A study conducted at European University and published in the journal Sport Training finds that 46% have active dental caries and 70% have periodontal disease. Experts say the very context of high-performance sport is an independent risk factor for oral pathology.

Elite athletes’ oral health is significantly worse than would be expected, even in professional settings with continuous medical and nutritional follow-up, Fernando Mata, professor in the Department of Pharmacy and Nutrition at the European University of Madrid, Madrid, Spain, and Cristina López de la Torre, Department of Biomedicine and Dentistry, Faculty of Biomedical Sciences and Sports at the European University of Andalusia, Málaga, Spain, told El Médico Interactivo. Both authored a study on athlete oral health that was published in Sport Training.

The study shows a very high prevalence of dental caries, dental erosion, and periodontal disease, with average rates of active caries near 46% and periodontal disease that can exceed 70% in some groups. Poor oral health is not merely an aesthetic or isolated problem; it has direct repercussions on athletic performance, recovery, systemic inflammation, and overall health.

Diet

The authors note factors inherent to high-performance sport — including a diet high in sugars, dehydration, oxidative stress, and changes to the oral microbiota — promote the development of oral disease. They recommend integrating oral health and sports dentistry into the multidisciplinary care of athletes, since oral health can be considered a silent determinant of sporting performance and long-term health.

The highest-risk profile for poorer oral health includes athletes who train and compete very frequently, especially in endurance or high-intensity sports. Also at risk are athletes who consume excessive sports drinks, gels, and supplements rich in fermentable carbohydrates and acids, resulting in repeated exposure of their tooth enamel.

Dehydration

Experts also point out that it’s important to consider those who suffer dehydration during exercise, which reduces salivary flow and diminishes saliva’s protective capacity, as well as those with insufficient or irregular oral hygiene habits, often due to lack of time, awareness, or regular access to the dentist. Furthermore, this group includes those who use mouthguards for extended periods, as this can lead to changes in the oral microbiota if not properly cleaned.

Another element to consider is that poor oral health tends to be more frequent and severe in men, both in the general population and among athletes. According to Mata and López de la Torre, men show a higher prevalence of periodontal disease, while women generally exhibit better oral hygiene habits and greater adherence to preventive checkups, which could explain part of the difference. Nevertheless, the problem is relevant in both sexes, and the differences may be modulated by the type of sport, diet, and competitive level.

Young Adults

The highest prevalence is observed in athletes and young adults, generally aged between 20 and 35 years, coinciding with the years of peak athletic performance. This finding is especially relevant because these are ages in which general health is theoretically optimal, and the early appearance of caries, erosion, or periodontitis indicates that factors associated with sport accelerate oral deterioration.

In most cases, affected athletes do not have relevant preexisting systemic conditions. Poor oral health appears mainly associated with chronic oxidative stress induced by intense training, low-grade inflammation, and changes in the oral microbiota related to the athletic lifestyle. This supports the idea that the context of high-performance sport is an independent risk factor for oral disease, beyond preexisting illnesses.

Nutrition is a key factor in this relationship. Frequent consumption of fermentable carbohydrates like gels, sports drinks, and bars increases the risk for caries, and acidic sports drinks promote dental erosion, especially when consumed during exercise and with low saliva flow. By contrast, diets high in protein and dairy may have a partially protective effect on enamel, and omega-3 fatty acids exhibit an anti-inflammatory effect beneficial for periodontal health.

Reduced Performance

Poor oral health affects performance through several mechanisms, the authors note, including pain and inflammation that interfere with sleep, concentration, and recovery; systemic inflammation that can compromise training adaptation; a higher risk for muscle and joint injuries, especially associated with periodontitis in sports such as soccer; and a negative impact on quality of life and psychological well-being. All of this can translate into reduced performance, increased fatigue, and decreased competitive availability.

In conclusion, the authors of this study say that current evidence confirms that oral health is an essential component of an athlete’s performance and health, and neglecting it has consequences that go far beyond the oral cavity. Integrating dentistry, nutrition, and training is not optional but a necessity grounded in science.

Mata and López de la Torre reported having no conflicts of interest.

This story was translated from El Medico Interactivo, part of the Medscape Professional Network.