An Idea with Some Bite: Solving the NFL's Concussion Dilemma

By ERIC McHUGH
The Patriot Ledger

If you were a nationally renowned oncologist and you told everyone you had discovered a cure for cancer, you would expect that they at least would hear you out, right?

Dr. Gerald Maher hasn’t found that Holy Grail. But after nearly 30 years of poking around inside the mouths of New England Patriots players as the club’s unofficial team dentist, the 60-year-old Marshfield grandfather is fairly certain he’s found a way to help stem the rising tide of concussions in the NFL.

Not stop it, mind you, but potentially reduce the numbers of beat-up brains on Sundays, Mondays and assorted Thursdays.

A noble cause, right? And, yet, the reception he’s gotten so far from the league has been chillier than one of those old metal Foxboro Stadium bleachers in the fourth quarter of a December night game.

‘‘Sometimes,’’ he said, ‘‘it’s frustrating.’’

From his office in Weymouth—Tom Brady could stand in the parking lot and hit South Shore Hospital with a deep throw—Maher has made thousands of trips down to Foxboro to outfit countless Patriots with his patented mouth guard.

About 40 players used it last season, he said. The first one to sign on: Running back Vagas Ferguson, way back in 1980.

It’s a device, Maher said, that’s simple and effective—two small pieces of acrylic that fit over the back four teeth of each side of the lower jaw, linked by a thin ‘‘lingual bar’’ that rests behind the front teeth and allows better breathing and communication than the conventional wraparound mouth guard.

It’s not cheap—$400 a pop, which includes an analysis of the jaw alignment and a custom fitting—but that seems a small price to pay if, in fact, it can stop gray matter from being scrambled inside helmets.

After all, the NFL has seen enough of that. Al Toon, Wayne Chrebet, Troy Aikman, Steve Young, Trent Green, Dan Morgan, etc., etc.—a sad litany of careers either prematurely ended or interrupted by the trauma of brain injuries.

The league estimates that there are about 100 concussions per season. How many of those are inevitable and how many could be prevented? No one knows for certain what the long-term implications are for players who have been concussed multiple times, but evidence is mounting that in some cases there might be a steep, potentially fatal, price to pay down the road.

Maher would like to offer some suggestions, but even as the NFL seems to be moving toward a more enlightened approach to concussion research, the former Holy Cross wrestler and rugby player finds himself on the outside looking in.

NFL spokesman Greg Aiello said the league is ‘‘always interested in looking at new ideas, new technology, new equipment.’’ Yet Maher has had two grant applications denied by the league—he said he requested $30,000 in 2004 and $89,000 in 2006 to conduct wide-ranging studies on the mouth guard—and he was not invited to speak at the league’s much-anticipated concussion conference in Chicago.

‘‘Dr. Maher has been banging the drum about this for a fairly long time,’’ said Dr. David Bell, the Cincinnati Bengals’ team dentist who last season began outfitting a handful of his players with Maher’s mouth guard. ‘‘It seems to make a lot of sense, but the research has been kind of light. The NFL easily could take a more proactive position and give more help to the players.’’

Point of aggravation

Maher’s main beef with the league is that in studying the causes of concussions it ignores the role of the temporomandibular joint (TMJ)—the meeting place of the lower jaw and the skull.

TMJ is Maher’s specialty, and it’s the basis for his mouth guard. Yet he is appalled that no one versed in the subject is on the league’s controversial, 14-member Committee on Mild Traumatic Brain Injury—a group that critics charge has downplayed the effects of concussions in order to limit the league’s liability in case of a class-action suit by former players.

‘‘I don’t expect they understand the biomechanics of the TMJ very well,’’ Maher said, ‘‘and it’s a piece of the puzzle. I think it’s a big piece of the puzzle, and to ignore any piece of the puzzle is not good science.’’

Maher said there are three ways to sustain a concussion—by a blow to the jaw, by a blow to the head, or by a whiplash effect on the neck. Maher’s mouth guard attempts to prevent the jaw-based concussions.

According to Maher, the NFL has said that those account for 70 percent of all concussions in games.

Maher’s mouth guard brings the lower jaw slightly forward, moving the condyle (the nobby tip of the jaw) to rest against a slightly thicker portion of the skull, thereby providing more cushioning. The mouth guard also ensures that the condyle does not slip off the thin disk of cartilage that is supposed to sit on top of it and act as a ‘‘shock absorber.’’

The point is to make the jaw absorb and dissipate the force of a blow that otherwise would radiate upward into the skull, where it could rattle the brain.

Maher said the NFL’s recent vow to make players tighten their chinstraps—a move the league’s researchers say will limit concussions—could actually exacerbate them.

If a player’s condyle were not properly aligned with the cartilage disk, Maher said, scrunching the jaw and the skull closer together would just increase the energy that would be transferred to the brain in a collision.

‘‘This stuff is so simple,’’ he said. ‘‘It makes so much sense. When I explain this to another dentist, they’ll say, ‘It’s just logical.’ I know. I’m not this great scientist that has invented nuclear physics here. It’s pure biomechanics.’’

Long list of admirers

Maher might not be feeling any love from the NFL, but he isn’t lacking for admirers.

—Mahercorlabs.com, the Web site for his company, Mahercor Laboratories LLC, is full of testimonials from Patriots players past and present—everyone from Dan Koppen and Asante Samuel to Dan Graham, Lawyer Milloy, Matt Chatham, Vincent Brisby, and Hall of Fame guard John Hannah.

Samuel, currently embroiled in a contract dispute with the team, says in his endorsement that he had suffered three previous concussions but hasn’t had one in three years since using the Maher mouth guard.

—Former Patriot Michael Haynes, the NFL’s vice president of player development, has gone to bat for Maher in the league office, albeit unsuccessfully so far.

‘‘Hopefully, some positive stuff will come out of it,’’ Haynes said last week. ‘‘It worked for me.’’

—Duxbury High School football coach David Maimaron swears by it. After the Green Dragons suffered a rash of concussions, Maher began outfitting some players before the 2005 season. Maimaron said no player wearing the guard has been concussed.

‘‘From what I’ve seen, first-hand experience, it works,’’ he said. ‘‘I think it’s a no-brainer. Every kid should wear it.’’