Elite athletes face hidden oral health crisis

Fraser Macdonald, Dental Tribune International

Wed. 15. April 2026

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LONDON, England: Elite athletes may represent peak physical performance, but growing evidence suggests that their oral health is often far from optimal—raising concerns for both performance and long-term well-being. Drawing together the latest evidence, a recent narrative review has examined why elite athletes may represent a distinctive preventive challenge for dentistry and why oral health should be considered more deliberately within high-performance sport.

Overall, the review found that caries, periodontal disease and erosive tooth wear are common in elite athletes. Although there was marked variability between studies, the prevalence of caries and erosive tooth wear appear to be higher than non-athlete cohorts of comparable age. The authors explain that elite athletes may face this distinctive oral health risk because the nutritional demands of training, competition and recovery often require frequent and prolonged intake of carbohydrates. At the same time, factors such as reduced salivary flow contribute to disease development, and training and competition schedules can make routine dental visits and treatment more difficult.

The review emphasises that oral health should be viewed within a broader, holistic ecosystem, including coaches, nutritionists and sporting organisations. Interventions focused solely on individual behaviour may thus be insufficient without systemic support. Notably, the review found that athletes often report good oral health knowledge and oral hygiene practices and suggests that this may indicate a willingness to accept oral health risk in pursuit of performance. For these reasons, education alone is unlikely to reduce oral disease, the authors suggest, and promoting oral health in elite athletes might be better considered as risk mitigation.

Because elite athletes are highly target-driven and are willing to adhere to structured programmes, the review suggests that interventions should address individual motivations and consider sporting routines and the support of the wider team. In this regard, the authors point to effective, low-cost strategies. Besides standard advice on high-fluoride toothpaste use and support of improved oral hygiene routines, they recommend regular screening and preventive coaching according to individual risk and timing such screening to be in the low season to allow for any treatment. They also set out dietary adjustments and practical changes to hydration, such as alternating water with sports drinks. The review also reports that behaviour change approaches—particularly those aligned with athletes’ motivators—have demonstrated improvements in knowledge, habits and self-reported performance.

Importantly, for athletes, poor oral health is not merely a clinical issue; it may impair performance. Previous research has already demonstrated a clear association between oral disease and reduced athletic performance, including impacts on training and competition outcomes. The authors argue that elite sport should be prioritised for oral health intervention—not only to protect athletes, but also to leverage their influence as role models for wider public health.

The study, titled “What do we know about elite athlete oral health?”, was published online on 27 February 2026 in the British Dental Journal.