The Oral Health of Elite Athletes in Ireland

Abstract

Background The oral cavity has been described as the window to general health as many diseases and medications can impact the oral cavity (Kane 2017). There is a greater appreciation that these oral conditions can have a greater systemic impact than appreciated in the past. These conventional unidimensional concepts of health have been replaced by a more holistic approach (Brondani and MacEntee 2014). Athlete diet and training regimes have been tailored to achieving optimal physical performance (Barr and Rideout 2004). Unfortunately, the importance of elite athlete oral health for peak-performance to date has been widely underappreciated. Fortunately, as more research is published, more governing bodies and sporting bodies are advocating the importance of oral health in elite athletes due to their potential increased exposure to risk factors for oral diseases (Tripodi et al. 2021). However, few studies have examined oral health directly and no such studies have specifically focused on Irish elite athletes. Therefore, the aim of this study was to describe the oral health of elite athletes in Ireland, describe current oral health practices and habits and evaluate the impact elite athlete?s oral health had on training and performance.

Methods This was a cross sectional observational study undertaken at two training facilities in Ireland. Participant information leaflets were distributed to Irish elite athletes involved with the Sport Ireland Institute (formerly the Irish Sports Council) inviting them to participate in the study. Ethical approval was granted by Trinity College Dublin Faculty Research Ethics Committee. Following receipt of informed consent, a standardised clinical history and examination was collected followed by a brief questionnaire. Data was electronically collected using open-source software, KoBoToolbox (Kobo Inc, USA).

Results In total, 88 athletes from 8 sports; Boxing (22), Rowing (21), Cycling (1), Swimming (5), Paracycling (6), Cricket (31), Gymnastics (1), Triathlon (1), were recruited and examined clinically. Overall, the results demonstrated fair to poor oral health. Dental caries was present in 72.7% of athletes, with an average of 1.75 teeth per athlete requiring restorative intervention. Dental erosion was present in 19.3%, gingivitis in 46.6% and periodontitis in 53.4% of participants. In total, 39.8% of athletes had experienced pain from their mouth, teeth or gums in the last 12 months. These findings were largely in agreement with previous research carried out at the London 2012 Olympic Games (Needleman et al. 2013). However, athletes presented with more natural teeth on average (30.1) than the 25.1 natural teeth on average reported in the general Northern Ireland population as part of the most recent Adult Dental Health Survey in 2009 where they were included (Health and Social Care Information Centre, 2009). There was also a higher proportion of athletes (94.3%) that presented with 18 or more sound untreated teeth comparted with the 39% of the general Northern Irish population (Health and Social Care Information Centre, 2009). However, there was a much higher prevalence of bleeding on probing (80.7% vs 64%) in the elite athlete population and higher incidence of erosion (19.3% vs 15%). Moreover 27% of athletes expressed that their oral health had impacted on their quality of life. Interestingly nearly all athletes rated their general health as good or very good (96.6%), which was a much greater proportion than for their oral health, where only 67% of athletes rated their oral health as good or very good.

Conclusions The oral health of Irish elite athletes attending both training facilities for clinical examination was generally fair to poor, resulting in substantial negative impacts on training and performance. Further research in this field is clearly needed; involving a greater number of athletes and wider variety of sporting disciplines. Health promotion and disease prevention interventions are urgently required to meet the needs of elite athletes in Ireland.