Oral health and elite sport performance

Oral health: Poor oral health is common in elite athletes. Oral health is a basic right of athletes but has consistently been shown to be poor with a high treatment need. Dental caries, dental erosion, periodontal disease and pericoronitis (infection around impacted teeth) are the principal oral health conditions affecting athletes. Dental trauma in ‘at-risk’ sports is also recognised. The effect of poor oral health on athletes may have both short-term and long-term consequences. In the short-term, poor oral health can cause pain and distress, difficulties in eating and sleeping, reduced quality of life and impact on performance (see below). The long-term consequences include increased risk of tooth loss, increased treatment need and resulting functional and psychological impairments.
Causes of poor oral health: There are many challenges to the oral health of elite athletes, some of which act at the level of the athlete and others within the peer, community and sport organisational level. These issues include nutritional challenges from frequent carbohydrate intake and acidic sports drinks, impairment of host responses due to dehydration, mouth drying and intensive training, poor health behaviours and oral health literacy and lack of effective health promotion/preventive support.
Impact on performance: Emerging athlete self-reported evidence suggests that poor oral health negatively affects the training and performance of athletes. The mechanisms behind this effect might include pain, reduced well-being and quality of life and increased systemic inflammation.
Improving and maintaining the oral health of athletes: Oral diseases are preventable with well-characterised interventions at low cost. Some interventions are more dependent on behavioural change and adherence to care than others. To achieve a sustained effect, oral health should be embedded within other aspects of health promotion taking into account the structural issues and inter-relationship of athletes within their sport and peer networks. Such an approach could in addition achieve mutual benefits for general health, well-being and performance. Regular assessments of oral health by a dental professional, especially preseason, will allow for personalisation of prevention plans and early treatment of any disease. National sport funders and policy organisations should take a lead in integrating such an approach. Mitigation of risk approaches should also be investigated as part of an oral health strategy.