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Dental Health for the Endurance Athlete- Derek Hopkins

Most people involved in endurance sport do so to maintain or improve their overall health.  Endurance sport stresses the body in certain ways causing physiologic change leading to these health benefits. These same stresses may have implications for dental health.

A main area of consideration for dental health for endurance athletes is tooth structure health.  This area of health relates to tooth decay and erosion.  Both involve loss of tooth structure.  Decay is loss of tooth structure from bacterial acid production.  Erosion is loss of tooth structure from dietary acid or gastric (stomach) acid.

Long periods of training or racing cause metabolic events that can reduce salivary flow.  Saliva has a cleansing and buffering function for both acid and bacteria.  As salivary flow is reduced, the oral environment may become more acidic.  Dentists now believe that decay can happen because of many (possibly more than 300 different types of bacteria).  The process is due to the biofilm on teeth.  The pH of the mouth can select for bacteria.  The more acidic the oral environment the greater the selection pressure for bacteria who produce and live in an acidic environment.  This can lead to increased risk of decay.

Sport drinks are often low pH.  Some energy drinks  have a pH of battery acid.  In addition, they may contain citric acid which binds calcium.  This is a serious problem as the acid dissolves calcium from teeth and the citric acid binds it and takes it away.

To ensure that endurance sport activity does not have a deleterious effect on tooth structure, it is best to consult your dentist.  There are tests available to determine the decay risk of an individual’s bacterial biofilm.  There are management protocols to break up the biofilm, increase the pH and put selection pressure for healthier bacteria in the oral environment.  This can reduce the risk of decay.  Your dentist can also advise you related to use of sport drink and maintaining dental health.  The goal should be to enjoy the health benefits of endurance sport and not compromise dental health.

Dr. Derek Hopkins (DMD, MS, RDT, FRCD(C)) is a restorative dental specialist practising in Victoria, British Columbia.