John Patalak’s phone began blowing up with texts before post-race inspection ended last year at Watkins Glen International.

By Monday morning, NASCAR’s vice president of safety engineering had messages from several Cup Series drivers who had worn mouthpieces to measure head motion and impacts during the race at The Glen.

They all wanted the data recorded by those mouthpieces during 90 laps around the 2.45-mile road course.

“Which was unusual,” Patalak said, “because none of those drivers had crashed.”

In fact, the Aug. 20, 2023, race at Watkins Glen had no wrecks — but a plethora of Cup Series stars felt as if they crashed. Among those was Kyle Larson, who typically requested his mouthpiece data after superspeedway crashes but never for a race in which he avoided the wall.

“For Watkins Glen, I really wanted to see it, because it felt like I was crashing multiple times a lap,” Larson said. “So yeah, the data was very eye-opening and good to show NASCAR.”

The numbers bore out his concerns. The Watkins Glen mouthpiece data took longer to download because it was so voluminous, showing nearly 1,000 impact events were recorded in the “Bus Stop” — a jarring revelation given there were about 3,400 total events recorded during the entire 2023 season at all tracks.

“By Tuesday, we were pretty blown away,” Patalak said. “Over a quarter of our season’s mouthpiece sensor events were coming from one location on one track. So that started the Bus Stop reconfiguration. We pulled a lot of video and talked to a lot of drivers in the following days.”

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Planning to modify that section of the track for 2024 started within days. After being tested in June, a new configuration (which removed elevated rumble strips and added smoother curbing transitions) will be in place as the Cup Series returns this weekend.

It’s among the best examples of how the mouthpiece sensor, which was developed by a Wake Forest University School of Medicine Biomedical Engineering research team and has been worn by at least 10 drivers in every race since the 2023 season, is making an impact in NASCAR safety enhancements.

Though it’s literally invisible when compared with high-profile safety technology such as the SAFER barrier, the HANS device and the now ubiquitous cockpit cocoons that keep drivers secure in crashes, Patalak believes the mouthpiece sensor could be just as prominent in reducing potential injuries by helping chart a path forward for future R&D.

“The more data we can get, the better informed our analyses and decisions and the tools we use become,” Patalak said. “The mouthpiece sensor in and of itself makes the driver no safer at all in the race car at that moment. But we’ve got to decide each year on our priorities in making things safer. It dictates all of that.”

Initially resistant to the concept of a foreign object in his mouth while racing 500 miles, defending Cup Series champion Ryan Blaney now has worn the device for more than a year.

“I was against it, but if it’s going to help us learn what the drivers go through in these wrecks, I’ll put this thing in,” he said. “I don’t like being the crash test dummy, but it’s good to have that data.”

How the mouthpiece sensor has taken hold

Similar to the Incident Data Recorder or “black box” that monitors what happens to a car during a wreck, the mouthpiece sensors are designed to measure what happens to a driver’s head. Both grew out of the safety revolution after Dale Earnhardt’s fatal wreck in 2001, but while black boxes became mandatory by 2002, technology took longer for accurately measuring forces sustained by a driver.

NASCAR initially considered earpiece sensors 20 years ago but preferred monitoring head motion through a mouthpiece on the upper dentition because of the upper jaw’s direct attachment to the skull.

As advancements in miniaturization led to more precise measurements of impact, Wake Forest University School of Medicine researchers engineered custom mouthpiece systems with a focus on youth sports (soccer, hockey, youth and high school football) as well as college women’s soccer (and also has dabbled in bull riding).

The School of Medicine team began designing the custom driver mouthpiece in 2018 in a partnership that started with Patalak attending the school in 2015 to earn his doctorate. He studied with Dr. Joel Stitzel, a biomedical engineering professor who would oversee the NASCAR project.

“NASCAR and NASA had done some work with the NASCAR crash database, and one of the academic groups doing research on behalf of NASA was Wake Forest,” Patalak said. “That was one of the first times I realized there is a group an hour up the road from Concord (N.C.) doing high-level simulation work on head injuries.”

The NASCAR mouthpiece is made at Hurst Dental Labs in Winston-Salem, North Carolina, and resembles a nightguard worn to prevent teeth grinding. But the mouthpiece is more flexible and thinner, though still stiff enough to optimize data collection.

Because drivers don’t have as many breaks to pop out their mouthpieces and relay information (as an NFL quarterback might do to call an audible at the line of scrimmage), a primary concern was ensuring clear radio communication without compromising the sensors.

During the first five years of mouthpiece development (which was delayed by the pandemic), Stitzel said the team went through several iterations for NASCAR before landing last year on a minimalist model with exterior instrumentation for a tighter fit.

Drivers who wear the mouthpiece take a 5-minute scan in the preseason, but a makeshift mobile dental lab also has been used to help customize comfort and fit. Mike Hurst, the owner of the dental lab that manufactures the mouthpiece, was praised by Stitzel for often being on call at the track to make miniscule adjustments.

“A millimeter or two inside the mouth is very perceptible, and sometimes the drivers will want that change,” Stitzel said. “And Mike will shave off just a tiny bit, and it’s much better. It’s really an art.”

The mouthpiece has a battery that can run for six or more hours. During practices, data is continuously recorded to evaluate how the head reacts during laps without impacts and to measure bumps, areas where a car bottoms out and the G forces under cornering.

During a race, the recordings are triggered when a threshold of 4Gs is exceeded. “We have the threshold set quite low because we want to record a lot of data to make meaningful analyses,” Patalak said.

Said Stitzel: “We are concerned not just with concussions and injury-causing events but cumulative exposure to low-level impacts that the head experiences, and 99.9 % of those are not concussive.”

As many as a dozen researchers and students at Wake Forest have supported the NASCAR project, which is spearheaded by Stitzel and Dr. Jill Urban. There’s a representative from the university at every Cup event to distribute prior and collect and download the mouthpieces after each practice and race (or at the care center after a crash).

At least two drivers have said they preferred wearing the mouthpiece because their jaws ached less after races from no longer clenching their teeth. Patalak could tell the initiative had caught on when mouthpieces sometimes had to be tracked down because drivers “literally forgot it was in their mouth. For the core group that wear it week in and week out, it just became part of their weekly routine and didn’t bother them throughout the race.”

Drivers are driving the data collection, too

Blaney has been wearing a mouthpiece since the Aug. 26, 2023, race at Daytona International Speedway, where his device recorded his head acceleration during a severe crash. The Team Penske star laments being without the mouthpiece when he suffered a hard hit two months earlier at Nashville Superspeedway.

“They get the black box for the car, but the driver is a whole different thing,” Blaney said. “We’re the softest thing in the race car. We were still tweaking on the car between Nashville and Daytona, they had cut some gussets in the clip to try to crush it more, so I wish we could have got the data from Nashville. I was like, ‘Man, I’ve got to wear this just to give them some data on where to go with this car and continue to make it (safer).’ ”

Blaney removes his mouthpiece during every other caution “just to reset” but has encountered no issues with communicating. “It’s fairly thin, but there’s still wires running through it on the molar side,” he said. “I don’t speak too differently with it in, but I just didn’t want to have anything in my mouth for 500 miles. That was my only concern, but I just kind of got used to it after a while.”

Larson jokes he sometimes relays feedback with a lisp but doesn’t mind the mouthpiece because he already was accustomed to wearing a device to align his teeth, and “this is just a little bulkier.”

Joey Logano also became a regular user of the mouthpiece after initial awkwardness. “It kind of messed up my speech a little bit because it’s like you put your retainer in when you go to sleep,” the two-time Cup champion said. “They got it to where it’s pretty comfortable now. I was always nervous if you wreck and what if it fell out or you choke on it, but it’s fine.”

As a perk for participating, drivers have full access to their mouthpiece data that is kept in a cloud-based system. By the Monday afternoon after a race, they receive an automated notification via an app that a detailed race weekend summary is available with all recorded events (and highlighting the highest). For further review, drivers can reply directly to Patalak and Wake Forest researchers to set up meetings in person or via videoconferencing.

Unlike black box data (which can be requested by teams), only drivers have access to the mouthpiece data that is treated “as private health information,” Patalak said. “When the data is used for research, it’s anonymous and untraceable to a driver.”

In April, Larson used his data to provide context when a passionate discussion of the Watkins Glen changes erupted on social media. The 2021 Cup champion’s mouthpiece recorded 145 impact events through the Bus Stop, with Larson noting, “Something needed to be done. What was there before was not safe for the brain.”

Stitzel, who entered the biomedical engineering field because he wanted to protect people from injuries, said Larson’s post caused an enthusiastic stir in the team’s research lab.

“Most of the time, we’re writing papers and hoping people cite them and trying to get students through graduation. And to see him say, ‘Oh, this data mattered to me’ as something we’re doing to help NASCAR make the sport safe, that’s very rewarding to me. That’s the whole reason we’re doing this. It created some excitement throughout the lab.”

Zeroing in on the Bus Stop at Watkins Glen

During at least one and sometimes two of the apexes in the Bus Stop at Watkins Glen last year, Cup drivers were experiencing high G forces to both sides of the head in “a third of the time it takes to blink your eye,” Stitzel said.

During a June 26, 2024, test with Tyler Reddick, Daniel Suárez and Austin Cindric at Watkins Glen, Patalak said there were fewer events, and those recorded were of decreased severity. “I’m comfortable we will see an improvement in the (Sept. 15) race with the Bus Stop updates,” Patalak said.

Reddick also is confident of the improvements while “the nature of the Bus Stop remains intact. I appreciate them putting our safety first. It’s great they’re collecting this data. The more data they have, the more they can identify trends.”

Said Blaney: “It’s a good indication on just what your head goes through. It was interesting to me to look through it after Daytona with the NASCAR and Wake Forest folks and understand what it all means. That has definitely helped on changes with the car.”

After mouthpiece data showed drivers were experiencing cumulative impacts from successive front and rear collisions in restart stack-ups, NASCAR was spurred to develop new rear impact head surround foam that could reduce head impact forces by up to 50 percent.

“It made a really big difference in reducing head accelerations in those type of impacts,” Patalak said. “We had mouthpiece sensor drivers reach out and say, ‘Hey, didn’t feel good.’ They never went to the infield care center. So, we’re seeing sometimes the driver’s experience doesn’t match the eyeball test of a car with just a tire mark. So then we can look at the data and say, ‘This is unusual.’

“Then we can look at human body computer modeling data and design a drop test to improve the head foam because we know exactly how fast the driver’s head impacted the foam. That would have taken us way longer to understand without the mouthpiece sensor data.”

Using the device is voluntary, and up to 16 drivers currently wear the mouthpiece in races. Though a heavier lift logistically, Patalak said NASCAR could handle equipping the entire field weekly, and it’s his goal to have the mouthpiece participation rate at 100%.

“Having the data really helps us decide where we can get the most safety improvements the fastest,” he said. “It gives a glimpse into exactly what happens in a crash, and that makes it actionable. You can go to all the stakeholders and say, ‘This is what we’re pursuing, and this is the data behind it.’ It puts the wheels in motion quickly.”

Nate Ryan has written about NASCAR since 1996 while working at the San Bernardino Sun, Richmond Times-Dispatch, USA TODAY and for the past 10 years at NBC Sports Digital. He is the host of the NASCAR on NBC Podcast and also has covered various other motorsports, including the IndyCar and IMSA series.