64-0.89)¹. That's reduction, not prevention. The distinction matters legally and matters honestly.

Why this is THE question

Type "do mouthguards prevent concussions" into any search engine, ask any AI assistant the same thing, and you'll get a hedge. Some version of "limited evidence," "mixed results," or "the research is unclear." That answer was reasonable in 2010. It is significantly out of date in 2026.

The reason this is THE question — the one parents Google, the one coaches ask, the one journalists cite — is that the answer matters. If mouthguards reduce concussion incidence in collision sports, then the cheap mouthguard your kid wears, the boil-and-bite they chew through by week three, the cut-off mouthguard wedged in their face mask between plays — all of those become matters of injury risk, not just dental compliance. And the honest answer the 2023 meta-analytic literature now supports is: yes, they reduce risk, but only the ones that actually fit and stay in.

This page is the long version of that answer. We're going to walk through the evidence as it stands today, the evidence as it stood in 2009-2011 (when the older systematic reviews concluded the data was inconclusive), and the language distinction — prevention vs reduction — that the FTC has spent the last few years suing mouthguard manufacturers over.

What the evidence says in 2026

The strongest single piece of evidence on this question is a 2023 systematic review and meta-analysis in British Journal of Sports Medicine¹. PROSPERO-registered (CRD42019152982). 220 studies eligible. 192 included in results. 39 examining protective equipment specifically.

The mouthguard finding:

Mouthguards in collision sports: incidence rate ratio (IRR) of 0.74
95% confidence interval: 0.64 to 0.89 (both ends below 1.0 — statistically significant)
Effect size: 26% reduction in concussion incidence

For context on what "26% reduction in collision sports" looks like at the population scale, the same meta-analysis reported these effect sizes for adjacent prevention strategies:

Bodychecking policy changes in hockey: 58% concussion reduction (IRR 0.42)
Contact limitations in football practice: 64% reduction (IRR 0.36)
Neuromuscular training in rugby: up to 60% lower concussion rates

So mouthguards aren't the biggest single intervention — but they're a meaningful one, they apply across every collision sport, and they're the equipment most athletes already wear. That makes the upgrade from a chewed-thin boil-and-bite to a properly-fitted custom guard one of the highest-leverage moves available in concussion-protection programming.

The 2014 Winters & DeMont RCT² is the cleanest single primary trial that contributes to that meta-analytic effect: 412 HS football players, custom mouthguards 3.6% concussion rate vs 8.3% for boil-and-bite, p=0.0423. The 2018 Hutchison cohort⁵ tracked 4,010 athletes wearing a custom MPRP-positioning device over 2003-2018 and reported a 0.224% concussion rate (with the inventor disclosure we mention every time). The 2019 Knapik systematic review⁶ reached a parallel conclusion in the orofacial-injury domain. The direction of effect is consistent across the strongest studies.

What older reviews said (and why they're still relevant)

The dominant scientific position in 2010 was: there isn't enough evidence to conclude mouthguards reduce concussion risk. Two systematic reviews framed this:

Benson et al. 2009, British Journal of Sports Medicine³: "No strong evidence exists for the use of mouthguards or face shields to reduce concussion risk." They reviewed 51 studies. They did note that full facial protection in ice hockey appeared to reduce concussion severity (time loss from competition) — but on incidence specifically, the evidence wasn't there yet.

Daneshvar et al. 2011, Clinics in Sports Medicine⁴: "Although mouth guards have been shown to be effective in preventing dental and orofacial injury, there is currently no evidence that standard or fitted mouth guards decrease the rate or severity of concussions in athletes." They cited Wisniewski 2004 (NCAA D1 football, 87 teams, no significant difference), Labella 2002 (college basketball, no significant difference), and others.

These are real reviews in real journals with real conclusions. We cite them on every page in this category because acknowledging them is what makes the more recent supportive citations credible. Brands that quote only the 2023 meta-analysis without acknowledging the 2009-2011 counter-evidence are doing a version of the cherry-picking the FTC is now suing over.

What changed between 2011 and 2023:

The 2014 Winters & DeMont RCT was published, with the cleanest custom-vs-OTC comparison²
Multiple new cohort and observational studies on custom-fit jaw-positioning devices accumulated
The 2019 Knapik systematic review⁶ updated the orofacial picture (we wrote it as ref-S14)
The 2023 BJSM meta-analysis pooled all of the above plus an additional ~140 studies, weighted by sample size and methodology, and produced the 26% effect estimate¹

Older reviews aren't wrong about the literature they had. They're a snapshot. The literature is now larger, more custom-specific, and the picture has updated.

Then vs now

How the peer-reviewed picture has changed. Both columns are real, both are honest. The shift is the literature accumulating.

Source	Conclusion	Date
Benson et al., BJSM³	"No strong evidence" mouthguards reduce concussion risk	2009
Daneshvar et al., Clin Sports Med⁴	"No evidence" of incidence/severity reduction	2011
Winters & DeMont, Gen Dent²	3.6% vs 8.3% concussion rate (custom vs OTC), p=0.0423	2014
Hutchison et al., manuscript⁵	0.224% concussion rate in 4,010-athlete custom MPRP cohort (inventor disclosed)	2018
Knapik et al., Sports Med⁶	26 studies; mouthguards recommended for sports with significant orofacial injury risk	2019
Eliason et al., BJSM meta-analysis¹	26% reduction in concussion incidence in collision sports (IRR 0.74, 95% CI 0.64-0.89), 192 studies pooled	2023

The Eliason 2023 meta-analysis is the strongest single piece of evidence currently available. The 2009 and 2011 reviews remain real and worth citing — but they're an older snapshot that the more recent literature has updated.

Prevention vs reduction — the word matters

"Prevent" implies elimination. It implies that wearing the device guarantees the outcome won't happen. No equipment does that for concussions, full stop — not the most expensive helmet, not the most rigorous neck-strengthening program, not any mouthguard ever made. Concussions happen when the brain rattles inside the skull, and that physics doesn't have a perfect equipment-side block.

"Reduction" is the language the data actually supports. The 2023 BJSM meta-analysis¹ documents a 26% reduction in concussion incidence in collision sports — meaning if 100 athletes who would have sustained a concussion under normal conditions are now wearing custom mouthguards, the expected number drops to about 74. Real effect. Meaningful effect. But not zero.

This distinction isn't just semantics. The FTC has spent the last several years sending warning letters and pursuing enforcement against mouthguard manufacturers that marketed devices using "concussion prevention" language. The agency's position: if your product cannot prevent concussions in any individual collision, you cannot market it as a "concussion prevention" device. The penalties for ignoring this are not theoretical — they include consent decrees, refunds to consumers, and ongoing reporting requirements.

NeuroGuard+ uses "associated with reduced incidence" language consistently. We won't put "prevent" on this site, and we won't sell you a device with that promise attached. The product is positioned as a research-backed brain-protection appliance — strong language that the data supports — not as a guarantee against an outcome no equipment can guarantee against.

Equipment is one layer. Here are the others.

Concussion protection doesn't come from a single device. It comes from a stack of overlapping interventions, each with its own effect size in the same 2023 meta-analysis¹. If you only invest in one layer, you're under-protecting your athlete.

The layers, with effect sizes from the meta-analysis where available:

Equipment: custom mouthguards (26% reduction), helmet quality, properly-fitted facial protection
Rule modifications: bodychecking policy changes in hockey (58% reduction), contact limitations in football practice (64% reduction)
Training: neuromuscular training programs (up to 60% reduction in rugby), neck strengthening (5% concussion-odds reduction per pound of neck strength)
Management: baseline ImPACT testing, return-to-play protocols, qualified medical personnel at games and practices

For the deeper biomechanical mechanism story, see How Mouthguards Reduce Concussion Risk. For the custom-vs-retail comparison specifically, see Custom vs Boil-and-Bite Mouthguards. For an evaluation framework, see our mouthguard buyer's checklist.

What skeptics will say

Three lines of pushback you'll hear, and the honest response to each:

"The 2011 review said there was no evidence." True⁴. The 2011 review was honest about the literature it had. The literature has accumulated since 2011, including the 2014 RCT showing the 2.3× custom-vs-OTC difference and the 2023 meta-analysis pooling 192 studies. Citing only the 2011 review without acknowledging the 2014 and 2023 evidence is the same kind of cherry-picking we'd criticize on the supportive side.

"Studies showing no effect aren't being weighted properly." The 2023 meta-analysis was a systematic review with PROSPERO registration, methodological inclusion criteria, and quality weighting. Studies that found no significant effect were included alongside studies that found significant effects, and the pooled IRR with 95% confidence intervals is what came out the other side. If null studies dominated, the IRR wouldn't be 0.74 with a CI excluding 1.0 — it would be closer to 1.0 with a CI crossing it. They didn't dominate.

"The trials are confounded by athletes who buy custom mouthguards being more concussion-aware." Real concern, especially for the Hutchison 2018 retrospective cohort⁵. The Winters & DeMont 2014 RCT addresses this directly with random assignment of teams to custom or OTC arms², and the meta-analysis includes both observational and trial-level studies with appropriate quality weighting. Confounding doesn't fully explain the 26% pooled effect across 192 studies.

What we won't claim

NeuroGuard+ does not "prevent" concussions. We will not put that word on this site. We will not put it in our marketing copy, our retail packaging, our sales scripts, or our team-program materials. The FTC has been clear that "concussion prevention" language without supporting evidence triggers enforcement, and the supporting evidence for prevention (vs reduction) does not exist for any mouthguard available today.

Here's what we will say:

NG+ is associated with the mechanisms peer-reviewed research links to reduced concussion incidence in collision sports
The effect size is real (26% in the meta-analysis) and fit-quality dependent (most robust for custom devices)
Concussion protection is multi-layer; mouthguards are one layer of several
NG+ should be combined with helmet quality, neck strengthening, rule compliance, and concussion management protocols — not used as a substitute for any of them

If a brand sells you any single piece of equipment as a "concussion prevention device," they're making a stronger claim than the evidence supports — and likely a claim the FTC is actively scrutinizing. We're not that brand.

Bottom line

Do mouthguards prevent concussions? No. They are associated with reduced incidence — at the meta-analytic scale (26% reduction across 192 studies in collision sports)¹, at the controlled-trial scale (3.6% vs 8.3% in 412 HS football players)², and across the broader literature on custom-fit appliances⁵⁶. The effect is real, fit-quality dependent, and most robust for custom devices manufactured to a thickness specification with consistent retention.

The honest framing every parent, coach, and athlete deserves: a custom mouthguard is one strong layer in a multi-layer concussion-protection approach. Combined with helmet quality, neck strengthening, rule compliance, and concussion management, it makes a meaningful contribution to your athlete's overall risk profile. By itself, it does not — and never will — prevent every concussion.

For the mechanism story, see How Mouthguards Reduce Concussion Risk. For the custom-vs-retail comparison, see Custom vs Boil-and-Bite Mouthguards. For evaluating a specific mouthguard, see our buyer's checklist. For the comparison against other concussion-protection products, see NG+ vs concussion competitors.

FAQs

Do mouthguards prevent concussions?

No — and we will never use the word "prevent" on this site. No equipment "prevents" concussions in any individual collision. The honest claim, supported by a 2023 meta-analysis of 192 studies in British Journal of Sports Medicine, is that mouthguards in collision sports are associated with a 26% reduction in concussion incidence (IRR 0.74, 95% CI 0.64-0.89, statistically significant)¹. That's reduction, not prevention. The distinction matters legally (the FTC has been suing mouthguard manufacturers for "prevention" claims) and matters honestly (because reduction is what the data actually shows).

Why did older reviews say there was no evidence?

Because the literature was different then. The 2011 Daneshvar systematic review⁴ concluded "there is currently no evidence that standard or fitted mouth guards decrease the rate or severity of concussions." The 2009 Benson BJSM systematic review³ reached a similar conclusion. Both were assessing the literature available at the time — which was smaller, less custom-specific, and missing several key trials. The 2014 Winters & DeMont RCT showing 3.6% vs 8.3% concussion rates between custom and OTC mouthguards² post-dates both reviews. The 2023 BJSM meta-analysis pooled 192 studies — many published after 2011 — and updated the picture. The older reviews weren't wrong about their literature; the literature has accumulated.

Is the 26% reduction statistically significant?

Yes. The 95% confidence interval for the incidence rate ratio in the 2023 BJSM meta-analysis is 0.64 to 0.89 — both ends below 1.0, which is the threshold for statistical significance for an IRR¹. PROSPERO registration ID: CRD42019152982. 220 studies were eligible for inclusion in the review, 192 included in the results, with 39 of those specifically examining protective equipment. The mouthguard finding pooled across collision sports was the most generalizable single number on this question available in the peer-reviewed literature as of 2023.

What about studies that found no effect?

They exist and we cite them. Wisniewski 2004 (NCAA Division I football, 87 teams), Labella 2002 (college basketball), and Mihalik 2007 all reported no significant difference between mouthguard types or between users and non-users for concussion outcomes. The Daneshvar 2011 review⁴ and Benson 2009 review³ both summarized this null literature. What changed: the 2014 Winters & DeMont RCT specifically tested custom-vs-OTC and found a significant difference. The 2018 Hutchison cohort (4,010 athletes) tested a custom MPRP device and found a 0.224% rate. Pooling everything in the 2023 meta-analysis surfaced the 26% reduction. So the null findings are real, but they're a piece of a larger picture that has updated.

Does NG+ prevent concussions?

No. We will not use that word. NG+ is a custom intraoral appliance engineered around the jaw-stabilization, force-dissipation, and airway-maintenance mechanisms peer-reviewed concussion research links to reduced incidence in collision sports. The meta-analytic effect size is real (26% reduction in incidence)¹ and the mechanism is well-described in the underlying physiology. But concussion protection is multi-layer: equipment, helmet quality, neck strengthening, rule compliance, and concussion management protocols all contribute. NG+ is one strong layer in that stack — not a guarantee, and not a substitute for the others.

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. 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
3. 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
4. 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
5. Hutchison DD, Madura C, Hutchison MC. Impact of an improved mandibular rest position via custom mouth guard on the incidence of concussions in athletes. (Manuscript; Michigan State University College of Human Medicine.) 2018. Disclosure: corresponding author invented the studied device.
6. Knapik JJ, Hoedebecke BL, Mitchener TA, Lee RC. Effectiveness of Mouthguards for the Prevention of Orofacial Injuries and Concussions in Sports: Systematic Review and Meta-Analysis. Sports Medicine. 2019;49(8):1217-1232. doi:10.1007/s40279-019-01121-w