Immediate Cervical Muscle Response to Optimal Occlusal Positioning: A Crucial Part of Concussion Risk Management

<b>Objectives:</b> Strong cervical musculature is recognized as a protective factor against sports-related concussions. Evidence suggests that jaw clenching may activate cervical muscles, potentially reducing head acceleration during impact. <b>Methods:</b> This observational cohort study examined the immediate effects of a customized interocclusal orthotic (CIO) on cervical muscle performance. Forty-two healthy adults (≥18 years) underwent strength and endurance testing with and without a CIO using a digital pressure gauge and six directional isometric contractions. Descriptive statistics and two-way repeated-measures MANOVA models were applied to evaluate condition effects. <b>Results:</b> CIO use produced significant improvements in cervical muscle strength and endurance across all directions compared to non-use. Forward flexion strength increased by 12.96% (<i>p</i> < 0.001, ηp² = 0.185), backward extension by 10.34% (<i>p</i> = 0.017, ηp² = 0.091), right rotation by 19.03% (<i>p</i> < 0.001, ηp² = 0.333) and left rotation by 19.86% (<i>p</i> < 0.001, ηp² = 0.353). Endurance gains demonstrated large effect sizes, with flexor endurance improving by 44.57% (<i>p</i> < 0.001, ηp² = 0.447). <b>Conclusions:</b> Optimized jaw alignment using a customized orthotic can elicit immediate, clinically meaningful enhancements in cervical strength and endurance, suggesting a promising adjunct for concussion risk mitigation in contact sports.