This document discusses the relationship between exercise, oral health, and athletic performance. It finds that many athletes do not practice proper oral hygiene and have high rates of dental injuries, cavities, erosion, and gum disease. Poor oral health can negatively impact athletic performance through increased inflammation, malocclusion, infection, and pain. Maintaining oral health through regular cleanings, use of mouthguards, proper hydration, and limiting acidic drinks can help reduce oral issues and improve exercise. The recommendations encourage athletes to prioritize prevention through good oral hygiene habits and seeking dental care.

1. EXERCISE
AND
ORAL HEALTH
MEDICAL DEPARTMENT DENTAID

2. THE IMPORTANCE OF EXERCISING
Routine exercise has many known benefits:
 Increased fitness
 Improved health
 Prevention of systemic diseases
 Sense of wellbeing
 Increased self-esteem
Physical activity can have an impact on oral health.

3. THE IMPORTANCE OF ORAL HEALTH
A recent review of the literature revealed that competitive athletes do not have proper oral
health:
Injuries: 14-47%
Caries: 15-75%
Dental erosion: 36-85%
Periodontitis: 15%
5-18% of athletes recognise that oral health problems may have had a negative impact on their
athletic performance.
Ashley P, Di Iorio A, Cole E, Tanday A, Needleman I. Oral health of elite athletes and association with performance: a systematic review. Br J Sports Med 2015; 49 (1): 14-19

4. THE EFFECTS OF EXERCISE
ON ORAL HEALTH

5. Psychomotor- and performance-related factors influence periodontal health 2.
Poor aerobic capacity, foot balance and reaction are associated with inferior periodontal
health.
EXERCISE ORAL HEALTH. BENEFITS
Obesity may be a risk factor for periodontitis1.
Persons with lower BMI and higher oxygen consumption have better periodontal health.
1. Shimazaki Y, Egami Y, Matsubara T, Koike G, Akifusa S, Jingu S, Yamashita Y. Relationship between obesity and physical fitness and periodontitis. J Periodontol 2010; 81 (8): 1.124-1.131.
2. Wakai K, Kawamura T, Umemura O, Hara Y, Machida J, Anno T, Ichihara Y, Mizuno Y, Tamakoshi A, Lin Y, Nakayama T, Ohno Y. Associations of medical status and physical fitness with periodontal
disease. J Clin Periodontol. 1999 Oct;26(10):664-72.
3. Sanders AE, Slade GD, Fitzsimmons TR, Bartold PM. Physical activity, inflammatory biomarkers in gingival crevicular fluid and periodontitis. J Clin Periodontol 2009; 36 (5): 388-395
Protection against excessive inflammatory response in periodontitis3.
Exercising during leisure time is associated with lower inflammatory markers.

6. EXERCISE ORAL HEALTH. BENEFITS
Stress reduction3,4
Playing sports during leisure time reduces stress and
protects against its harmful effects. Stress is considered to
be a risk factor for periodontal disease.
Improved glycaemic control in diabetic patients1,2
Both aerobic exercise and resistance training improve insulin action and glucose control. Poor
glucose control in diabetic patients may assist in the development of periodontal disease.
1. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B; American College of Sports Medicine; American Diabetes Association. Exercise and type 2
diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010 Dec;33(12):e147-67.
2. Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol. 2013 Apr;40 Suppl 14:S113-34
3. Agudelo LZ, Femenía T, Orhan F, Porsmyr-Palmertz M, Goiny M, Martinez-Redondo V, Correia JC, Izadi M, Bhat M, Schuppe-Koistinen I, Pettersson AT, Ferreira DM, Krook A, Barres R, Zierath JR, Erhardt S,
Lindskog M, Ruas JL. Skeletal muscle PGC-1α1 modulates kynurenine metabolism and mediates resilience to stress-induced depression. Cell. 2014 Sep 25;159(1):33-45
4. Barbieri G, Mateos L, Bascones A. Papel del estrés en la etiopatogenia de la Enfermedad Periodontal. Av Periodo n Implantol. 2003; 15,2: 77-86.

7. EXERCISE ORAL HEALTH. RISKS
Dental fractures
Injuries from sports components (floor, racket, wall, etc.)
Bruxism
Common, due to the stress many athletes undergo
Xerostomia
Consequence of intense exercise and mouth breathing, which can also cause temporary bad breath
Caries
The high sugar content of sports drinks, as well as the usual carbohydrate-rich diets of athletes and
decreased saliva from xerostomia
Tooth sensitivity
From enamel erosion caused by:
- the acidity of isotonic or energy drinks and soft drinks - bruxismo
- teeth coming in contact with chlorine (swimmers)

8. THE EFFECTS OF ORAL
HEALTH ON EXERCISE

9. ORAL HEALTH EXERCISE. RISKS
Systemic inflammation resulting from periodontitis
May increase the risk of having other conditions and could worsen athletic
performance
Malocclusion and bruxism
Overloading jaws and transfer of tension to neck and back - muscle contractures
Bacteraemia resulting form oral infections
Infection may cause fatigue
Inadequate chewing
Slower digestion and reduced energy power in athletes
Dental injury or pain
Inferior athletic performance (and reduced quality of life)
Martínez Medina IA., Bleró A., Navarro Montes CS., Ratia Mártínez F., Sánchez Aguilera F (23 de abril de 2009). El dolor de espalda causado por malposiciones dentarias. Gaceta Dental.
Needleman I, Ashley P, Petrie A, Fortune F, Turner W, Jones J, Niggli J, Engebretsen L, Budgett R, Donos N, Clough T, Porter S. Oral health and impact on performance of athletes participating
in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med. 2013 Nov;47(16):1054-8
Carrasquer A. Mejora tu rendimiento deportivo: ¡empieza por tu boca! Cuida tus Encías. SEPA Divulgación. 2015; 8:4-8

10. RECOMMENDATIONS

11. Prevention solves most oral problems
Importance of changing habits that are harmful for oral health and long-term compliance
with these. This may require professional help.
The use of mouthguards  prevents dental fractures
Proper hydration  prevents dry mouth and reduces the risk of caries
Regular dental check-ups  dentists and hygienists are dedicated to caring for oral health,
and if necessary, to diagnosing and treating emerging oral-related problems
Using a night guard for bruxism
Do not consume an excessive amount of isotonic drinks, limiting them to
high intensity exercise.
RECOMMENDATIONS

12. RECOMMENDATIONS. ORAL HYGIENE
Brush teeth 2 times per day or after meals (night time very important)
After consuming acidic drinks, wait at least 10 min before brushing.
A toothbrush should be replaced every 3 months or when filaments
appear to be worn
Interproximal hygiene
Daily use of a tongue cleaner
Use of toothpaste and mouthwash:
with fluoride to prevent the onset of caries
with antiseptics to prevent gum disease
with moisturisers or sialogogues (stimulants of salivary secretion) in persons with dry mouth after
physical activity
Consult your pharmacist who can recommend the most suitable oral hygiene
products for you.

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