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Endurance athletes may be more prone to tooth erosion and caries, researchers say

November 03, 2014

by Stacie Crozie

Although high level athletes — including runners and triathletes, are probably healthier than the average person, their training practices may put them at a greater risk of dental erosion and caries, according to researchers in Germany.

The study, Effect of Endurance Training on Dental Erosion, Caries and Saliva, published online June 11 in the Scandinavian Journal of Medicine & Science in Sports, evaluated 35 triathletes who trained at least five hours per week and 35 non-exercising individuals. Participants completed a questionnaire, providing their age, gender, height, body weight, oral hygiene practices and weekly training schedules. They also provided information on the beverages they drank and sports nutrition products used during training. All participants had clinical oral exams and had saliva output and pH testing during inactivity. Fifteen athletes also had saliva assessments during exercise. The pH of swimming pools used for triathletes’ training was also factored into the data.

Although the salivary output and pH of athletes and non-athletes was similar when they were inactive, athletes showed an increased risk for dental erosion and their salivary flow rates decreased and saliva pH increased significantly during activity. In addition, scientists said that there was a significant correlation between the cumulative training time of the athletes and their likelihood to have caries.

The effects of physical training and use of sports drinks and nutrition lower the pH of athletes’ saliva to levels where dental erosion can occur, said Dr. Cornelia Frese, lead author for the study.

“With a lowered intra-oral pH dental erosion and caries can occur,” said Dr. Frese. “We saw that the weekly training time correlates with caries prevalence. We assume that longer training time is consistent with a higher intake of carbohydrate sports bars, gels and drinks and this might cause a higher risk for caries.”

Dr. Frese also said that physiological changes in the athletes contribute to the problems.

“Exercise activates the sympathetic drive and suppresses the parasympathetic innervation of salivary glands,” she said. “Additionally athletes breath through the mouth during hard exercise and the mouth gets dry. If they consume sports nutrition/drinks at this moment saliva protection might be diminished.”

Athletes need a special oral health regimen, she said, and “use of a fluoride containing toothpaste is important. The fluoride in the toothpaste increases the resistance of tooth hard tissue against caries and erosive challenges.”

Your patients can find more tips on nutrition and good oral health, the benefits of fluoride and the importance of regular oral care and dental exams at MouthHealthy.org, the ADA’s consumer Web site.