Oral Health tips for athletes

IMPORTANT ORAL HEALTH TIPS FOR ATHLETES:

It is critical to limit and then remove infection from your body if you want to achieve optimal athletic
performance. As an Elite Athlete, Weekend warrior, University athlete or School star athlete, you may consult with a performance coach, sports nutritionist and physiotherapist to achieve optimal physical and mental health. You must not forget your oral health.


Why is oral health important to athletes?


Oral bacteria are continually present in our mouths. Increased levels of training time and intensity can lead to higher use of pre- and intra- workout sports drinks, gels and bars to replace used energy. These workout supplements are high in carbohydrate ‘sugars’ which stick to your teeth providing food for oral bacteria. These oral bacteria also produce ‘acids’ which attack your teeth resulting in caries (holes) of your teeth, with time. If these carious lesions or ‘holes’ are left untreated, the nerve inside the tooth can be affected creating an abscess. Should there be enough tooth material left to save the tooth, root canal treatment will probably need to be followed by a crown. Understandably the above bacterial localised infection can result in severe pain and time needed for dental treatment. This is all time away from training and competition, as well as significant costs involved with treatment. Sports drinks have been reported to have PH’s of 2.4 – 4.5 which is highly acidic. This acidity will damage and weaken all tooth surfaces. This makes the teeth more susceptible to bacterial acid attack and dental erosion.
Signs of dental erosion are chipping of the edges of your front teeth (run a fingernail across the edge
of you front teeth to see if your tooth edge is smooth) and the formation of hollows or depressions
on the biting surfaces of your teeth. In severe cases of erosion, your fillings will start to stand out
from the surrounding tooth structure.


On the necks of the teeth, just above the gum, you may notice orange brown stains, this is due to
the enamel being eroded away. When you over-brush these areas in an attempt to clean there, you
will literally brush away tooth material as well. In severe cases this can lead to loss of gum and bone
around the teeth, called recession. Clenching your jaws together during intense periods of strength or interval training also causes accelerated wear of your teeth. This wear can be on the surface causing chipping and fracture of your teeth, as well as ‘abfraction’ where the enamel splits of the necks of the teeth above the gum line.

 

These have all been local factors that affect the teeth, gums and bone around the teeth.

There is however another disease of the oral cavity that can have far reaching and serious effects on
different organs of your body. Periodontal disease is a common oral disease that affects up to 50% of adults worldwide in one form or another, from bleeding gums initially, to moving and then loss of teeth in the most severe stages. To highlight the severity of the correlation between Periodontal disease and whole body health, the following research was published in February 2021. The authors reported that people with Periodontal disease who contracted Covid-19 were 3.5 times more likely to be admitted to ICU, 4.5 times more likely to need ventilation and almost 9 times more likely to die, compared to those without gum disease. Professor Nicola West, who is the Secretary General of the European Federation of Periodontology (EFP) is reported via the EFP as saying. “This study highlights another association between gum disease and our systemic health and reiterates the need for ongoing, lifelong dental care for people susceptible to gum disease and a strong preventative approach to periodontitis for populations as a whole”.


Professor Mariano Sanz, who chaired the “Perio Workshop 2019” as reported by the European
Federation of Periodontology comments that “Periodontitis is a devastating condition which
leads not only to pain and soreness in the gums, but also to chewing problems, unpleasant
changes to tooth length and position, poor self-esteem, withdrawal from social activities, and an
increased risk of other inflammatory conditions including diabetes.”


These chronic inflammatory conditions can severely affect optimal athletic performance.
The European Federation of Periodontology advocates the following to prevent gum disease:
- Brush your teeth carefully more than once a day using a manual or powered toothbrush.
- Clean between your teeth daily using an interdental brush (or floss)
- Specific mouth rinses or tooth pastes can be used on top of cleaning to reduce inflammation
- Do not smoke, maintain a healthy weight, eat a balanced diet, exercise, reduce stress.
- If you have diabetes, control your blood sugar.


In addition, we recommend that you see your dentist ,at least every 6 months, to check for
Periodontal disease, caries, erosion and recession.


We wish you every success in your pursuit of optimal general and oral health and your sporting
goals.

Athletes and oral health:


You train intensely, giving your best efforts, you eat a well balanced diet and consult with your
performance coach. How should you care for your teeth and mouth in an attempt to maintain
athletic performance and oral health.

- Brush your teeth well at least twice a day
- Clean between your teeth at least once a day well with dental floss

- Ask your dentist about mouth rinses, toothpastes, pastes/gels to reduce bacteria and strengthen the teeth
- Eat properly and ensure that you have sufficient carbohydrates the day before you train, so that you need to use less sports drinks, gels or bars during your training. Remember that
sports drinks are generally acidic, while drinks, gels and bars are all high in ‘sugars’. The acidity and sugars are both detrimental to oral health.
- Don’t rinse your mouth or ‘swish’ with the sports drink. A triathlon bottle with pipe/straw will help to limit contact of the drink with your teeth.
- Rinse/swish your mouth well with water after a sports drink, bar or gel. This helps to wash the acids and sugars away. The stickier the gel or bar, the longer the sugar will stick to your
teeth.
- Mix your sports drinks with cold water where possible. This decreases the acidic effect. Citric and malic acid in the sports drinks contributes to overall acidity and therefor tooth damage
- Do not brush your teeth for at least an hour after having sports drinks, gels or bars. The 'softened’ enamel can be more easily removed.
- It is recommended not to use a whitening toothpaste within an hour of using your sports drinks, gels and bars. These may be more abrasive and may cause further damage if used.
- Yoghurts, milk, cheese will help to protect the affected tooth surfaces.
- Avoid dehydration. Not only will this dangerously affect your athletic performance, but your saliva flow will be reduced. Saliva is important to wash away the acids and sugars, as well as neutralise the acids from sports supplements and oral bacteria.
- Discuss your athletic goals, training and oral health with your dentist.
- Due to the higher risks of oral damage associated with increased training, it is critical that you consult with your dentist more regularly.


Muscle strength, flexibility, balance and jaw position:


It has been reported, as recently as December 2020, by the BMJ Open Sport and Exercise
medicine publication which is the official journal of the British Association of Sport and Exercise medicine (BASEM), that jaw position affects muscle strength, flexibility and balance.
The BMJ researchers reported that on average the lower jaw physiologic rest bite had a statistical significant positive effect on athletic performance. On average the physiologic rest bite provided an increase of 5.8% in lower body power, an 10% increase in upper body power, a 14% increase in hamstring flexibility and a 4.8% increase in  balance and stability, compared to the habitual bite.


We look forward to welcoming you to our High Performance Dental Practice and sharing your
unique journey with you!