Studies have consistently reported poor oral health in elite athletes, the detrimental effects of which not only impact their general health, but also their athletic performance. Balancing both dental medicine and sport, Zak Lee-Green is the perfect person to shed light on the topic. In addition to his career as a dentist, he is part of the Great Britain Rowing Team and has won two British Indoor Rowing Championships in a row, as well as a silver medal at the 2017 World Rowing Championships.
Dr Lee-Green, research has shown that dental caries, gingivitis and periodontal disease are more prevalent in elite athletes. What would you say are the causes?
As athletes competing at the highest possible level, the majority of our time is spent training, with an average of 16 training sessions per week. In order to fuel our bodies for this, we have to eat between 4,000 and 6,000 calories during the course of the day, which often includes simple sugars in the form of sports drinks and energy gels. The resulting plaque build-up, coupled with poor quality brushing, gives these dental health problems the perfect environment to thrive—and they often do so very quickly.
Can you tell me more about how oral health can influence athletic performance in general?
I think we should look at this in two different ways: acute and chronic influences. The acute influence is what we hear of most and can easily be linked to performance. For example, toothache, an abscess, peri-coronitis, all of which result in an athlete being pulled out of training or a competition. With a chronic problem, we are talking about the effects of persistent gingival inflammation on the body and the effects this may have on an athlete’s recovery and their ability to maximise their training. Whichever way you look at it, though, good oral health cannot be a bad thing!
What could be an effective way to motivate athletes to take care of their oral health?
As a dental team, we try to engage with as many of the athletes as possible and get as much useful information across to them as possible. Most athletes are very receptive to the idea that improving their oral health could improve their overall performance and few are willing to give that extra performance edge away! Empowering athletes to take care of their dental health seems to work much better than it does with the general public.
Have you or someone in your team experienced any problems in this regard?
I’ve seen a number of problems, ranging from a broken tooth to severe toothache, often with the added challenge of us being away on training camp or at a competition. We’ve had athletes miss training and even withdraw from the world championships due to avoidable dental problems.
How is the monitoring of an athlete’s oral health organised? And, what about your team specifically?
The athletes in the rowing team are responsible for organising their own dental care and there is no “organised” monitoring within the team or organisation. However, we see many of the athletes at our practice in Maidenhead. We also tailor our approach to ensure that the prevention advice and treatment each athlete receives maximises their oral health. In addition, we give dental health advice presentations regularly to ensure that athletes remember that their oral health is important.
What can sport organisations and athletes do themselves with regards to preventative oral health?
We have seen that by giving athletes tailored advice to maintain good oral health conditions and by demonstrating how their needs may differ from the general public’s needs has motivated them to give their oral health more attention. On our side, we can then use the tools we have available to us, such as fluoride rinses, high fluoride toothpaste and interdental cleaning aids to ensure good quality cleaning. As with the general population, these issues are easily resolved provided that our advice is acted upon and high standards of oral care are maintained. However, at youth athletes’ level, it becomes more difficult to have as much input as athletes are training at their own clubs and schools and are scattered across the country. It is therefore an additional job for coaches, parents, dentists and the athletes themselves to question their oral health and seek advice when required.
All in all, oral health is not just for athletes—we know that caries and gingivitis are easily solved and the benefits of having good oral health is no myth. Athletes are realising that it is another area for a potential small gain in their pursuit of being the best and with the input of tailored dental advice, I am confident that we can make big changes in the field.
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