Oral Health of Elite Athletes: Cause for Concern

Oral Health of Elite Athletes: Cause for Concern

The term “sport-washing” has been used to describe how international sport has been exploited by governments and commercial entities to exert soft power. One could argue that junk food and sugary drink sponsorship of sport is a particular type of sport-washing. Through the power of sport and association with elite athletes, brand’s can enhance their reputation and grow their business, despite evidence demonstrating the negative impacts of these products on our health.

Whilst elite athletes appear healthy and free from obvious health issues making them ideal brand ambassadors, high-calorie, low nutritional value foods can cause damage to their teeth and gums.  In this guest blog Professor Ian Needleman and Dr Paul Ashley of the Centre for Oral Health and Performance describe their research into athletes’ oral health.

Getting match fit and podium ready is tough and good mouth care can easily be forgotten. Elite level performance requires high levels of energy, and this often means consuming a lot of high-sugar food and drink.

Concerns about the oral health of athletes have been reported as long ago as the Summer Olympics in 1968. We suspected that dietary sugars and the acidity of food and drink could be having a negative impact on athletes wellbeing and the London Olympics in 2012 gave us the perfect opportunity to look at this in greater detail and recommend strategies to either prevent or mitigate the risk posed by certain food and drink products for elite athletes.

Results from this study confirmed our suspicions and the impact of this research with athletes opened the door to other disciplines including football, rowing, cycling and swimming amongst others, who also had concerns. We have now amassed a unique and comprehensive dataset of the oral health of athletes including data from the London Olympics study, our investigation into the oral health of footballers in 2014 and more recently the world’s first comprehensive oral screening of elite level athletes in the UK across a wide range of individual and team sports (Needleman et al., 2017).

Impact of food and drink products on oral health and performance

Teeth were affected with dental decay and acid erosion. If left untreated this caused pain and even infection which we know stopped athletes performing at the highest level. Inflamed gums were also common, which can lead to early tooth loss but more importantly causes inflammation in the rest of the body; hence the link between gum inflammation and diabetes and cardiac disease.

But perhaps the most significant finding was that a large proportion of athletes felt that their oral health was negatively affecting their performance (32%). One of our PhD students, Julie Gallagher, spent a lot of time with athletes on the training field carrying out this research and commented:

‘It’s easy to see how much pressure there is for young athletes to use sports drinks. In the sports centres and stadia where they train alongside elite groups there are banks of vending machines full of sports drinks. You have to look very hard to find plain water and there is certainly no milk on offer.’

Why does any of this matter? Well it matters to our athletes. Our sporting heroes have have told us very clearly that they believe poor oral health affects their performance. We’re now working hard to make sure that all those involved in elite sport are aware of the negative impact of high-sugar and / or acidic products on oral health and performance so they can perform at their best during competition without worrying about the long-term impact on their teeth and gums.

But this throws up a real contradiction – athletes are reporting oral and dental health problems, so why are they being used to promote food and drink products that can damage teeth and gums?

If we want to ensure that both athletes and the general public have good oral health, sport needs to grit its teeth and reconsider its relationship with junk food and sugary drinks brands.



Dr Ian Needleman

Ian is Professor of Restorative Dentistry and Evidence-Based Healthcare at UCL Eastman Dental Institute and Honorary Consultant in Periodontology with UCLH. He is a clinical specialist in periodontics at UCL and at PerioLondon and an Editor with the Cochrane Oral Health Group. His research interests are oral health in elite sport, improving clinical outcomes and the impact of oral health on general health, wellbeing and performance.

Dr Paul Ashley

Paul is academic lead of the Paediatric Dentistry Unit at UCL Eastman Dental Institute and Honorary Consultant in Paediatric Dentistry with UCLH. He is a Clinical Advisor for the Cochrane Oral Health Group and his research interests include diagnosis and management of caries in children and adults.



Needleman I, Ashley P, Fairbrother T, et al. Nutrition and oral health in sport: time for action. Br J Sports Med 2018;52:1483-1484.

Michael Viggars

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