Elite athletes have high rates of oral disease despite frequent brushing

Reviewed by Kate Anderton, B.Sc. (Editor)Aug 25 2019

Elite athletes have high rates of oral disease despite brushing their teeth more frequently than most people, finds a new UCL study.

The findings, published in the British Dental Journal, highlight potential for improvement as most of the athletes expressed an interest in changing their oral hygiene behavior to improve their oral health.

The UCL Eastman Dental Institute research team surveyed 352 Olympic and professional athletes across 11 sports, including cycling, swimming, rugby, football, rowing, hockey, sailing and athletics, when they provided dental check-ups for male and female athletes measuring tooth decay, gum health and acid erosion.

The researchers also asked athletes what they did to keep their mouth, teeth and gums healthy.

The dental check-ups revealed substantial amounts of oral disease as reported in a 2018 paper, finding that nearly half (49.1%) had untreated tooth decay, the large majority showed early signs of gum inflammation, and almost a third (32%) reported that their oral health had a negative impact on their training and performance.

Elite athletes have poor oral health despite their efforts to care for their teeth: this new study found that 94% reported brushing their teeth at least twice a day, and 44% reported regularly cleaning between their teeth (flossing) - substantially higher figures than for the general population (75% for twice-daily brushing and 21% for flossing).

The researchers found that the athletes regularly use sports drinks (87%), energy bars (59%) and energy gels (70%), which are known to damage teeth.

We found that a majority of the athletes in our survey already have good oral health-related habits in as much as they brush their teeth twice a day, visit the dentist regularly, don't smoke and have a healthy general diet.

However, they use sports drinks, energy gels and bars frequently during training and competition; the sugar in these products increases the risk of tooth decay and the acidity of them increases the risk of erosion. This could be contributing to the high levels of tooth decay and acid erosion we saw during the dental check-ups."

Dr Julie Gallagher, researcher, UCL Eastman Dental Institute Centre for Oral Health and Performance

The study builds on research carried out by the Centre since the London 2012 Olympics, led by Professor Ian Needleman. Previous findings have suggested that elite athletes may also face an elevated risk of oral disease from a dry mouth during intensive training.

Encouragingly, the surveyed athletes said they would consider adopting even better oral hygiene habits to tackle this and an intervention study has already been piloted.

Dr Gallagher said:

Athletes were willing to consider behavior changes such as additional fluoride use from mouthwash, more frequent dental visits, and reducing their intake of sports drinks, to improve oral health."

We subsequently asked some of them and support team members to help us design an oral health intervention study, based on contemporary behavior change theory and we will publish the results soon."

The Centre for Oral Health and Performance is recognized by the International Olympic Committee as an IOC Research Centre for Prevention of Injury and Protection of Athlete Health, jointly with the Institute of Sport, Exercise and Health and the National Centre for Sport Exercise and Health.

The researchers would like to think the athletes who participated and GB Cycling, GB Swimming, GB Rowing, GB Sailing, GB Gymnastics, GB Hockey, GB Athletics and GB Rugby Sevens plus England Rugby, Reading FC and Team Sky.