Bad teeth hurt your sporting chances...

Is brushing your teeth part of your exercise regime? Well if not, it probably should be, because poor dental health can dent your athletic performance according to new research.  Consumption of sugar-filled energy drinks and gels could lead to tooth decay and immunosupression during intensive bouts of physical sessions could make you more susceptible to oral diseases.

Kat Arney spoke to Ian Needleman from University College London to brush up on the science behind this...

Ian -   We carried out a large research study at the London Olympics, London 2012 and we included about 300 athletes and we found perhaps surprisingly that their oral health was very poor.  They had high levels of tooth decay, erosion of the teeth and gum disease, and a level which would be similar to a disadvantaged population.

Kat -   This seems strange to me because you think of athletes maybe as more healthy than the general population but you're saying that their teeth and their gums are really not in a great shape.

Ian -   Yeah, that's right.  So, they may appear more healthy, but their mouths were actually appear worse than the general population.  Perhaps even more surprising to a lot of people is, we asked athletes to rate the impact of their oral health on their training and performance.  And about 20%, about 1 in 5, felt that it was affecting their training and performance.  That's 20% at that level of an elite athlete who have a goal of - they ended up 4 years of achieving a really fantastic goal is quite a striking finding.

Kat -   So, it's nothing to do with whether their ankles are giving in or anything.  It could just be their teeth affecting their performance.

Ian -   Well, that's right.  I think that when we're talking about elite athletes, small effects can make the difference between a gold medal or no medal at all.  Oral health is likely to be one of many things related to health and psychology which will have an effect on athletes.  We also know, we've heard from a lot of team doctors and from coaches and physios, there are - in  addition to these sort of small effects - a few athletes get catastrophic problems.  So, acute infections which then take them out of an event, out of training for a long period of time, but those kind of acute things, those catastrophic events don't happen to too many people.

Kat -   Is this across the board no matter where in the world the athletes come from?  Obviously, the Olympics is an international event.

Ian -   Yeah, that's right.  certainly, from our data, it does seem to be widespread.  We've also looked - we've carried out something called a systematic review which looks at all of the evidence that's out there in the research literature.  And again, the findings are very similar, whether it's a developing country or whether it was a developed country, whether it's a country which has a fantastic provision of dental care or whether there isn't much available.

Kat -   So, what's causing this because when I think about athletes, I think about people who are eating healthy diets and all this kind of thing and when I think about tooth decay, I think about people who are eating lots of sweeties and not brushing their teeth properly?  What's causing these problems in athletes?

Ian -   Well, we think there are a number of things and nutrition, certainly you're right to pick on that.  That seems an obvious candidate and it certainly seems to be one of the factors.  So, nutrition could be high carb diets, it could energy supplements and suddenly, tooth decay is one of the factors which seems to be a problem in athletes.  It's what we know about tooth decay and sugars is its frequency. Of course, athletes will often take quite a high frequency of carbohydrates.

Kat -   This could be things like energy drinks or gels I guess.

Ian -   It could be those energy supplements, but it could also be their diet.  So, I think it's important to look more sort of holistically at the nutrition.  The energy drinks will be part of that and the gels, but it's not just that.  it's the diet generally.

Kat -   So, as well as things that they might be eating - so maybe sugary drinks or something like that - are there any other things that may be impacting their dental health?

Ian -   So, in athletes who breathe hard, what's going to happen is that their saliva will be dried up and saliva is very protective.  It's got natural antibacterial substances and antibodies.  So, losing that protection puts people at greater risk of oral diseases.  And also, what we know is some really good evidence that during periods of really intensive training, it will have an effect of immune suppression.  So, your immunity, your immune response protection against the bacteria, will be suppressed for short periods of time.  So again, it could increase your risk of oral diseases.

Kat -   What can we do to address this because obviously, if this is impacting on athletes' health and their performance, and their well-being, surely, it will be a good thing to try and improve this?

Ian -   It's really important for all of us, but particularly for elite athletes to be thinking about nutrition and diet.  And what we're saying is that if you need energy supplements in the form of drinks or gels for performance or a training, then use them.  But there are times when you don't need them, for instance when you're rehydrating, water is good, or are they hypotonic drinks which have very low levels of added sugars.  So, just train smart essentially.