How A Cyclists Oral Hygiene Is Key For Performance?

Our health is a high priority as cyclists, both for our longevity as athletes and for our performance. Our dental health is an essential aspect of our overall health. 

It’s not uncommon for athletes to lose significant training time or perform poorly due to dental issues.  Painful dental problems can negatively impact an athlete’s quality of life as well as their training availability and, therefore, their performance.

The types of food and drinks we consume and how we consume them can directly influence our oral health. While dental health is not technically a nutrition topic per se, our dietary intake is a critical determinant of oral health and is, therefore, an essential consideration for any cyclist.

A lack of awareness around issues with oral hygiene and diet can also play a factor in athletes developing dental problems like caries, dental erosion and peritonitis, which is the reason we thought it would be important to cover some of the strategies we can use to maximise oral health. 

In this week’s blog, we’ll look at some of the key strategies we can implement to modify our nutrition and general oral hygiene behaviours and help maximise dental health to ensure that dental problems aren’t costing you performance.  

On the whole, cyclists are at a heightened risk of dental problems compared to the general population for several reasons.

1. Poor saliva production – Exercise typically results in some degree of dehydration, which reduces saliva production in the mouth. Saliva is critical for protecting the teeth, so a decrease in saliva production combined with foods and drinks rich in sugars and acids can exacerbate tooth decay.
2. Increased airflow through the mouth – For sports like cycling, where there is an increased flow of air through the mouth, this can dry the mouth out and similar to the above, reduce the protection the teeth have from saliva.  
3. Impaired immune function – heavy training combined with other life stresses can impact an athlete's immunity which can increase the risk of dental issues such as Periodontal conditions.
4. Carbohydrate and acid intake – The frequent high intakes of sugars as endurance athletes, often in the form of foods and drinks high in acids, can further exacerbate tooth decay. Particuarly when using foods that are sticky.
5. Impact – Cyclists are often also at risk of serious dental injuries from crashes.

What can we do to limit dental issues in athlete?

From a general dental perspective, the current advice is as follows…

1. Brush twice daily, ideally once in the morning and immediately before bed.
2. Use a high-fluoride toothpaste containing at least 350 ppm fluoride. Under the guidance of a dentist, high-fluoride toothpastes like Colgate Duraphat may be worth considering to help remineralise the teeth.
3. Once finished brushing, spit rather than rinse further to expose the teeth to the fluoride within the toothpaste and maximise it's effect.
4. Check Up – Ensure you get at least two yearly check ups with a dentist.
5. Optimise Oral Hygiene—Trips to see a dental hygienist, combined with regular flossing to reduce plaque buildup, can help maintain dental health and give you an individual strategy to maintain dental health.
6. Use high fluoride mouthwashes when brushing is not possible.

The Nitrates Issue – The bacteria within our oral cavity (named the oral microbe) play a key role in supporting our health. In particular, for athletes, nitrates consumed within our diet either in foods and vegetables or through supplements such as beetroot juice require the bacteria within the mouth to convert the nitrate to nitrite before it is converted to nitrous oxide, where it can play a role in improving our performance. As such, we have to be careful using antibacterial mouthwashes as these can destroy the oral microbe and prevent an athlete from achieving any benefits from nitrates. Potentially negatively impacting health. Therefore any mouth rinses should be flubased and not antibacterial. 

From a nutrition perspective…

1. Limit the intake of acidic and sugar-rich supplements to times when they are required (i.e. just during training sessions which are intense and long enough in duration to warrant carbohydrate intake).
2. Stay hydrated to help support saliva production, and consider the use of snoods to help limit air exposure in the mouth, particularly in dry environments.
3. The two-bottle method – When using sports drinks or similar, adopt a two-bottle strategy, chasing a sports drink with water to help mitigate the effects of the sugars and acidity and support hydration.
4. Chasing acidic foods like fruits with alkaline foods like cheese can help neutralise the acidity and limit the erosion they cause.
5. Choose low-acidity sports nutrition products. For example, avoiding citrus flavours that often have citric acid can help remove the impact of acidity. 

The infographic below, put together by some world leaders on the topic of athletes' oral health, is worth checking out too. 

Coach Ben  

References

Needleman, I., Ashley, P., Fairbrother, T., Fine, P., Gallagher, J., Kings, D., Maughan, R. J., Melin, A. K., & Naylor, M. (2018). Nutrition and oral health in sport: time for action. British journal of sports medicine, 52(23), 1483–1484. https://doi.org/10.1136/bjsports-2017-098919

Gallagher, J., Ashley, P., Petrie, A., & Needleman, I. (2019). Oral health-related behaviours reported by elite and professional athletes. British dental journal, 227(4), 276–280. https://doi.org/10.1038/s41415-019-0617-8