Oral health of elite athletes and association with performance: a systematic review.
BACKGROUND
We aimed to systematically review the epidemiology of oral disease and trauma in the elite athlete population and to investigate the impact of oral health on sporting performance.


METHODS
Authors searched Ovid MEDLINE (1950 to October 2013), Ovid EMBASE (1980 to October 2013), EBSCO SPORTDiscus (up to October 2013) and OpenGrey (http://www.opengrey.eu). No date or language restrictions were applied. Papers were included if they evaluated the oral health of professional athletes. The methodological quality of papers was evaluated using a modification of the Newcastle-Ottawa scale.


RESULTS
The literature search led to 9858 potentially relevant citations. Following a set of predefined exclusion criteria, 34 studies remained. Twenty-six studies reported on dental trauma, which ranged in prevalence from 14% to 47% varying by sport and country. Sixteen studies considered the oral health of athletes and reported high prevalence of oral diseases: dental caries 15-75%, dental erosion 36-85%, periodontal disease 15%. In four studies, a range between 5% and 18% of athletes reported negative impact of oral health or trauma on performance. The methodological quality of included studies was generally low.


CONCLUSIONS
Within the limits of the review, oral health of athletes is poor. We hypothesise that poor oral health associates with self-reported performance; however, this needs to be tested. Further studies on representative samples of athletes are needed to assess the size of the problem of poor oral health as well as to investigate the possible impact on performance using objective measures of performance.
Unit of Paediatric Dentistry, UCL Eastman Dental Institute, London, UK.
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P
Ashley
UCL Eastman Dental Institute, London, UK.
A
http://orcid.org/0000-0003-3880-6213
A
Di Iorio
Eastman Dental Hospital, UCLH, London, UK.
E
E
Cole
Eastman Dental Hospital, UCLH, London, UK.
A
A
Tanday
UCL Eastman Dental Institute, London, UK.
I
I
Needleman
D054874:Athletic Performance / Q000502:physiology*; D003731:Dental Caries / Q000150:complications / Q000503:physiopathology; D006304:Health Status; D006801:Humans; D009059:Mouth Diseases / Q000150:complications / Q000503:physiopathology; D009909:Oral Health; D010510:Periodontal Diseases / Q000150:complications / Q000503:physiopathology; D010809:Physical Fitness / Q000502:physiology; D014077:Tooth Erosion / Q000150:complications / Q000503:physiopathology
Dentistry; Evidence based review; Teeth