So yes, of course, oral hygiene matters. But it’s not everything, as new research in the BDJ reminds.

The study was just the latest to look at the oral health of elite athletes. It included Olympians and pros alike, representing 11 sports all together. But when it came to the state of their teeth, those 352 participants were a lot less elite.

Nearly half had untreated tooth decay. Almost all had early signs of gum disease. About a third reported their oral health having had a negative impact on their training and performance.

What makes this all the more surprising is that most of these athletes also reported practicing good oral hygiene. Nearly all said they brushed twice a day, while 44% reported flossing daily – figures much higher than for the general public. They don’t smoke. They tend to eat healthfully.

Yet, as a group, their teeth and gums were a mess.

And for that, much of the credit can go to the sports drinks, energy gels, and energy bars they frequently consume. Nearly 90% reported drinking the beverages regularly, with another 70% using gels and 59% using the bars.

Constantly consuming these often sugar-packed products mean a feast for the harmful microbes that live in even the cleanest mouth. That means more and longer exposure to the acidic waste they produce. Those acids destroy tooth enamel, leaving the teeth more vulnerable to decay.

Sugars also fuel the chronic inflammation that’s the hallmark of gum disease and acidify the extracellular matrix (terrain), further paving the way for a variety of health issues in the future.

These results echo those of earlier studies we’ve blogged about, which also pointed to other potential reasons for poor dental health among elite athletes. These include

  • Dry mouth, with less saliva protecting the teeth.
  • Carb-loading.
  • Bruxing (clenching and grinding), during times of exertion, as well as during sleep.
  • Stress.

In many cases, it may be a combination of factors, with high sugar/carb consumption being the most constant. All the toothbrushing and flossing and dental visits in the world are only going to be partly helpful at best if the body is constantly taking in sugars.

Those things still matter, of course. But there’s still bound to be plenty of damage to deal with. As one researcher has put it,

Without sugars, the chain of causation is broken, so the disease does not occur (Sheiham 1967). So, it is clear that sugars start the process and set off a causal chain; the only crucial factor that determines the caries process in practice is sugars. The other factors are additional factors that alter the primary effect of sugars, not alternative contributors (Sheiham 1987; Scheutz and Poulsen 1999)….

Image by Michael McCullough, via Flickr


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