With rugby fans across Europe excited about the upcoming Six Nations, few realise – from players to supporters – that healthy teeth and gums could help determine who dominates the scrum.

Poor oral health is proven to negatively impact training and performance amongst elite athletes (1, 2) – and with cavities more common in rugby union than almost every other sport (2), this match day preparation should start long before the mouthguards go in.

International oral healthcare company Sunstar supported the original launch of the Sports Dentistry Guidelines with the FDI (World Dental Federation), and holds global events on the theme.

Poor oral health is prevalent in high performance sport. In one study of 302 elite athletes, almost half had not undergone a dental examination or hygiene care in the previous year. 55 per cent presented with dental cavities, 45 per cent with dental erosion, and 76 per cent with gingivitis (1). Further research shows odds of cavities being 2.4x higher in team sports – and highest in rugby (2). Meanwhile, one recent study also suggests that professional rugby players have poorer oral health than the general population (3).

Male internationals have more to watch out for than females; not only is erosion most prevalent in both male athletes and team sports (2), men are also more likely to ignore their oral health and neglect dentist visits (4). The impact of poor oral health is striking: 40 per cent of athletes reported being ‘bothered by their oral health’, whilst 28 per cent also reported an impact on the quality of life and 18 per cent on their training and performance (1).

There are several factors behind top athletes’ significant risk of oral disease – from calorie intake to training intensity. Team nutritionists have previously revealed that rugby stars could require up to 6,000 calories a day across multiple meals and supplements; frequent snacking, along with highly sugary and acidic energy drinks and protein bars, is a major source of enamel erosion and tooth decay. An intensive training programme, paired with pre-game nerves, can also lead to increased mouth breathing and ‘dry mouth’, which promotes bacterial growth as the protective benefits of saliva are lost.

How does oral health impact training and performance in rugby?

  • Sleep and diet are crucial to athletic performance, but painful dental issues or malocclusion (crooked bite) can cause insomnia and difficulties eating – as England prop Ellis Genge found when suffering from an impacted wisdom tooth ahead of an important match last year.
  • Tooth decay (cavities) and gum disease can cause and maintain inflammation and infections in the body – directly impacting overall wellbeing and injury recovery. When paired with stress, these conditions may be accentuated.
  • Trauma (such as dental fractures or jaw dislocation) - which is prevalent in rugby – and malocclusion can impact several factors relating to performance, including digestion, posture, balance and sleep.
  • Toothache and other oral health issues can result in severe pain, resulting in poor performance or even withdrawal from the match or competition.

Martijn Verhulst, medical liaison manager for Sunstar Medical Affairs, says, “As rugby union renews its commitments to becoming the most progressive sport on player welfare, a player-centric and holistic approach must include oral health – which goes beyond the mouth itself.

“From international to grassroots, players at all levels stand to benefit from a better awareness of the performance link. There is no better place to start than with the foundations: brush your teeth twice a day, clean between your teeth, and rinse your mouth after meals – and don’t forget your dental check-up twice a year.”

Sophie Dartevelle, FDI council member and chair of the FDI Sports Dentistry Task Team, adds, “Oral health is the next greatest challenge for rugby to tackle. No athlete would neglect a thorough warm-up or much-needed visit to the physio – our aim is to foster the same approach to oral care.

“Our Sports Dentistry Guidelines provide amateur athletes, professional athletes, dentists and sports physicians, and sports organisations with easily incorporated oral hygiene recommendations to optimise overall well-being and performance.”

Watch the FDI’s latest educational video, featuring top-of-the-table French Fédérale 2 team Stade Nantais Rugby, here.

For a copy of the Sports Dentistry Guidelines with the FDI (World Dental Federation) supported by Sunstar, visit: https://www.sunstar.com/healthy-thinking/sports-dentistry-project-with-fdi-world-dental-federation/

References

  1. 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. British Journal of Sports Medicine.
  2. Gallagher J, Ashley P, Petrie A & Needleman I. Oral health and performance impacts in elite and professional athletes. Community Dentistry and Oral Epidemiology.
  3. Minty M, Canceill T, Lê S, Dubois P, Amestoy O, Loubieres O, Christensen JE, Champion C, Azalbert V, Grasset E, Hardy S, Loubes J-M, Mallet J-P, Tercé F, Vergnes J-N, Burcelin R, Serino M, Diemer F, Blasco-Baque V. Oral health and microbiota status in professional rugby players: A case-control study. Journal of Dentistry,
  4. Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. American Journal of Men’s Health.

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