Despite big prize money and lucrative endorsement contracts, elite athletes are struggling to look after their teeth.
A report published today in the British Journal of Sports Medicine claims the dental health of the world's top professional sportsmen and women is on a par with non-athletes living in poor communities who can't afford to regularly visit a dentist.
A number of factors are blamed, including high-carb diets, acidic sports drinks, a heightened risk of eating disorders and even having a dry mouth whilst competing.
The report was commissioned after the London 2012 Olympic Games, where almost a third of all medical visits where for dental issues, second only to the expected musculoskeletal problems athletes regularly deal with.
After looking at 39 published studies on the topic, the authors came to the conclusion there is a lack of education for athletes about the importance of good dental health and how it can affect performance.
"With clear psychosocial impacts of oral health, it would be surprising if training and performance were not affected in those athletes with poor oral health," they wrote, adding that at the elite level, problems with dental health could be the difference between winning and losing.
Particularly at risk are athletes competing in sports with an aesthetic component, or in which performance and weight are closely linked – such as boxing, horse riding and gymnastics – due to athletes' use of extreme diets to lose and gain weight as required.
"It is therefore critical that elite athletes are screened for not only dental disease but what can be the ﬁrst/earliest signs of eating disorders that manifest themselves in the oral cavity," the report states.
Acidic, high-carb sports drinks are also suspected of contributing to tooth decay, particularly when used during or after activity which causes the mouth to dry out.
"Dehydration and local drying of the mouth during sporting activity might increase the impact of carbohydrates on cavities and acidic drinks on erosion by reducing salivary ﬂow, or amount, and therefore impairing the protective properties of saliva."
Exercise itself could also prevent microbes in the mouth from fighting periodontal disease by temporarily suppressing the immune system.
The report also claims that athletes from rich countries are no less likely to suffer from dental health problems than those from poor countries, even though the solutions are "simple and cheap".
"To achieve a sustained effect, oral health should be embedded within other aspects of health promotion, taking into account the structural issues and inter-relationship of athletes within their sport and peer networks," the authors write.
"National sport funders and policy organisations should take a lead in integrating such an approach."
source: newshub archive