Are Endurance Athletes a Dentist’s Worst Nightmare? – iRunFar

Did my current root canal immediate this text? Probably. Has this matter been on my thoughts with every sip of sugary sports activities drink and each chunk of gummy sweet ingested throughout my ultrarunning profession? Most undoubtedly. The “sugary drinks trigger cavities” speak has been a standard narrative between endurance athletes and their dentists for a very long time — and one which till just lately appeared backed by science (4).

So, what does the science at the moment say and what do endurance athletes really want to fret about in the case of their oral well being?

The issues that gas our adventures within the mountains also can gas tooth erosion. Photograph: iRunFar/Eszter Horanyi

Why Is Oral Well being Essential?

After we consider oral well being, it’s possible we expect solely about dental caries (cavities), however oral well being goes effectively past tooth decay. When oral well being is poor, micro organism not solely work away on the enamel (exterior) and pulp (inside) of your tooth, however it might additionally trigger irritation of your gums, resulting in gum illness (periodontitis). Extra critically, it might result in different systemic situations, or ailments that go far past your mouth. These situations and ailments embrace endocarditis (an infection and irritation of the interior lining of your coronary heart), heart problems, and pneumonia. Primarily, good oral well being is sweet to your general well being and well-being.

Whereas that needs to be sufficient to get us all dashing off to floss and brush our tooth, poor oral well being has additionally been linked to poor athletic efficiency! A few of this affect is probably going because of ache and systemic irritation related to tooth decay and/or gum illness (2). And it’s widespread; 30% of all medical emergencies handled on the 2012 Olympic Video games have been induced by oral ailments (6). On the flip facet, different research present good oral well being to be correlated with higher performances and ends in ultra-endurance races extra broadly (5).

Stages of tooth decay

Tooth decay can begin small, slowly consuming into your enamel. Regularly over time, with out correct therapy by your dentist, it might progress via your enamel, into your dentin (bony tissue), and ultimately into the pulp of your tooth, which might kill the nerve in your tooth and finally create an abscess (pocket of an infection). Photograph: Shutterstock

How Are Endurance Sports activities Arduous on Our Tooth?

So, what’s it about endurance coaching and racing particularly that has given us a foul popularity with dentists? Endurance coaching and racing create an ideal storm for potential cavity creation. The foremost hit checklist contains the next:

  • Frequent carbohydrate drinks and snacks feed our micro organism.
  • Respiratory onerous for a very long time as we do whereas operating each reduces the quantity of saliva we produce and the composition of that saliva, decreasing its protecting properties (and making our mouth extra acidic).
  • Different acidic issues embrace ultra-racing favorites: vomiting and gastroesophageal reflux.
  • Stress creates the next chance of clenching and/or grinding our tooth (1,3).
Jeri Chua - WeRunFar 4

Ultrarunner Jeri Chua snacking. Photograph: Jethro De Decker

This stuff individually and, even worse, together, are a recipe for tooth decay and poor oral well being. However do endurance athletes have the next incidence of dental points?

Based mostly on the newest research carried out on German and French athletes, it looks like we’re about common and never that totally different from our extra leisure friends. The hyperlink? Whereas consuming ‘worse’ diets than our friends, we’re as possible, maybe much more possible, to adjust to the beneficial each day and biannual dental care of brushing, flossing, and seeing our dentists. What this says to me is that whereas we’re usually creating an ideal storm for oral chaos, we will counter it successfully with applicable dental care.

How Can You Make Your Dentist Proud?

Funnily sufficient, this can be a query I’ve requested myself on multiple event, and so for this text, I believed, who higher to ask than an precise dentist! Enter skilled path runner and ultrarunner Arden Younger, who, when she will not be operating and racing everywhere in the world, is a dentist in Calgary, Alberta. What follows is that interview, full of recommendation and information on tips on how to impress your dentist.

Arden Young George Waterfalls 50k

Arden Younger ending the George Waterfalls 50k. Photograph: Mike McMonagle

iRunFar: Ultrarunning coaching and racing look like the proper storm for poor oral well being. Is it as unhealthy because it appears?

Arden Younger: It may be, however the harm is preventable! As an athlete, you go to your therapeutic massage therapist, your physiotherapist, and your dietician. However do you go to your dentist? Bodily well being and health enable our our bodies to carry out unimaginable feats of endurance within the mountains, however the place does oral well being play into all of this? The mouth, in any case, is linked to the remainder of the physique. And once I take into consideration the entire gas that went into operating my final extremely — the gummies, gels, sports activities drinks, and sweet — it appears like a variety of the issues I inform my sufferers to not devour. Operating helps preserve us wholesome, mentally and bodily, so what may probably go flawed with the ultrarunning-oral well being combo?

iRunFar: What ought to I be most involved about as an ultrarunner?

Younger: [laughs] Let me depend them. Excessive frequency and quantity of carbohydrate consumption, over prolonged durations of time, creates a buffet for unhealthy oral micro organism. We’re speaking the sports activities drinks, gummies, gels, sweet, and cookies — the gas your physique must do these onerous issues, additionally fuels the cavity-creators. Micro organism, like Streptococcus mutans, will eat these sugars and produce acid as a waste product, which erodes the tooth’s protecting layer of enamel and ultimately can create a cavity. Sticky meals, plus the excessive frequency of consumption, create a protracted acid assault.

Saliva usually sits at a pH of 6.2 to 7.6, however once we add within the acid produced by micro organism, acidic meals and drinks, and a few of the glamour of ultrarunning — vomiting and acid reflux disease — that pH drops. Our saliva thus turns into extra acidic.

When the pH of saliva drops beneath 5.5, tooth enamel begins to interrupt down. Enamel can not develop again, so this harm is everlasting. Acid erosion will improve sensitivity to scorching, chilly, and candy, in addition to make you extra vulnerable to growing cavities. As well as, mouth-breathing and dehydration scale back the quantity of saliva obtainable to scrub away meals particles and neutralize acid.

Lastly, clenching and grinding — at instances of excessive stress, ache, and focus, we frequently clench our jaws or grind our tooth. Lots of stress is held within the facial muscle tissue, generally with out our consciousness. This will harm present fillings and even chip tooth. On that word, attempt to keep away from the actually stale or onerous gummies that may pull off a crown or break a filling.

So, my abstract reply to, “Why is it so unhealthy?” It’s a mix of lengthy period and excessive frequency of sticky sugars, acidic oral atmosphere, and stress.

iRunFar: Ought to I brush my tooth throughout a 100-mile race or after a long term? 

Younger: One factor that basically helps is rinsing with plain water after every sugar consumption. This may assist wash away the particles and neutralize the acidic pH. One other good choice is to chew sugar-free or xylitol gum as a result of it’ll stimulate salivation, and xylitol is bacteriostatic to Streptococcus mutans. This implies it’ll really change the standard of your oral micro organism with extended use.

Brushing your tooth throughout an extremely or after a long term is nice as a result of it removes plaque (i.e., the biofilm of micro organism and meals that sticks to the tooth and units up a cavity manufacturing facility) and offers you a dose of fluoride that helps stop cavities. Nonetheless, attempt to not brush your tooth instantly after consuming one thing acidic, as it might really trigger extra enamel put on, since you’re brushing it within the demineralized state. It’s higher when you can rinse with water, and look ahead to an hour for the pH to neutralize.

iRunFar: For those who may provide a couple of items of recommendation to the path runners and ultrarunners studying this, to fight any athletics-specific dental woes, what would they be?

Younger: A number of different issues you are able to do to assist fight ultrarunning-exacerbated dental points:

  1. Rinse your mouth with plain water after consuming.
  2. Keep hydrated.
  3. Keep good each day oral hygiene. Brush at the least twice a day, floss your tooth, use a fluoridated toothpaste, see your dentist for yearly checkups, and get your tooth cleaned by a dental hygienist at the least twice per yr.
  4. Get pleasure from a nutritious diet with loads of non-sugary hydration while you’re not coaching or racing.
  5. Get an evening guard to put on, particularly throughout excessive stress or after large efforts, to assist scale back put on in your tooth, facial muscle tissue, and jaw joints.
  6. For those who discover you’re a type of cavity-prone individuals, add a excessive fluoride toothpaste (for instance, PreviDent 5000) into your each day brushing routine. This may create extra fluorapatite in your tooth construction and improve its resistance to demineralization.

iRunFar: Okay, so how can I impress my dentist? 

Younger: Floss! For actual, I really like those who usually floss. You’ll adore it too, belief me. And get an electrical toothbrush. I personally love the Philips Sonicare. It really will make a distinction to your gum well being. Embrace toothpaste with fluoride. I really like pure, natural merchandise, however there’s a motive why the Facilities for Illness Management and Prevention named group water fluoridation one of many 10 nice public well being achievements of the twentieth century. It really works. And get your common, preventative dental checkups and cleanings.

Arden Young with her nephew

Arden Younger at work along with her nephew, who has mastered the artwork of impressing his dentist! Photograph courtesy of Arden Younger.

Takeaway Ideas

Brush and Floss

You heard the dentist! Brush and floss. It doesn’t need to occur throughout your race. The truth is, you shouldn’t brush in case your mouth is simply too acidic, however twice a day and an hour after ingesting sugary food and drinks. This not solely protects your tooth but in addition protects your gum well being as effectively.

Swish, Swish, Swish

That’s proper, the most effective methods on the run to fight the sugary cocktails we’re recognized to ingest is to easily rinse with water. I do know water generally is a treasured commodity throughout a protracted, scorching race, however don’t fear you gained’t waste any right here. You do need to swish, however you don’t need to spit! You’ll be able to swish first along with your consuming water. Periodically rinsing your mouth with regular water can assist to scrub away particles and neutralize the pH of your mouth, staving off a corrosive atmosphere.

Think about Fluorinated Toothpaste

That is true notably in case you are cavity inclined. Brushing with a fluoride toothpaste is protecting to the construction of your tooth and will increase their resistance to enamel erosion.

Go to Your Dentist
I do know, they’re scary, they’re inconvenient, and they are often costly. However exterior of doing the fundamentals, routine cleanings and visits to your dentist are the most effective methods to keep away from conditions like the foundation canal I needed to have the week of this yr’s Western States 100.

Name for Feedback

  • Do you are taking your toothbrush with you on a protracted extremely?!
  • What different practices do you will have for caring for your oral well being as a runner?

References

  1. Coudert, S., Jacq, R., & Bas, A.-C. (2022). The analysis of oral and Dental Well being and behavioural danger amongst ultra-endurance athletes: A cross-sectional epidemiological examine.Analysis in Sports activities Medication, 1–9. https://doi.org/10.1080/15438627.2022.2042296
  2. Frese, C., Wohlrab, T., Sheng, L., Kieser, M., Krisam, J., Frese, F., & Wolff, D. (2018). Medical administration and prevention of dental caries in athletes: A four-year randomized managed medical trial.Scientific Studies8(1). https://doi.org/10.1038/s41598-018-34777-x
  3. Merle CL, Richter L, Challakh N, Haak R, Schmalz G, Needleman I, Wolfarth B, Ziebolz D, Wüstenfeld J. Orofacial situations and oral well being conduct of younger athletes: A comparability of newbie and aggressive sports activities. Scand J Med Sci Sports activities. 2022 Could;32(5):903-912. doi: 10.1111/sms.14143. Epub 2022 Mar 7. PMID: 35174553.
  4. Gallagher, J., Ashley, P., Petrie, A. et al.Oral health-related behaviours reported by elite {and professional} athletes. Br Dent J 227, 276–280 (2019). https://doi.org/10.1038/s41415-019-0617-8
  5. Belinchón-deMiguel P, Ruisoto P, Knechtle B, Nikolaidis PT, Herrera-Tapias B, Clemente-Suárez VJ. Predictors of Athlete’s Efficiency in Extremely-Endurance Mountain Races. Worldwide Journal of Environmental Analysis and Public Well being. 2021; 18(3):956. https://doi.org/10.3390/ijerph18030956
  6. De la Parte, A., Monticelli, F., Toro-Román, V., & Pradas, F. (2021). Variations in oral well being standing in elite athletes based on sport modalities. Sustainability13(13), 7282. https://doi.org/10.3390/su13137282

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