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

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

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

The issues that gas our adventures within the mountains may gas tooth erosion. Picture: 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 nicely past tooth decay. When oral well being is poor, micro organism not solely work away on the enamel (exterior) and pulp (inside) of your enamel, however it may possibly additionally trigger irritation of your gums, resulting in gum illness (periodontitis). Extra critically, it may possibly result in different systemic situations, or illnesses that go far past your mouth. These situations and illnesses 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 in your total well being and well-being.

Whereas that needs to be sufficient to get us all dashing off to floss and brush our enamel, 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 had been induced by oral illnesses (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).

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

How Are Endurance Sports activities Laborious on Our Enamel?

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

• Frequent carbohydrate drinks and snacks feed our micro organism.
• Respiratory laborious 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 a better chance of clenching and/or grinding our enamel (1,3).

Ultrarunner Jeri Chua snacking. Picture: 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 a better incidence of dental points?

Primarily based on the latest research carried out on German and French athletes, it looks as if 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 really helpful day by 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 a couple of event, and so for this text, I assumed, who higher to ask than an precise dentist! Enter skilled path runner and ultrarunner Arden Younger, who, when she isn’t operating and racing all around the world, is a dentist in Calgary, Alberta. What follows is that interview, full of recommendation and data on learn how to impress your dentist.

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

iRunFar: Ultrarunning coaching and racing seem to be the right storm for poor oral well being. Is it as dangerous because it appears?

Arden Younger: It may be, however the injury 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 spite of everything, is linked to the remainder of the physique. And after I take into consideration the entire gas that went into operating my final extremely — the gummies, gels, sports activities drinks, and sweet — it feels like numerous the issues I inform my sufferers to not eat. Working helps maintain us wholesome, mentally and bodily, so what might presumably go improper 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 intervals of time, creates a buffet for dangerous oral micro organism. We’re speaking the sports activities drinks, gummies, gels, sweet, and cookies — the gas your physique must do these laborious 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 enamel’s protecting layer of enamel and finally 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 among the glamour of ultrarunning — vomiting and acid reflux disorder — that pH drops. Our saliva thus turns into extra acidic.

When the pH of saliva drops under 5.5, tooth enamel begins to interrupt down. Enamel can’t develop again, so this injury is everlasting. Acid erosion will enhance sensitivity to sizzling, chilly, and candy, in addition to make you extra susceptible to creating cavities. As well as, mouth-breathing and dehydration cut back the quantity of saliva out there 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 enamel. Numerous rigidity is held within the facial muscular tissues, typically with out our consciousness. This could injury current fillings and even chip enamel. On that observe, attempt to keep away from the actually stale or laborious gummies that may pull off a crown or break a filling.

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

iRunFar: Ought to I brush my enamel throughout a 100-mile race or after a future? 

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 possibility 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 truly change the standard of your oral micro organism with extended use.

Brushing your enamel throughout an extremely or after a future is nice as a result of it removes plaque (i.e., the biofilm of micro organism and meals that sticks to the enamel and units up a cavity manufacturing unit) and provides you a dose of fluoride that helps stop cavities. Nonetheless, attempt to not brush your enamel instantly after consuming one thing acidic, as it may possibly truly trigger extra enamel put on, since you’re brushing it within the demineralized state. It’s higher in the event you can rinse with water, and anticipate an hour for the pH to neutralize.

iRunFar: When you might 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. Preserve good day by day oral hygiene. Brush a minimum of twice a day, floss your enamel, use a fluoridated toothpaste, see your dentist for yearly checkups, and get your enamel cleaned by a dental hygienist a minimum of twice per 12 months.
4. Get pleasure from a nutritious diet with loads of non-sugary hydration whenever you’re not coaching or racing.
5. Get an evening guard to put on, particularly throughout excessive stress or after huge efforts, to assist cut back put on in your enamel, facial muscular tissues, and jaw joints.
6. When you discover you’re a type of cavity-prone folks, add a excessive fluoride toothpaste (for instance, PreviDent 5000) into your day by day brushing routine. This may create extra fluorapatite in your tooth construction and enhance its resistance to demineralization.

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

Younger: Floss! For actual, I like people who usually floss. You’ll like it too, belief me. And get an electrical toothbrush. I personally love the Philips Sonicare. It actually will make a distinction to your gum well being. Embrace toothpaste with fluoride. I 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 Younger at work together with her nephew, who has mastered the artwork of impressing his dentist! Picture courtesy of Arden Younger.

Takeaway Suggestions

Brush and Floss

You heard the dentist! Brush and floss. It doesn’t need to occur throughout your race. In truth, 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 enamel but additionally protects your gum well being as nicely.

Swish, Swish, Swish

That’s proper, top-of-the-line methods on the run to fight the sugary cocktails we’re identified to ingest is to easily rinse with water. I do know water generally is a treasured commodity throughout an extended, sizzling 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 possibly can swish first along with your consuming water. Periodically rinsing your mouth with regular water may also help to scrub away particles and neutralize the pH of your mouth, staving off a corrosive setting.

Take into account Fluorinated Toothpaste

That is true notably in case you are cavity inclined. Brushing with a fluoride toothpaste is protecting to the construction of your enamel 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 top-of-the-line methods to keep away from conditions like the foundation canal I needed to have the week of this 12 months’s Western States 100.

Name for Feedback

• Do you’re taking your toothbrush with you on an extended extremely?!
• What different practices do you will have for taking good care of 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 research.Analysis in Sports activities Drugs, 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). Scientific administration and prevention of dental caries in athletes: A four-year randomized managed scientific trial.Scientific Experiences, 8(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 habits of younger athletes: A comparability of novice 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 in response to sport modalities. Sustainability, 13(13), 7282. https://doi.org/10.3390/su13137282