A question of sportUncategorised
Posted by: The Probe 24th February 2020
As the 2020 Summer Olympics in Tokyo draw closer, the debate on how sport can have an impact on oral health is once again thrown into the fray. This has always been a hotbed of discussion, but now there is new evidence to suggest that the situation may perhaps be worse than was originally anticipated.[i]
The research carried out by the UCL Eastman Dental Institute found that of 352 Olympic and professional athletes surveyed, 49.1% had untreated tooth decay, while 32% felt that their oral health was having a negative impact on training and performance. A large majority also had early signs of gum inflammation,i but what’s most worrying of all is that this is in spite of good oral health practises.
As with other aspects of their life, it turns out that professional athletes are, for the most part, fairly fastidious about oral hygiene, with the report stating that 94% brushed their teeth at least twice daily and 44% regularly cleaned interdentally. When you consider that the figures for the general population are at 73% for twice-daily brushing and 27% for interdental cleaning,[ii] it’s amazing to think that athletes’ oral health is in such peril.
Of course, the problem isn’t necessarily because of their attitude towards oral health and daily routine, but rather as a result of practises associated with training and competing – diet being the main culprit. In order to compete at a high level, athletes are required to follow a strict regime that includes, amongst other things, sufficient consumption of carbohydrates that provide energy and healthy sources of protein.[iii] Typical foods include brown rice, fruit, pasta, fish, lean meat, eggs, beans and lentils, as well as cheese, yoghurt and milk – all of which are considered healthy when consumed as part of a balanced diet. However, during training and competitions, athletes also tend to consume snacks such as protein bars. While these are convenient to eat on the go and helpful in maintaining energy levels, they can be harmful to oral health – the reason for this being that they contain so much sugar. In fact, the sugar content of an average protein bar could rival that of some of the most notorious sugary treats.[iv]
The same goes for energy gels and sports drinks, which also form part of most athletes’ diets.i Between the sugar content and acidity (one study showed that this can range from 9.74-13.44 mls of 0.1M NaOH) of these drinks,[v] athletes are at extremely high risk of dental caries and tooth erosion – not to mention that the proinflammatory effects of a high carbohydrate diet can also increase the chance of periodontal disease.[vi] However, it’s not just diet that athletes have to be mindful of when it comes to their oral health – at least in certain sports anyway.
For athletes where there is a lot of airflow involved with their sport, it is not uncommon for saliva flow to be reduced, leading to local drying of the mouth and, in turn, complications such as caries and oral infections.[vii] This means that for cyclists, runners, triathletes and the like, there’s a lot more to worry about than just what they’re consuming. Let’s not forget either how athletes such as footballers have been found to be suffering in recent years. It was only in 2015 that a study revealed nearly 4 out of 10 top-level UK footballers surveyed had advanced tooth decay and 1 in 20 had irreversible periodontal disease.[viii] With all this in mind, it is clear that greater action and intervention is needed if athletes’ oral health is to be improved moving forward.
The news that an intervention study has already been piloted then – and that dental professionals have provided advice on increased fluoride use, more frequent dental visits and replacement of energy supplements with more oral-friendly alternatives – will be music to many people’s ears. What remains is for these recommendations to be passed down to amateur athletes so that they too can protect themselves against potential risks and maintain good oral health. While a typical patient may not be at risk on the same scale as a professional athlete or Olympian would, there is a chance that their oral health and daily regime could be in a worse state to begin with. We know, after all, that professional athletes typically have better oral hygiene routines than the general public.ii
If this is the case with your patients, or you are currently treating people who you know are active participants in sports, then an explanation of effective practises and demonstration of the correct techniques will go a long way. To achieve an effective clean easily and safely, Curaprox recommends the Hydrosonic Pro electric toothbrush. Boasting gentle CUREN® bristles and an intuitively designed brush head that enables the user to clean hard-to-reach areas, the Hydrosonic Pro is an ideal choice for any patient that needs a helping hand in maintaining their oral health.
Together with the profession’s continued vigilance on monitoring the nation’s oral health, from professional athletes and Olympians to the wider community, let us hope that we see some improvement in 2020 and beyond.
[i] Julie Gallagher, Paul Ashley, Aviva Petrie & Ian Needleman. Oral health-related behaviours reported by elite and professional athletes. British Dental Journal, 2019. Accessed online 16th October 2019 at https://www.nature.com/articles/s41415-019-0617-8
[ii] Simply Health. Consumer Oral Health Survey 2019. Accessed online 16th October 2019 at https://www.simplyhealth.co.uk/content/dam/simplyhealth/denplan/documents/simplyhealth-COHS-2019.pdf
[iii] NHS. Food and drinks for sport. Accessed online 10th October at https://www.nhs.uk/live-well/eat-well/food-and-drinks-for-sport/
[v] Rees J, Loyn T, McAndrew R. The acidic and erosive potential of five sports drinks. Eur J Prosthodont Restor Dent. 2005;13(4):186-90. Accessed online 16th October 2019 at https://www.ncbi.nlm.nih.gov/pubmed/16411577
[vi] Chapple ILC. Potential mechanisms underpinning the nutritional modulation of periodontal inflammation. J Am Dent Assoc 2009;140:178–84. Accessed online 16th October 2019 at https://www.ncbi.nlm.nih.gov/pubmed/19188414
[vii] Dodds M, Roland S, Edgar M, Thornhill M. “Saliva: A review of its role in maintaining oral health and preventing dental disease. BDJ Team volume 2, Article number: 15123 (2015). Accessed online 16th October 2019 at https://www.nature.com/articles/bdjteam2015123
[viii] Needleman I, Ashley P, Meehan L, Petrie A, Weller R, Mcnally S, Ayer C, Hanna R, Hunt I, Kell S, Ridgewell P, Taylor R. Poor oral health including active caries in 187 UK professional male football players: clinical dental examination performed by dentists. Br J Sports Med. (2015). Accessed online 16th October 2019 at bjsm.bmj.com/content/early/2015/10/01/bjsports-2015-094953.short?g=w_bjsm_ahead_tab
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