Protective equipment and the prevention of concussion - what is the evidence?

The complex nature of the evaluation and management of concussion lends to controversy, and the immediate and long-term implications still are being investigated. Various types of protective equipment have been used as a means to prevent concussions, and protective equipment is being used more frequently in different sports. Recent investigations have suggested that a protective, but not preventive, effect may be afforded by mouthguard use in rugby players, headgear use in soccer players, and customized mandibular orthotic use in football players. The use of faceshields has not shown a proven benefit in preventing the incidence of sport-related concussion in ice hockey or field hockey participants. Further studies are needed to clarify the role of protective equipment in the prevention of sport-related concussion.