Dental Health and Performance

When I run workshops for young athletes encouraging them to take care of their general health and wellbeing, I advise them to look after their teeth and to visit a dentist regularly. Right on que, a hand will go up (often one of a parent), and I can predict what the next question will be. “What have teeth to do with performance?”

Yes Eliz, what have teeth to do with performance?

Well let me start with an extreme case. Alan Campbell…. British rower….training for 2008 Beijing Olympics…abscessed lower-left wisdom tooth… disaster! The infection from the abscess spread to his shoulder, back and later his right knee. The knee required surgery two months before the games and required Campbell to miss six weeks on-water training, in the run-up to what was meant to be the biggest race of his life. 

Campbell finished fifth in the single-sculls final in what may, forever, have been a case of ‘what could have been’. Thankfully, this story has a happy ending. Campbell won bronze in London four years later. And learned an important life lesson in the process: our teeth can not only ruin our sleep, they can trample all over our dreams.

Campbell’s case is not an isolated one. Empirical (controlled scientific studies done by the scientists) and anecdotal evidence (observations of those in the know, this case people like dentists) suggests that athletes have poor dental health. Their finely honed bodies, often epitomising the very picture of health, often cover up a mouth full of bad teeth.

Causes

There are a number of proposed reasons why high-performance athletes have bad teeth, though little research has been done specifically on the causes of poor dental health in athletes.

Direct impact or trauma is a major cause of dental morbidity in sportspeople. Impact sports such as hockey, basketball and rugby have a high incidence of broken teeth, and worse. 

This is the obvious stuff. But there is substantial poor dental health even in those who participate in sports which involve no person-to-person impact.

The high volumes of carbohydrates required to meet energy demands can have a negative effect on teeth, particularly when a large portion of those carbohydrates come in the form of sugary, acidic sports drinks, gels and energy bars.

Physiological changes which occur during exercise may also play a role. These include decreased salivary flow and drying of the mouth (saliva is needed to regenerate tooth enamel) and exercise-induced immune suppression.

Grinding of teeth when lifting weights, or generally at night from stress, may also wear down teeth.

And then there’s the practical things like not making oral health a priority. Frequent travel may lead to busy high-performance athletes missing their regular check-ups, or pushing them down the to-do list. 

And then there’s the expense of keeping your teeth in check. Athletes struggling to make ends meet may simple not be able to afford regular check-ups or the cost of any follow-up maintenance work required.

The role of eating disorders, particularly bulimia, which is not uncommon in sport, cannot be overstated. Stomach acid, which will come in contact with teeth during vomiting, has a catastrophic effect on teeth, and can erode away dental enamel in a relatively short time period.

Something else to bear in mind is that individuals generally have the most trouble with their teeth, especially problem wisdom teeth, from the early twenties to their mid-thirties, the age bracket in which the vast majority of high performing athletes fall.

Effects

Dental health has a direct effect on general wellbeing and quality of life. The effect on sports performances can be both direct and indirect. 

Pain - from sensitivity, cavities and abscesses -  is the most obvious consequence of poor dental health. This can lead to sleepless nights, effecting performance and training, and indirectly leading to an increased risk of injury. Pain and dental discomfort can affect eating, and can have psychological impact on performance.

Tooth and gum infections can lead to systemic inflammatory response – a condition which is closely related to sepsis – and which isn’t good for either your general health or your sporting performance. 

A mouth full of bad teeth can also make an individual self-conscious which doesn’t do much for confidence.

Recommendations

• Brush and floss regularly

• Have regular dental check-ups. Use the off season to get any work required done.

• If you participate in an impact sport, always wear a custom made mouth guard in potential impact situations (games and contact training)

• If you find yourself grinding your teeth at night, seek help, both in reducing the stress that is causing the grinding, but also in protecting your teeth. You may need to wear a mouth guard at night.

And keep smiling!

Some further reading:

Oral health and elite sport performance A Consensus Statement, Needleman et al, 2015.

'Garbage mouth': Why many Olympic athletes have terrible dental problems Leicester, 2016.