Oral Hygiene and Endurance Athletes

Thought folks on this forum might benefit from the advice in this article. Obviously, some things that are good for performance on the bike aren’t great for overall health. There are trade-offs, but I like that the article had a few relatively easy modifications.

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Great post. I’ve been thinking a lot about this lately and there is basically nothing on the forum about it (lots of bluetooth, no teeth).

There are some other good things out there. I particularly like this one from cycling tips:

Personally, I’ve been trying to limit my use of hydration drinks. I had been using them with every ride but am now trying 1/2 concentration or just plain water. One of the culprits is supposed to be acidity and Beta Fuel is marketed as being pH neutral so I’ve been trying that on longer weekend rides. I’m not sure I buy the gels as being a big culprit. I eat them so quickly, they don’t touch my teeth. Other than that I’m for sure going to talk to my dentist about all this the next time I go.

For the trainer road employees out there, this would be a great topic for a deep dive on the podcast. It effects all of us and until this post, no on has mentioned it.

I started thinking about all of the sugar back in 2016 when I saw this post from Ted King, where he states:

I brushed my teeth today!

(Okay, I brush my teeth every day. Twice most days, sometimes thrice when I’m riding 200 miles at a go and eating lots of sugar. Tim Johnson taught me that.)

Definitely agree this is something we need to be more aware of.

All the more reason to use gels that don’t taste that great. You are more likely to just squirt it directly down your throat. Since there are more than enough sweet receptors on the back of your tongue, you don’t have to worry about missing the anticipatory response. So these days when shopping for gels, I’m actually paying a lot of attention to the shape of the packaging and how it fits in my mouth.

Not to mention having carbs in your bidon is a hassle in my opinion. A water and minimalist electrolyte solution is much more versatile and hygienic. Constantly sucking on something sweet must confuse your stomach quite a bit, kind of like the overproduction of gastric acid when you are always chewing gum.

Coffee is also a big culprit here. Again due to its acidity.

Thanks for posting, have read quite a few articles like this over the years. It’s one reason I use very little in the way of proper sports nutrition products (main other reason is cost). It shouldn’t really be a surprise that constantly putting sugar in your mouth isn’t great for your teeth!

My approach for the last 10 years (broadly in line with the recommendations of the article) has been:

  • Sugary sports drinks are the worst as you’re sipping and just topping up the sugar in your mouth. I’ve almost completely eliminated these from my cycling, only time I’ve used them recently has been during the run on longer triathlons when I need cals and my body can’t handle anything solid
  • For longer/harder races and training sessions where I need sugar, I make sure I’m drinking water after I take it on to flush my teeth (I also tend to use Haribo or jelly babies as the sugar source instead of gels, but that’s a cost and flavour thing, they’re no better for my teeth)
  • Wherever possible I use more natural and less sugary nutrition. Bananas, dates, trail mix, etc. Again washed down with water as those foods still pack quite a bit of sugar. This actually covers pretty much all my training apart from races and the occasional long hard group ride which is race-like in it’s intensity

The suggestion of special high fluoride toothpaste is a new one on me, will take to my dentist about that, doesn’t quite seem right since if more fluoride was a good thing you would think all toothpastes would have higher levels as standard. Not using mouthwash is also something I hadn’t heard before, will have to check whether my mouthwash is antiseptic!

No need to stop using gels or carb drinks. Just rinse with water each time. I use them a lot and my hygienist hasn’t seen any problems with my teeth.

Also make sure to brush your teeth before drinking something that attacks your teeth, like acidity drink. The toothpaste is there to protect your teeth, not to clean it.

I know people who have a breakfast and afterwards brush their teeth. Not a good idea, acids from an orange juice attack your teeth and you then brush off the protective layer.

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Indeed, a critical topic. For me a visit to the dentist a few years ago was a real shocker. Not just financially. Ever since I basically adopt the 2-bidon-strategy. Only exception is during races.

I’ve done that my whole life, currently 55, with zero issues. Rather the contrary as brushing after breakfast removes any food for the bacteria to feast on. In fact, common advice here in Sweden as long as I can remember, has been to brush your teeth after every meal for that very reason. Toothpaste also contains detergents and mild polishing agents to aid the cleaning process.
What’s in your toothpaste? A look at 5 common ingredients

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Might get away with food that isn’t acidic. I saw the impact after an experiment with coke during my time as a student. You can feel as see the damage it did after a single use.

You should know, however, that brushing your teeth after eating can sometimes affect your tooth enamel. According to the Mayo Clinic, if you’ve consumed anything acidic, you should avoid brushing your teeth for at least 30 minutes. Foods containing citric acid , like oranges, grapefruits and lemons, weaken tooth enamel. Brushing too soon after eating them can damage the enamel in its weakened
Consequently, it’s a good idea to brush your teeth before eating an acidic food and to drink a glass of water when you are finished to wash away the acids. As an alternative to waiting to brush your teeth, try eating nutritious foods that are low in carbohydrates and sugar after eating something acidic. This will help reduce the harmful acids that such foods can create.

Science :face_with_raised_eyebrow:

https://www.nature.com/articles/s41407-019-0127-1

the overall findings in summary were that the acidic nature of sports drinks has the potential to cause dental erosion, however, saliva control and frequency of consumption - habit, is more important in this instance. In addition, it was the studies agreed that enamel surface was softened by sports drinks once consumed but did not qualify as erosion; there was no correlation with sports drinks and dental erosion. In addition, Antunes et al. (2016)12 highlights the fact that with the use of isotonic sports drinks, there is no association with dental erosion.

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Yet still, we have this:

https://www.nature.com/articles/s41415-019-0617-8

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Ah I read about this stuff a while back and got quite concerned as well. Especially the extremely low pH value of these sports drinks. I even used citrates and soda to bring the sportsdrinks to neutral pH… a funny side effect: they tasted like absolutely nothing afterwards :sweat_smile:

But now I just use water for 1-2 hour rides. No need for any sugar for such short sessions and for the one or two long rides per week… it’s like whatever…
I think when it comes to dental health (and general heath) the stuff we eat in between rides has a much greater impact (I mean most of us still spend like 95 % of their time NOT on the bike :wink: ), especially when those darn coworkers keep having birthdays and bring cake to work :drooling_face:
just pay attention to your day to day habits and keep brushing your teeth people :smile:

Yeh, I mean. It’s not a crisis level thing. And yeh, for stuff between 1-2 hours, unless it’s a indoor interval session over 90min, I also only drink water.

I brush twice a day, floss once a day and my other sugary stuff is basically taken in training. I don’t drink soda, don’t sweeten my coffee, etc. I’ve always done the “two bottle” method and use a pretty dilute sports drink because I get burnt out on sweet stuff quickly. I haven’t had a cavity or any dental work for over 10 years.

I thought this would be a useful article for the forum, because, despite good dental habits, the surveyed athletes do have more dental problems than average people with typically worse habits. I also liked that the tips were pretty minor interventions (ie, change your toothpaste) that wouldn’t really effect your life.