Flossing boosts athletic performance, study shows

Flossing and using a high fluoride toothpaste could help elite athletes improve their performance, a study suggests.

Research has previously shown elite athletes to have substantial rates of oral disease, including tooth decay and gum inflammation, which negatively affect their wellbeing and sporting performance.

These issues are caused by several factors, including physical activity causing dry breath which in the long-term increases the risk of tooth decay and gum diseases, along with an increased sugar intake from energy supplements.

In an attempt to remedy the issue, scientists at the UCL Centre for Oral Health and Performance (COHP) designed a programme aimed at changing behaviours by educating elite athletes about oral health and providing simple interventions to help their daily toothcare routines.

“Poor oral health of elite athletes is common and is associated with negative performance. However, compared with other health and training pressures, oral health care is not a high priority in elite sport,” the study’s lead author, Dr Julie Gallagher, said.

“We therefore wanted to develop a programme which was aligned with the existing high-performance culture of the athletes and their teams. Underpinning the study was health behaviour psychology, which included education, self-motivation, goal setting, and an easy to use toolkit, ensuring the athletes had a readily available opportunity to improve.”

In the study, published in the journal BMJ Open Sport & Exercise Medicine, 62 athletes from two Great Britain Olympic Teams, rowing and cycling, and one Premiership Rugby Club, Gloucester Rugby, were asked to watch a 10-minute presentation designed to build motivation to improve oral health.

They also watched three 90-second films featuring GB rower Zak Lee-Green focused on increasing oral health knowledge and skills to perform optimum oral health behaviour.

Each athlete received an oral health screening to check for diseases such as tooth decay or gum inflammation, then were given a follow-up report with tailored advice and an oral health toolkit, containing a manual toothbrush, prescription fluoride toothpaste and flosspicks.

They were asked to brush their teeth for two minutes twice a day, before training in the morning and before bed in the evening.

The athletes who took part in the study reported significantly reduced effects on their performance related to poor oral health.

Athletes filled out an adapted Oslo Sports Trauma Research Centre Overuse Injury Questionnaire focused on oral health, which showed their mean scores fell from 8.73 (out of 100) to 2.73 at the end of the study.

In addition, the number of athletes who reported a zero score, meaning they had no negative sporting impact from oral health issues, increased from 51.6 per cent to 98.2 per cent by the end of the study.

Their use of prescription toothpaste increased from 12.9 per cent to 80.4 per cent, while use of interdental cleaning aids at least two to three times a week increased from 16.2 per cent to 34 per cent. The incidence of bleeding gums remained unchanged.

Zak Lee-Green, a member of the GB Rowing Team and a dentist who took part in the study, said: “As athletes we are acutely aware of the marginal gains required to achieve peak performance and maintaining good oral health is a prime example of an area often overlooked.

“This programme has gone a step further than showing the positive effect of excellent oral health on everyday life and has shown the potential benefits for improved performance, helping us reach the highest levels of sport.

“It can only be a step in the right direction if the sporting role models of the present and future are managing their oral health in the same way that they do their elite training.”

Co-author and UCL Centre for Oral Health and Performance lead, Professor Ian Needleman, said: “To compete at the top level elite athletes need to make the most of marginal gains and maintaining good oral health has been proven to have real performance benefits.

“With so many other competing interests, such as training, nutrition, sleep and mental health, it is remarkable to see such great rates of adherence to the new routines in a high-performance environment.”