Oral Health in Sport

The Faculty of Sport and Exercise Medicine (FSEM) UK recognises that poor oral health of athletes is a consistent finding in research studies and has produced this six point guide for sport and exercise medicine practitioners.

There is insufficient data to determine differences between sports in this regard. However, poor oral health can have impacts such as pain and reduced quality of life.  It might also negatively affect training and performance and can induce systemic inflammation. In the longer-term, poor oral health will increase an individual’s life-long dental treatment burden.

  • Dental trauma in ‘at-risk’ sports (i.e. any sport with increased risk of head injury) is common. Prevention (using mouthguards) and management is well established.
  • The prevalence of oral diseases in athletes is poorly understood, but is likely to be high on the basis of current evidence. Data suggest that dental caries, dental erosion and poor periodontal health are similar per age group to disadvantaged populations. Other oral conditions such as infections around wisdom teeth, pericoronitis, may also affect athletic performance.
  • There are a number of possible causes of poor oral health in sport. These may include nutrition (carbohydrate intake and erosive potential), lack of awareness of oral health, oral dehydration from mouth drying and reduced salivary flow, negative health behaviours such as poor oral hygiene  and exercise-induced immune suppression.
  • Oral diseases are preventable and simple interventions with good evidence of efficacy exist. Work is ongoing to produce a prevention toolkit for athletes based on best available evidence. In the interim, prevention should be based on key simple messages including, minimising carbohydrate intake and acidic sports drinks as far as practicable (both amount and frequency), flossing once daily, toothbrushing twice daily for two minutes, use of fluoride toothpastes with at least 1,450ppm fluoride but preferably 5,000ppm and dental examinations twice yearly including application of sodium fluoride varnish.
  • Strategies to promote oral health should be embedded within Sport and Exercise Medicine. Key components include, identifying opportunities to promote oral health across the different strata and stakeholders in sport, understanding the determinants of oral health in athletes, prevention of oral diseases and setting responsibilities for delivering oral health promotion.
  • All athletes should receive a comprehensive dental examination, at least twice yearly including pre-season. The dental examination should lead to a personalised preventive plan as well as the provision of any treatment required.  Illness surveillance should include sufficient detail on oral health to allow evaluation of the impact of oral health promotion.


©Faculty of Sport and Exercise Medicine UK - Oral Health in Sport October 2014, to be reviewed October 2017.

Authors: Prof Ian Needleman UCL Eastman Dental Institute, Dr Paul Ashley UCL Eastman Dental Institute, Dr Lyndon Meehan, Dental Practice, Dr Mike Loosemore, UCL Institute for Sport Exercise and Health


Needleman et al. Oral health and impact on performance of athletes participating in the London 2012 Olympic Games: a cross-sectional study. Br J Sports Med 2013 47: 1054-1058

Ashley et al. Oral Health and Impact on Performance of Athletes: a systematic review. Submitted 2014

This statement supports the Consensus Statement published in the Br J Sports Medicine 2014 - Oral Health and Elite Sport Performance, Needleman et al.

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