Why are top athletes experiencing a tooth decay epidemic?

Why are top athletes experiencing a tooth decay epidemic?

You wouldn’t think that competitive athletes, both amateurs and professionals, would have many oral health issues. They’re usually fit, healthy, active and non-smoking individuals with healthy diets. Not only that, a whopping 94% of elite athletes brush their teeth twice daily as opposed to the rest of us. (According to Australia’s oral health tracker, only around 50% of Australians brush their teeth twice a day. Worse still, only 5% of us flossed daily.)

Alarming rates of oral disease among athletes

However, in a study published recently by English dental researchers from University College London, it was discovered that elite athletes have significantly higher rates of oral disease than everyone else.

As hard as that is to believe, the UCL study was comprehensive and surveyed 352 Olympic and professional athletes from a wide range of sports including athletics, swimming, cycling, rugby league, soccer, hockey, rowing and sailing. All athletes in the study were given oral health checkups that included assessments for tooth decay, gum disease and tooth erosion. They were also surveyed about their oral care and hygiene habits.

Athletes scored high on oral health habits

As far as oral habits go, elite athletes scored impressive results compared to the rest of the population. On top of the 94% who brushed twice daily, 44% flossed or practiced interdental cleaning daily.

The same athletes scored low in their oral health check up

But now for the bad news! Despite all their commendable efforts to maintain their oral health, top athletes experienced alarming rates of oral disease. In the English study, researchers found that 49.1% had tooth decay that was untreated, and of those, nearly all had gum inflammation. When interviewed, 32% stated that their oral health issues had a negative effect on their performance and training.


The paradox explained by UCL researchers

Professor Ian Needlemen, who led the UCL study, reported that there were two main factors that contributed to this grim picture of oral health among the athletes. The first, was their regular use of sports drinks, energy bars and energy gels, all of which consist of sweetened refined carbohydrates. These types of foods and drinks are sticky and contribute greatly to tooth decay and erosion.

In addition, during extended periods of intensive physical activity, the athletes experienced dehydration and a dry mouth. Without adequate hydration, the acidic food and drink residue in their mouths was not being rinsed out by enough saliva.

All elite athletes need to adopt better oral health habits

In conclusion, one of the lead UCL researchers, Dr Julie Gallagher, has recommended that all elite athletes should rethink their intake of energy foods and beverages, adopt more thorough oral health habits and visit their dentist more often.



Julie Gallagher, Paul Ashley, Aviva Petrie & Ian Needleman. Oral health-related behaviours reported by elite and professional athletes. British Dental Journal, 2019 DOI: 10.1038/s41415-019-0617-8


If you have tartar or calculus, you may be at risk of calcified arteries and heart disease

TC-Dental-Group-Upper-Mt-Gravatt-dentist-tartar- calculus

Tartar or calculus is an oral condition where a calcified build up occurs behind or outside your teeth along the gum line. Most oral health information will tell you that tartar is the end result of plaque that has hardened because it hasn’t been removed regularly through brushing and flossing.

Once tartar forms on your teeth, only your dentist can remove it during a dental clean via a nonsurgical dental procedure called scaling. This dental technique utilises a special instrument to remove tartar build up from your teeth above, along and below the gum line.

Tartar is a biomarker for calcium build-up in your body

However, whether you have experienced light or heavy tartar doesn’t mean you just have oral care and hygiene issues, it may also be a sign that you have trouble metabolising calcium.

If your body has difficulty metabolising calcium, it may be going to all sorts of places in your body, like your artery walls, joints, soft tissue and saliva. Everywhere it seems except for your bones and teeth where it’s needed most.

How do high calcium levels in your body cause tartar?

Tartar is not just made up of hardened plaque. It also contains a lot of calcium. So where does this calcium originate? It comes from your saliva. The higher the calcium levels are in your saliva, the more prone you are to developing tartar on your teeth.

Why does tartar only form in certain areas of your teeth?

Tartar, or calculus, usually forms on tooth surfaces that are close to your saliva glands. The saliva glands under your tongue are chiefly responsible for tartar build-up behind your bottom front teeth, and the glands in your cheeks can affect the outside surfaces of your molars.

TC-Dental-Group-Upper-Mt-Gravatt-arterial plaque

What are the health risks of high calcium levels in the body?

High calcium levels in your body can build up in all the wrong places which may cause a range of health issues. These include joint issues, coronary calcification, calcified arterial plaque, heart disease, tartar – and very weak teeth and bones.


The risks of mouthwashes

The risks of mouthwashes

Are oral mouthwashes doing you more harm than good?

There are mouthwashes and there are mouthwashes.

Some are pro-biotic, some are fluoridated to help strengthen tooth enamel, while others contain alcohol and are meant to zap all the oral bacteria in your mouth to kingdom come – or for at least 24 hours till they regenerate and the bad breath starts up again! However, it’s the latter mouthwash option that has come under increasing scrutiny and been red flagged by oral health researchers in recent years.

Should you use alcohol-containing mouthwash to eliminate “99%” of the germs in your mouth?

Maybe not. While it’s true that certain oral bacteria cause acidic plaque that should be prevented to maintain good oral health, there are other essential oral bacteria that are quite beneficial and extremely important to your oral and digestive health.

Together, this community of “good and bad” oral bacteria make up what is known as the oral microbiome. Using a mouthwash that kills 99% of oral bacteria in your mouth means that you are eliminating not just the bad bugs but the good ones as well.

Additionally, alcohol-based mouthwashes can dry out your mouth and reduce saliva which is essential for oral health.

What is the oral microbiome?

The oral microbiome is a large and diverse ecosystem of microbiota aka oral bacteria in your mouth that is second only to the gut microbiome in size. Within it are well over 700 species of oral bacteria living side by side. When your oral microbiome is in balance, your gut flora usually is also and vice-versa.


How do good oral bacteria contribute to good oral health?

When your oral microbiome is in balance, the presence of good bacteria outcompetes the pathogenic bacteria and prevents them from accumulating together en masse via plaque and dumping huge amounts of bacterial acid onto your teeth – thus causing bad breath, tooth decay and gum disease.

Additionally, beneficial bacteria can prevent pathogenic oral bacteria from reaching critical mass, after which they may start to invade your bloodstream and other parts of your body.

Good helpful oral bacterial strains include Lactobacillus salivarius, Lactobacillus reuteri, Lactobacillus brevis and A12.

Since beneficial bacteria can keep pathogenic bacteria in check, you’ll experience a reduction in:

  • plaque build-up,
  • gum disease inflammation,
  • gingivitis,
  • bleeding gums, and
  • bad breath (halitosis).

Certain beneficial oral bacteria can also help prevent oral infection and oral cancer.

What causes an imbalance of good and bad oral bacteria?

Unfortunately, when your diet predominately consists of refined carbohydrates and simple sugars – i.e. sweets, pastries, white flour products and sweet drinks – bad oral bacteria can take over your oral micrbiome. Pathogenic gram negative bacteria outnumber the beneficial ones and start to wreak havoc on your teeth.

Other factors that may contribute to an imbalance of your oral flora include poor oral care, a weakened immune system, genetics and a reduced saliva flow, aka dry mouth.

Mouthwashes that may be harmful to your oral microbiome

You may take probiotics – as opposed to antibiotics – to improve your gut bacterial flora. So why shouldn’t it be any different for your oral microbiome? Essentially, alcohol-containing mouthwashes act as antiseptics and antibiotics destroying a large part of your oral microbiome indiscriminately.

The most harmful mouthwashes to your oral microbiome include ones containing alcohol, hydrogen peroxide and chlorhexidine.

The best way to rebalance your oral microbiome

Eat more fermented pre and probiotic foods, such as raw asparagus and sauerkraut, and fibre-rich vegetables, such as celery, to balance your oral and gut flora.

Include calcium rich foods in your diet such as yoghurt, soft cheeses, kefir and vegetable stalks, such as the stalks of silverbeet or broccoli. Keep in mind that the stalks of any above-ground vegetables often contain higher concentrations of calcium than the leaves or flowers.

Pre and probiotics are also available in concentrated supplements. However, people with weakened immune system should consult their G.P. if they are considering taking them.

Gentler mouthwash options

Listerine, Colgate and other producers of mouthwash are currently researching mouthwash formulas that selectively target pathogenic oral bacteria. However, these products are still in the pipeline.

Fortunately, there are a wide range of probiotic oral mouth washes and rinses available that are alcohol free. These may gentler on your beneficial oral bacteria, teeth and gums. To check out what’s available near you, just Google “oral probiotic mouthwash/mouthrinse” in their Shopping Search bar. Check out product reviews and testimonials to find a product that suits your oral health needs.

Click the following links to check out clinical studies that examine the role of beneficial oral bacteria and the oral microbiome:

When do I need a mouthguard for teeth grinding?

When do I need a mouthguard for teeth grinding?

You may need a mouthguard, known as a nightguard, if you have a chronic teeth grinding habit. If you don’t address the physical/psychological reasons for your teeth grinding habit (i.e. stress), nor use a night guard, you may experience further complications that may put your teeth at risk of permanent damage.

That said, everyone grinds, clenches or gnashes their teeth at one time or another. Most times we don’t even know we do it because teeth grinding, or bruxism, is usually subconscious behaviour, and symptoms aren’t always noticeable at first. It’s not until a partner or carer notices, or one experiences advanced symptoms that you may start to figure out what you’ve been doing with your teeth at night. But when does grinding become a problem that puts your oral health at risk?

The common symptoms of bruxism that indicate you may need to wear a “night guard” mouthguard from your dentist, include:

  • Dull headaches or ear pain – if you wake up with either of these symptoms, the reason could be teeth grinding at night.
  • Sore toothaches – a dull toothache may indicate excess pressure on your teeth from grinding.   
  • Facial stiffness – this symptom may indicate that your facial muscles have tensed for a long period indicating extended teeth grinding.
  • Medication – some medications, such as anti-depressants, cause teeth grinding while you sleep.
  • Non-stop grinding – if you have temporary or chronic stress issues, your teeth may be grinding on them at night.
  • Intense jaw clenching – this may cause your teeth to clench also.
  • Chipped tooth – if you notice a chip on a tooth or wear on the cusps/edges of your teeth – that is not the result of “poor” food choices (e.g. ice cubes) – you may be grinding your teeth excessively.
  • Sore, inflamed jaw joints in the morning – this may be a sign of temporomandibular joint disorder (TMJD) which can occur from teeth grinding.

If you suspect that you have any of the signs and symptoms listed above and may be grinding your teeth, the next step is to see your dentist for a proper diagnosis and potential treatment options.


Teeth grinding may arise from a range of physical and/or psychological issues that will need to be dealt with – especially for children who are experiencing stress, anger and/or anxiety issues.  In the meantime, if you (or a family member) are experiencing bruxism, your dentist can help prevent any further oral health complications – such as attrition – by fitting you with a custom “nightguard” mouthguard that you can wear comfortably at night.

Magnetic microbots to become dental assistants

Magnetic microbots to become dental assistants

Above: Sequential images of a magnetic microbot ploughing through a petri dish containing a biofilm (Credit: University of Pennsylvania)

An American research and development team made up of engineers, biologists and dentists at the University of Pennsylvania have created the next generation of dental assistants – teeny-tiny micro-robots.

These micro-robots are capable of cleaning biofilms, such as oral plaque, with great control and precision via an external magnetic field.

What are bio-films?

Bio-films are thin, slimy, highly-resilient films containing bacterial colonies that can be home to several hundred bacterial species. Bio-films secret a glue-like substance and can stick extremely well to any non-shedding surface.

Examples of biofilms include oral, arterial and brain plaques, as well as biofilms in catheters or water lines.

How do dental micro-robots work?

Dental micro-robots are a type of CAR device which stands for Catalytic Antimicrobial Robots. They are able to completely and systematically breakdown and remove biofilms from a range of surfaces, including the curved surfaces of a tooth. At the same time, CARs kill embedded bacteria and all other residual material until there is nothing left of the biofilm but a completely clean surface.
How are dental micro-robots controlled?

Dental micro-robots, or CARs, are controlled and driven by external magnetic fields, in a similar way to how an aquarium magnet cleaner uses a magnetic handle to control a magnetic scrubber on the inside of aquarium glass. CARs, like aquarium scrubbers, are magnetic also, and follow the direction of an external magnetic field.

Pending further technological development, the motion and direction of the CARs will be actively informed by 3D image scans of the dental plaque sooner or later, which will make them more intelligent and effective at targeting dental plaque on a range of tooth surfaces.

TC Dental Group micro-robots


Geelsu Hwang, Amauri J. Paula, Elizabeth E. Hunter, Yuan Liu, Alaa Babeer, Bekir Karabucak, Kathleen Stebe, Vijay Kumar, Edward Steager, Hyun Koo. Catalytic antimicrobial robots for biofilm eradication. Science Robotics, 2019; 4 (29): eaaw2388 DOI: 10.1126/scirobotics.aaw2388

How much fluoride is just right for good oral health?

How much fluoride is just right for good oral health?

Fluoride is a natural occurring mineral that is found in the environment in water sources that have filtered through volcanic rocks and soil. There is no question that fluoride is an essential factor to develop and maintain strong healthy teeth. This reduces the risk of tooth decay and other oral health complications.

How is fluoride delivered?

Fluoride can be delivered to the body systemically or topically.

Topical fluorides include fluoride toothpastes, mouth rinses, gels and varnishes. These act by strengthening the teeth directly, and making them more resistant to tooth decay. However, the beneficial effects of topical fluorides, apart from varnishes, wear off easily. This is why you should wait at least 30 min after applying topical fluorides before eating or drinking again.

Systemic fluorides are ingested and integrated into developing tooth structures. Systemic fluoride can be found in tap water, fluoride supplements, and food and drinks such as shellfish, chicken, potatoes, grapes and rice. If these foods have been prepared with tap water, the concentration of fluoride is further increased. Once systemic fluoride enters the body, it can also make its way into your saliva, which provides a continual fluoride wash over your teeth.

How much fluoride is required by the body?

The amount of fluoride your body needs depends on your body weight. As a general rule, children need 0.5mg (500?g) of fluoride daily. This why kids should only use a small pea-sized amount of toothpaste on their toothbrushes, and be taught to spit not swallow. Adults need between 3 to 4mg (3000-4000?g) daily.

The upper limit of fluoride intake is 2.5 times the recommended intake. Beyond this level, fluoride may have negative health effects.


Too much fluoride can lead to fluorosis

While the right amount of fluoride intake is essential to strengthen tooth enamel and prevent oral health issues, too much can have adverse effects. If a child consumes too much fluoride as their teeth are developing, they can experience an oral condition called fluorosis.
Fluorosis leads to white or brown discolouration or spots on tooth enamel. However, it is only a cosmetic effect and affects the appearance of teeth, not their health or strength. If you are a parent and notice any of these signs, consult with your family dentist. They can determine if any discolouration is the result of fluorosis, and recommend ways to limit your child’s fluoride intake.

On the other hand, your dentist may identify signs of a fluoride deficiency, which should also be avoided as this leads to softer enamel and weaker teeth.

Cranberries to help in the fight against tooth decay

Cranberries to help in the fight against tooth decay

In March 2019, oral health researchers at the University of Queensland published the results of a study on the oral bacterial fighting properties of cranberries and other dark-coloured fruit berries.
Previous clinical research has shown cranberry polyphenols to have antimicrobial qualities. But the UQ team took another step, and further investigated the effects of cranberry extracts on oral bacteria samples derived from saliva.

What they found was that cranberries are excellent for your oral health!

Traditional benefits of cranberry

There has always been an awareness of the health benefits of cranberries in recorded human history. The American cranberry had been used by Native American Indians for centuries to treat scurvy, and to help heal stomach and liver problems.

Earlier still, the Ancient Romans were well aware of its medicinal value. And in England, cranberries were a go-to remedy for diarrhoea, scurvy, fevers, and skin, urinary and genital infections.

Nowadays, clinical studies have proven that cranberries are indeed medicinally beneficial for many of the same ailments that ancient people experienced. However, science has gone on to discover other health benefits including lowering the risk of heart and neurological disease, regulating inflammation and inhibiting cancer cell proliferation.


The UQ Cranberry test results.

The UQ researchers’ test results show that the polyphenols, or phytochemicals, abundantly present in cranberries had a significant inhibiting effect on the types of oral bacteria that cause tooth decay and cavities.

After a 12 hour period, oral bacterial bio-film samples treated with cranberry extracts showed a 38% drop in bio-mass, a 44% reduction in acid formation and a 51% reduction of bacterial colony forming units (CFUs).

The UQ researchers now plan to develop an oral care and hygiene product for daily use containing the medicinally beneficial Cranberry extract used in their study.


Interview: ‘We intend to ultimately develop a daily use oral care product with a natural substance? (2019, April 4). Retrieved from https://ap.dental-tribune.com/news/interview-we-intend-to-ultimately-develop-a-daily-use-oral-care-product-with-a-natural-substance/

Philip, N., Bandara, H., Leishman, S. J., & Walsh, L. J. (2019). Effect of polyphenol-rich cranberry extracts on cariogenic biofilm properties and microbial composition of polymicrobial biofilms. Archives of Oral Biology, 102, 1-6. doi:10.1016/j.archoralbio.2019.03.026

Philip, N., & Walsh, L. (2019). Cranberry Polyphenols: Natural Weapons against Dental Caries. Dentistry Journal, 7(1), 20. doi:10.3390/dj7010020

Have you experienced tooth erosion?

Have you experienced tooth erosion?

Most people are familiar with tooth decay but not tooth erosion. Tooth erosion should not be confused with tooth decay which is a type of tooth damage caused by bacterial acidic by-products – however they are similar.

What is tooth erosion and what causes it?

Tooth erosion occurs when you lose tooth structure, namely your tooth enamel, due to chemicals. The chemicals that cause erosion are found in acidic food and drinks, or acid refluxed from your stomach.

If you consume excessive amounts of acidic food and drinks daily, then you have probably already experienced tooth erosion without realising it. For example, soft drinks can contain high amounts of citric and phosphoric acid. Sipping on them as opposed to using a straw can bath your teeth in an acid bath that can wear away your teeth continually.

Other possible causes of tooth erosion include bulimia, GI problems, certain medications and genetics.

How does your dentist measure tooth erosion?

Your dentist measures tooth erosion by comparing the thickness of enamel on each tooth. There are also other signs of tooth erosion that your dentist looks out for, including:

  • darker or yellowish discolouration of your teeth indicating the dissolving of enamel,
  • sensitivity to hot, cold or sweet foods,
  • thin or transparent front teeth tips,
  • shape changes to your teeth that can give them a concave appearance,
  • a glassy appearance on your tooth surfaces,
  • flattened or pitted chewing surfaces of your molars, and
  • the impression that your natural tooth structure appears to be sinking around a filling.


How can tooth erosion be prevented and treated?

To prevent erosion, limit the amount of acidic foods and beverages that you consume. When you eat or drink them, do so promptly and try rinsing any residue left in your mouth with water.

As far as dental treatment goes, there’s only so much your dentist can do since enamel loss is irreversible. However, your dentist can restore an eroded tooth to protect the inner tooth structure or dentin. Try using a fluoride or desensitising toothpaste to strengthen your tooth enamel as well.

How a high-fibre diet can improve your oral health

How a high-fibre diet can improve your oral health

A new study* conducted by New Zealand researchers at the University of Otago aims to figure out why high fibre foods are good for your oral health. Previous clinical research has already established that a higher fibre and wholegrain intake is beneficial for oral health, but the Kiwi scientists now want to better understand the actual mechanism that makes it so.

How do high fibre foods benefit your oral health?

Although the links between a high fibre diet and better oral health have been recognised by a number of studies, the reasons why still need more confirmation. However, scientists have identified a few potentially beneficial mechanisms that occur when you consume foods high in fibre:

  1. Cleansing action. The fibre in high fibre foods may gently scrap and buff your tooth surfaces, removing plaque build-up in the process.
  2. Oral bacterial inhibition. Certain substances found in the bran layer of wholegrains may inhibit the growth of oral bacteria.
  3. Chewing increases saliva production. Consuming high fibre foods involves a lot of healthy chewing. This increases your mouth’s production of cleansing, anti-bacterial saliva, as well as stimulating blood flow to your teeth & gums.

What are the best high-fibre foods?

High-fibre foods refer to foods that are high in dietary fibre. To get the fibre you need, there are a number of foods that are rich in fibre, including:

  • Vegetables – Vegetables that are rich in fibre are generally richer or darker in colour but there are exceptions. High fibre veges include carrots, celery, broccoli, beetroot, leafy greens (incl. spinach, silver beet, pak choi & kale) and potatoes (incl. sweet potato).
  • Fruit – High fibre fruits include apples, oranges, pears, bananas and berries.
  • Wholegrains – Wholegrain foods that are high in fibre include intact wholegrains and finely milled wholegrains such as whole grain breads (dark rye, pumpernickel & whole wheat), oats, brown rice, wild rice, bran and barley. Choose bread with at least 3 grams of fibre per slice.
  • Beans and legumes – Try adding more lentils, peas and beans to your casseroles, soups and salads.
  • Seeds & Nuts – Watch the calories but try loading up on chia seeds, quinoa, pumpkin seeds, sunflower seeds, pistachios and almonds.


How much fibre should you eat per day?

The Heart Foundation’s recommended intake of fibre per day is 30 grams for men and 25 grams for women. Children aged between 4 and 8 years old should consume at least 18 grams. Girls aged between 9 and 18 years old should increase their intake gradually from 20 to 22 grams, while boys need to consume 24 to 28 grams. But it’s totally ok to eat more than these recommended amounts!

To simplify, this recommended fibre intake translates into:

  • approx. 4 serves of wholegrain or wholemeal foods daily,
  • approx. 5 serves of vegetables, beans or legumes daily, and
  • approx. 2 serves of fruit daily.


* Dental Tribune International. (2019, January 24). Researchers investigate link between high fibre diets and oral health. Retrieved from https://ap.dental-tribune.com/news/researchers-investigate-link-between-high-fibre-diets-and-oral-health/

Clean your tongue for better oral & general health!

Clean your tongue for better oral & general health!

Keeping your tongue clean is an important part of oral health care and hygiene. Why? Because oral bacteria can build up on your tongue, just like it does on your teeth.

If excess bacteria accumulate on your tongue, you may experience halitosis or bad breath. But that’s not all. You may also be at higher risk of more serious oral health complications, such as oral infections, periodontal disease and lung infections.

Daily tongue cleaning reduces your risk of gum disease (periodontal disease)

Cleaning your tongue is very important if you want to reduce pathogenic tongue bacteria. Take Fusobacterium Nucleatum for example. It is a highly invasive bacterium that causes periodontal (gum) disease.

F. Nucleatum feed off fermenting carbohydrates and cause dental plaque. These microorganisms live quite comfortably in the mucus on your tongue. They can proliferate into huge colonies within tongue mucus, which can contain 100s of millions of these nasty rod-shaped critters. Now imagine brushing your teeth, but not your tongue.

What happens next?

As soon as you put down your toothbrush and close your mouth, your bacterially coated tongue is going to redeposit millions of bacteria straight back onto the teeth you’ve just cleaned! F. Nucleatum can also infect the head, neck, chest, lungs, liver and abdomen if given the opportunity.

Tongue cleaning may help prevent lung infections

Tongue cleaning is a crucial part of a general health routine to help prevent pathogenic bacteria from spreading to the rest of your body. Many previous clinical studies have shown that you can inhale aspirated oral bacteria from your mouth straight into your lungs. This can lead to health complications if your immune system is under par.

According to a new study published by Japanese dental researchers in August 2018, a bacterial imbalance on your tongue can lead to pneumonia and other respiratory health problems – especially if you are an older adult with missing teeth, high plaque levels and more tooth decay than usual.

The Japanese researchers noted that equal attention should be given to maintaining proper oral care of the tongue, as well as the teeth and gums, for good oral health.