Did you know that runners are actually MORE PRONE to serious dental problems than the rest of the population? Dr Nigel Carter OBE, Chief Executive of the Oral Health Foundation explains how a healthy mouth equals a healthy body

Dr Nigel Carter

Dr Nigel Carter OBE BDS LDS (RCS)

Inside the runner’s mouth – a tale of sugar and acid

A study of almost 300 athletes at the London 2012 Olympics reported that a majority displayed “poor oral health,” including high levels of tooth decay, often in conjunction with gum disease and erosion of the tooth enamel. The study, published in the British Journal of Sports Medicine, suggested cavities, tooth erosion and gum disease were common amongst high level athletes. What is especially worrying is that a fifth of the athletes surveyed indicated their oral health actually damaged their training and performance.

The beaming smiles of gold-medal winners Usain Bolt, Jessica Ennis-Hill and Mo Farah are some of the defining memories of London 2012 but behind many athletes’ smiles are serious oral health problems which may inhibit performance.

For the cause of all these problems, we must look towards an athlete’s diet. As you know, the diet of a runner is vitally important: it gives you the fuel to run, the means to recover and the ability to relax. But there can be major issues with what you consume.

As mentioned earlier, sugar is the enemy to our oral health; this is because sugar causes tooth decay. Tooth decay happens when sugar reacts with the bacteria in plaque on your teeth. This forms acid which attacks the teeth and destroys the enamel. After this happens many times, the enamel breaks down, forming a hole or ‘cavity’ into the soft and sensitive dentine underneath. Tooth decay almost always leads to the tooth needing to be filled or even removed! Many of the energy drinks and gels you may use to fuel your muscles and improve your performance have incredibly high levels of sugar so by using them you are at a higher risk of developing tooth decay.

Apart from the sugar, another big problem that runners face is the acids in their diet. Many of these drinks and gels contain phosphoric or citric acid which have a terrible effect on teeth.

You obviously don’t want to expose your teeth to acid at the best of times, but by using these drinks that is exactly what is happening and this leads to tooth erosion. Erosion is the loss of tooth enamel caused by acid attack. When the enamel is worn away it exposes the dentine underneath. Because the dentine is sensitive, your teeth will be more sensitive to heat and cold, or acidic and sugary foods and drinks. This heightened sensitivity also suggests that the nerves of the teeth are irritated and inflamed.

Other issues

Apart from sugar and acid, scientists also point to some other reasons why athletes may at high risk to serious dental health problems.

Runners are heavy breathers; it’s something you can’t escape but did you also know that this may be having a negative effect on your oral health as your gasping for that oxygen?

Breathing rapidly through the mouth reduces the saliva flow leading to dry mouth; a dry mouth is the perfect breeding ground for bacteria, combined with the sugar through sipping on a drink the mouth becomes filled with decay causing bacteria.

Other stresses on the immune system by training may also put you at risk of oral diseases. You spend so much time fixated on your training routine that you ignore what is going on in areas of your body not directly related to it. Then when a problem does occur in one of these neglected areas, it can become the very cause of a downturn in your performance.

Put protection in place

What is obvious is that you should try to avoid consuming sugary or acidic foods and drinks wherever possible to give your mouth the best chance of staying healthy, but sometimes as runners this may be unavoidable. A focus then needs to be on neutralising the effects of the sugar and acids as quickly as possible.

Top tips for runners:

  1. Stay hydrated – Essential in many aspects of running and a simple and highly effective way of protecting your teeth before, during and after training.
  2. Be patient – After you eat or drink anything acidic the enamel on your teeth is softened. Brushing within this time brushes away particles of enamel leading to dental erosion. Wait an hour after eating or drinking anything to brush your teeth to give the teeth a chance to recover.
  3. Try not to snack and sip – Difficult if you are running a marathon or an ultra… but if you sip a sugary drink over the course of a few hours, you never give the teeth a chance to recover and expose them to constant attack. Try to consume sugary and acidic food and drink in one go and if possible as part of a meal.
  4. Limit – Only have sports drinks and gels where strictly necessary to minimise the time your teeth are exposed to harmful sugars and acids.
  5. Chewing sugar-free gum helps to promote the production of saliva which neutralises acids. Chewing after eating or drink anything is a great way to help look after your teeth on the go.
  6. Rinse your mouth with water after consuming sugary food and drinks to rise off any sugary residue which can attack you teeth over an extended time.
  7. Brush for two minutes twice a day with a toothpaste containing between 1350-1500 parts per million of fluoride. If your teeth are really sensitive you should use sensitive toothpaste as your main toothpaste and a soft toothbrush.
  8. Ask your dentist – Let them know you’re a runner and discuss ways to prevent tooth decay.