August 31, 2009
Dental device helps reduce concussion risk for athletes
By MARK KRAM
Philadelphia Daily News
kramm@phillynews.com

TO CLEAR UP any confusion that has surrounded the dental appliance he has developed, Dr. Gerald Maher stresses that it is only useful in preventing concussions up to a point. When a player takes a solid hit to the head, or experiences a jolt to the neck that produces a whiplash effect, he says there is "nothing" that his device would be able to do to avert head trauma. Chances are that player would end up with a concussion.

But it's the player who takes a blow to the jaw that "The Maher Mouth Guard" could conceivably help. By creating a more stable relationship between with the jaw and skull at the temporomandibular joint (TMJ), the appliance better enables players to dissipate the force that originates from a violent blow to the chin area. Without that shock absorber in place, a concussion and/or other neurological damage can occur when the jaw slams into the skull.

"This is not a panacea," says Maher, the team dentist for the New England Patriots. "What it is, is a TMJ device that places the teeth in better position to withstand a blow. That is what it does. And it has prevented some concussions."

Concussions have been an increasing concern in sports, chiefly in the NFL and NHL. Long range, they can been linked to the onset of chronic traumatic encephalopathy (CTE), a brain abnormality that leaves some former players battling memory impairment, emotional instability, erratic behavior and issues with impulse control. CTE has also been discovered in the autopsies of former NFL players Tom McHale and John Grimsley, both of whom died prematurely in their 40s last year—McHale of a drug overdose; and Grimsley of an accidental self-inflicted gunshot wound. While the NFL has formed a committee to study the effects of concussions, it has not yet endorsed "The Maher Mouth Guard" for leaguewide use. Maher has had better luck with the NHL, which he says has been "actively pursuing" a dialogue with him.

With the publication of a peer-reviewed paper that was released recently in the journal Dental Traumatology, Maher says there is now scholarly support for the anecdotal evidence he has accumulated since he developed the appliance back in the 1970s. Former boxing champion Marvin Hagler was an early success story for Maher, who has since used it with equal success in his work with the Patriots. Former players such as John Hannah and Lawyer Milloy both became advocates of it. So did Asante Samuel and Ellis Hobbs, both of whom played for the Patriots before signing with the Eagles.

Samuel is quoted on the Mahercor Laboratories Web site as saying that he has not had a concussion since he began wearing The Maher Mouth Guard for more than 3 years.

Hobbs says he had not had a history of concussion but believes it prevented him from having any. "Well, I have been hit before where I know that if I did not have it in, I know would have gotten one," says Hobbs. "Plus, it is not as bulky as some of the other appliances I have used, which allows me to breathe and communicate easier. It works."

Co-authored by Maher, Dave Singh, the director of continuing education for the SMILE Foundation, and Ray R. Padilla, lecturer at the UCLA School of Dentistry, the paper that appeared in Dental Traumatology focused on a 3-year study of high school athletes with a history of concussion. According to Maher, the high school players who participated in the study had to continue playing in college or beyond.

"We ended up with 31 players in the study who continued to play their sport in college," says Maher. "What we found was that between them they had approximatley 53 concussions before wearing the appliances. And they only had three between them after they began wearing the appliance."

Maher adds that high school athletes are especially prone to concussions. "In fact, high school athletes are more susceptible to concussions than NFL players," says Maher. "When you are young and you are still developing, your parts are still not lined up properly—especially your teeth or your neck. You are still growing and chances are you have not yet had your final growth spurt. Some [young people] have. But I would say over 50 percent of them have not, which is to say that the head, the jaw and the cervical are not yet perfectly aligned."

Maher says he plans to submit his paper to the NFL for review. He says that even if the appliance can lead to some decrease in concussion, it would be worthy, given the problems some NFL players have had with cognitive function in their later years. Says Maher: "Football players get beat up. And some of them become mentally impaired. Hopefully, something like this can help."

The NHL has been far more receptive to Maher, who has consulted with the Washington Capitals, San Jose Sharks, Minnesota Wild and others (but not the Flyers). According to Maher, the American Hockey League's Hershey Bears were fitted with the appliance last year and have experienced excellent results.

"They had had 11 concussions before they used the appliance," Maher says of the Washington affiliate. "Afterward, they did not have a single concussion."

Maher adds that he expects it to be widely used in the AHL this year.

"I am interested in prevention," says Maher. "I would like to intercept the concussion before it happens. And in cases where the jaw or chin is involved, we have proven we can do that."

And he says the players have been in large part receptive.

"They seem to love it," he says. "Not every single one of them, but the vast majority of them. www.mahercor.com

Link to 08/09 Journal of Dental Traumatology study

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