The Importance of Oral Health to Athletes’ Overall Well-Being: A Mini Review

Physical activity and sports participation have long been recognized as important components of maintaining optimal health and fitness and have gained attention as a recommended method for healthy living [1]. In recent years, the sports science community has devoted much attention to research on various exercise practices aimed at promoting healthy living, weight management, and overall health, as well as training programs designed for high-level athletic performance [2,3]. Both amateur and professional athletes worldwide participate in regular exercise regimes or scientifically designed training programs to achieve health and performance goals and aim to improve their sporting performance [4]. To take full advantage of the numerous benefits of regular exercise, including improved muscle strength and cardiovascular endurance, it is important to implement training programs in a manner that is both physiologically balanced and health-conscious [5]. However, recognizing that intense training programs can potentially lead to negative health outcomes and increase the risk of injury when undertaken without appropriate health considerations, and the need to protect athlete health is of paramount importance [6]. In this context, one of the often overlooked but critical aspects of an athlete’s overall health profile is oral health.

Oral health is increasingly recognized as an important factor affecting both overall health and exercise performance for athletes at all levels [7]. Research suggests that oral and dental health problems may have direct effects on the athlete’s quality of life and general health status, and it is emphasized that oral and dental health is closely related to the cardiovascular system but also to overall health [8]. It is therefore imperative that oral health be considered an integral component of an athlete’s comprehensive health management strategy, with potential implications for both overall well-being and sports performance [9]. Sports professionals and healthcare providers can contribute to a more holistic approach to athlete care by integrating oral health considerations into athletic training and health care programs. This approach not only supports optimal performance but also long-term health and well-being in the athletic population [10].

Recent clinical studies in medicine and dentistry have shed light on the complex relationship between oral health and athletic performance. These studies have revealed considerable information regarding the potential consequences of certain nutritional strategies commonly used in sports [11]. Specifically, the practice of high carbohydrate consumption intended to provide enhanced energy support for superior athletic results may inadvertently contribute to oral health problems among athletes [12]. It is widely accepted that excessive carbohydrate intake in sports nutrition, although beneficial in terms of providing energy, can be a significant risk factor for various oral health problems. These problems include, but are not limited to, periodontal diseases and dental caries, and can cause many other oral and dental health problems [8]. Frequent consumption of high-sugar sports drinks and energydense foods, which are often at the center of these nutritional approaches, is an issue that needs to be carefully considered, as it creates an oral environment that leads to bacterial proliferation and demineralization of tooth enamel [13]. Additionally, emerging evidence suggests that potential suppression of the immune system resulting from prolonged and intense exercise regimes may increase the risk of developing oral health problems [14]. This immunological effect, combined with nutritional factors, is bound to create a complex interplay of variables that can affect an athlete’s oral health status and, in turn, their overall performance and wellbeing. Moreover, the potential suppression of the immune system resulting from long-term and intense exercise regimes increases the risk of developing oral health problems [15].

In recent years, scientific research on athlete health has increasingly focused on the effects of oral and dental health on general athlete health and performance, and clinical studies in the field aim to explain the potential effects of oral and dental health problems on the health status and competitive performance of athletes [8]. These ongoing studies underline the importance of integrating oral health considerations into comprehensive athlete care programs. From a preventive medicine perspective, regular and timely oral and dental health checks are very important for athletes in order to reduce the risk of oral health problems and their potential consequences on athletic performance, and utmost care and discipline in this regard is essential [10]. Numerous studies have demonstrated the positive effects of routine oral health care on both athlete health and sports performance, repeatedly highlighting the need for proactive oral care strategies in athletic populations [16]. It is important to remember that the importance of oral health extends beyond athletic performance and plays an important role in overall health and well-being. Research has shown that individuals with common oral health problems may be at increased risk for systemic diseases, especially cardiovascular disorders [17]. For this reason, it should not be overlooked that regular dental and oral health evaluations can contribute to reducing the frequency of sports-related injuries, as well as helping to create the physiological conditions necessary for a healthy life [18].

It has been observed that there is a growing recognition of the potential relationship between oral health and athletic performance. Many athletes have shared their experiences of how oral health issues can sometimes have a negative impact on their performance and overall well-being. In a significant number of articles examining the importance of oral health in relation to athletic performance, the potential impact of oral health on athletic performance is emphasized as being of utmost importance. Research has highlighted the prevalence of certain oral health conditions, such as dental caries, dental erosion, gum disease, and pericoronitis, among athletes [16,19]. These conditions can compromise oral health and potentially lead to significant physical discomfort, which may hinder an athlete’s ability to train effectively and perform at their best. Research has examined the impact of oral health on athletic success, with findings indicating a correlation between oral health status and performance outcomes [20]. Notably, two studies focusing on Olympic athletes highlighted the importance of maintaining good oral health for athletic success. These studies suggested that athletes with better oral health reported enhanced performance levels, which could indicate that oral health is a vital component of an athlete’s overall health strategy. In a broader context, a study that included both athletes and nonathletes revealed that approximately 8 out of 100 subjects reported that oral health problems impacted their exercise routines. More notably, 5 out of 100 individuals indicated that oral health issues had a substantial impact on their athletic performance [20]. These findings underscore the importance for athletes to consider oral health as a crucial aspect of their training and health maintenance routines. It seems that the findings might have implications for more than just individual performance. There is a possibility that poor oral health could have long-term consequences for athletes’ careers. Chronic oral health issues may lead to systemic health problems, which could affect an athlete’s longevity in their sport. For example, there is a link between periodontal disease and systemic inflammation, which can impair recovery and increase the risk of injury [19]. Therefore, it may be beneficial for athletes to consider proactively addressing their oral health as a way to enhance not only performance but also overall health and career sustainability.

Recent research in sports medicine and dentistry emphasizes the important role of oral health in athletic performance and overall health. Research shows that the most common oral health problems among athletes are tooth decay and periodontal disease [7]. These adverse health conditions can lead to poor oral health, which can have far-reaching consequences for both athletic performance and overall health [8]. The possible negative impact of poor oral health on athletic performance is a growing concern in sports science and it is of great importance to take urgent measures in this regard. Untreated oral and dental problems can negatively impact various aspects of physical activity, including muscle mass, strength, and function [21]. Furthermore, the effects of poor oral health can extend beyond immediate performance, potentially impacting the athlete’s long-term health and career longevity [16]. In light of these findings, it is critical that oral health issues in the athlete population be addressed quickly and effectively. Effective measures on athlete health should be implemented by integrating preventive measures and early intervention strategies into comprehensive athlete care programs to reduce potential negative effects on performance and general health [22].

Recent clinical studies investigating the relationship between oral health and sports performance have revealed interesting insights into nutritional practices commonly used in elite athletics. High-carbohydrate diets, which are frequently used to provide increased energy support for increased athletic performance, may inadvertently present challenges to oral health [11]. Although these nutritional programs aim to optimize energy availability and athletic results, they can potentially contribute to oral health problems if not carefully managed [23,24]. It is generally accepted that excessive carbohydrate consumption, a frequently used sports nutrition strategy, may be a risk factor for a variety of oral health problems, including periodontal problems and dental caries [12]. Frequent consumption of high-sugar sports drinks and energydense foods, which are often at the center of these nutritional approaches, can create an oral environment conducive to bacterial growth and demineralization of tooth enamel [13].

Recent research in sports medicine and dentistry has underscored the significant impact of oral health on athletic performance, revealing a complex interplay between oral conditions and overall well-being. Tooth decay and periodontal diseases are among the most prevalent oral health issues faced by athletes, and these conditions have the potential to compromise not only their oral health but also their athletic capabilities. For instance, studies have shown that athletes with untreated dental issues may experience increased pain and discomfort, which can lead to decreased concentration and performance during training and competition. Moreover, the consequences of poor oral health extend beyond immediate athletic performance. Chronic oral diseases can contribute to systemic health problems, including cardiovascular disease and diabetes, which are particularly concerning for athletes who rely on optimal physical condition for peak performance. For example, the inflammation associated with periodontal disease can lead to systemic inflammation, which may affect muscle recovery and endurance. This underscores the importance of maintaining good oral hygiene as part of an overall health regimen for athletes. In light of these findings, it would be beneficial for sports organizations and teams to consider integrating dental health assessments into regular health check-ups for athletes. This could be a valuable step in facilitating the early identification and management of oral health concerns, with the aim of preserving performance and ensuring long-term health.

Furthermore, education plays a vital role in this initiative. Athletes, coaches, and support staff should be informed about the importance of oral health and its direct correlation with athletic performance. Workshops and informational sessions can be implemented to raise awareness about proper oral hygiene practices, the significance of regular dental visits, and the potential impact of oral health on overall athletic success. From the perspective of sports medicine and athlete health, a more detailed approach to oral and dental health is not just beneficial but essential. By recognizing the potential effects of oral health on athletic performance, we can develop more comprehensive health strategies that encompass both physical and oral health. Through appropriate preventive and interventional measures, we can optimize the health and performance of athletes across various disciplines, enhancing not only their athletic capabilities but also their overall quality of life. Fostering a culture that values oral health as a critical component of athletic training and performance will contribute to the longevity of athletes’ careers and their overall well-being.

We would like to express our special thanks to Evangelia STAVROPOULOU for her very successful contribution to the literature research process and unique academic support in the publication during the process of this review article.

1. World Health Organization (2020) WHO guidelines on physical activity and sedentary behaviour.
2. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, et al. (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise 43(7): 1334-1359.
3. Pedersen BK, Saltin B (2015) Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports 25(S3): 1-72.
4. Mujika I, Halson S, Burke LM, Balagué G, Farrow D (2018) An integrated, multifactorial approach to periodization for optimal performance in individual and team sports. International Journal of Sports Physiology and Performance 13(5): 538-561.
5. American College of Sports Medicine (2018) ACSM's guidelines for exercise testing and prescription. (10^th edn), Wolters Kluwer, Netherlands, pp. 1-480.
6. Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, et al. (2016) How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. British Journal of Sports Medicine 50(17): 1030-1041.
7. Needleman I, Ashley P, Fine P, Haddad F, Loosemore M, et al. (2015) Oral health and elite sport performance. British Journal of Sports Medicine 49(1): 3-6.
8. Ashley P, Di Iorio A, Cole E, Tanday A, Needleman I (2015) Oral health of elite athletes and association with performance: A systematic review. British Journal of Sports Medicine 49(1): 14-19.
9. Gallagher J, Ashley P, Petrie A, Needleman I (2018) Oral health and performance impacts in elite and professional athletes. Community Dentistry and Oral Epidemiology 46(6): 563-568.
10. Needleman I, Ashley P, Meehan L, Petrie A, Weiler R, et al. (2018) Poor oral health including active caries in 187 UK professional male football players: Clinical dental examination performed by dentists. British Journal of Sports Medicine 50(1): 41-44.
11. Burke LM, Hawley JA, Wong SH, Jeukendrup AE (2011) Carbohydrates for training and competition. Journal of Sports Sciences 29(sup1): S17-S27.
12. Moynihan PJ, Kelly SAM (2014) Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines. Journal of Dental Research 93(1): 8-18.
13. Bryson WJ, Brown RH, Grunau C (2013) Sports drinks and dental erosion. General Dentistry 61(3): 38-44.
14. Gleeson M (2007) Immune function in sport and exercise. Journal of Applied Physiology 103(2): 693-699.
15. Minty M, Canceill T, Lê S, Dubois P, Amestoy O, et al. (2018) Oral health and microbiota status in professional rugby players: A case-control study. Journal of Dentistry 79: 53-60.
16. Gallagher J (2017) Oral health of UK athletes and impact on performance. Monaco Abstracts 51: 320-321.
17. Dietrich T, Webb I, Stenhouse L, Pattni A, Ready D, et al. (2017) Evidence summary: the relationship between oral and cardiovascular disease. British Dental Journal 222(5): 381-385.
18. Aldossri M, Farmer J, Saarela O, Rosella L, Quiñonez C (2021) Oral health and cardiovascular disease: Mapping clinical heterogeneity and methodological gaps. JDR Clinical & Translational Research 6(4): 390-401.
19. Needleman I, Ashley P, Fine P, Haddad F, Loosemore M, et al. (2017) Infographic: Oral health in elite athletes. British Journal of Sports Medicine 51(9): 757.
20. Gay-Escoda G, Vieira-Duarte-Perreira DM, Ardèvol J, Pruna R, Fernandez J, et al. (2011) Study of the effect of oral health on the physical condition of professional soccer players of Football Club Barcelona. Med Oral Pathol 16(3): e436-e439.
21. Cullinan MP, Seymour GJ (2013) Periodontal disease and systemic illness: Will the evidence ever be enough? Periodontology 2000 62(1): 271-286.
22. Needleman I, Ashley P, Fine P, Haddad F, Loosemore M, et al. (2013) Oral health and impact on the performance of athletes participating in the London 2012 Olympic Games: A cross-sectional study. Br J Sports Med 47(16): 1054-1058.
23. Thomas DT, Erdman KA, Burke LM (2016) Nutrition and athletic performance. Med Sci Sports Exerc 48(3): 543-568.
24. Vitale K, Getzin A (2019) Nutrition and supplement update for the endurance athlete: Review and recommendations. Nutrients 11(6): 1289.