A healthy mouth supports top athletes’ performance and goals

By Nina Garlo-Melkas, communications manager, Koite Health

Research has showed a direct link between oral health and sports performance. Annimari Korte, a Finnish Olympic athlete, was disappointed when sports bodies such as her home country’s Olympic committee do not support the oral health of athletes like they support general health by paying for medical and physiotherapy services.

Korte said that insufficient information is the most significant reason sport organisations do not support their athletes’ oral health. She added, “Studies have shown that oral problems such as gingivitis and periodontitis reduce performance.”

a Finnish Olympic athlete Annimari Korte

Further, elite sport is said to be a significant risk factors for the onset of oral diseases. According to a study, caries is found in up to 70% of competitive athletes, dental erosion in almost 40% and severe gum disease, periodontitis, in up to 15% of top athletes. Various underlying medical conditions can hamper training results and impair sporting performance.

In 2004 Athens Olympics, the second most requested health service for athletes after physiotherapy services was dental care. In 2012 London Olympics, up to 55% of athletes had high caries levels, 76% had gingivitis, and 14% had periodontal disease.

One study examined the oral health of top Dutch athletes before the Rio 2016 Olympics. This study found that almost 50% of top athletes needed regular dental care and suggested that oral health screening — included in the overall preventive healthcare of elite athletes — is essential to ensure that athletes are healthy during competitions such as the Olympic and Paralympic games.

Despite the link between good oral health and athlete performance, oral health is not part of most nutrition curricula or integrated within athlete health strategies.

Inflammatory oral diseases such as gingivitis and periodontitis are common in top athletes. Oral diseases such as gingivitis and periodontitis have been reported to harm the performance of athletes. One reason is the pain and discomfort associated with oral diseases, making concentrating difficult and hampering training results. Links have also been reported between muscle injuries and poor oral health in athletes.

Physical strain attributes to the high prevalence of inflammatory oral diseases in competitive athletes. Heavy training increases the body’s stress levels, which directly affect oral health and susceptibility to the onset of various gum diseases. Physical exertion reportedly affects the composition of saliva during exercise and reduces its secretion. Frequent oral breathing during exercise and dehydration further contribute to dry mouth. All these factors predispose to tooth decay and enamel erosion, contributing to the onset of inflammatory oral diseases.

Saliva secretion has a variety of effects on dental health. Saliva prevents decay by restoring the pH of the oral cavity from acidic to neutral after eating and by helping to restore minerals dissolved by acids to the tooth surface. Saliva also removes 2-4g of microbes daily from the mouth and tooth surface to the digestive tract.

Dietary choices also contribute to the oral health of athletes. Rigorous training programmes require regular eating, supplemented by ‘sports nutrition’ such as carbohydrate gels and bars consumed during training. This strains oral health by increasing the number of daily acid attacks in the mouth.

Korte held the Finnish record in the 100m hurdles from 2019-2023

Korte also represented Finland several times in world championships. But she has not had an easy career, as a bout of illness forced her to take a five-year break from competing in 2012. The health challenges taught Korte the importance of overall well-being, including good oral health.

“Regular oral health professional visits would help detect oral health problems early. For example, severe and often asymptomatic periodontitis can be very detrimental to an athlete’s overall health and well-being,” said Korte, “At least primary dental care should be covered for competitive athletes, as it affects their overall health and sporting performance.”

Juuso Simpanen, a trail runner turned professional, echoed her views on the importance of oral health for athletes. “If your mouth is not in good shape, it will also hurt your results,” he added.

As an endurance athlete, Simpanen eats often to meet the high-energy demands of training. He said, “Consuming high amounts of energy exposes my teeth to constant acid attacks. That is why I pay attention to my oral health. I brush my teeth morning and evening, floss and use antibacterial photodynamic Lumoral-treatment regularly.”

In addition to heart disease, oral diseases are linked to lung disease, diabetes and metabolic problems in healthy people. Periodontal disease is a long-standing inflammation of the gums. Over time, the inflammation damages the attachment tissue of the teeth, causing the collagen fibres that hold the teeth to the jawbone to break. In the worst case, this will lead to tooth loss. Early signs of periodontal disease include reddened and swollen gums, bleeding of gums and bad breath.

Inflammation of the gums causes low-grade inflammation in the body, which is linked to vascular health and the performance of athletes. Oral bacteria lingering on tooth surfaces and gum pockets are spread throughout the body when teeth are brushed, and food is chewed. Even asymptomatic oral conditions can affect the health of the whole body.

“Statistics show that people with a healthy mouth live longer. Each missing tooth reduces life expectancy, [which is not often] talked about,” said Tommi Pätilä, a specialist in cardiac and organ transplant surgery at HUS New Children’s Hospital. He is one of the developers of the antibacterial Lumoral method.

According to Pätilä, it is estimated that up to two out of three people over the age of 30 suffer from periodontitis. This common gum disease can lead to tooth loss if left untreated, but it is also linked to severe heart events. According to a study, a first heart attack is 30% more common in people with periodontal disease than in healthy people of the same age.

The Lumoral treatment, developed by Finnish researchers, is said to improve dental self-care and oral health when traditional methods are insufficient. The Lumoral treatment can remove 99.9% of plaque bacteria from the surface of the teeth. Lumoral is a targeted treatment, which means that the normal and important bacterial flora in the mouth is preserved and simultaneously, gum inflammation is controlled.