Academy Footballer's Oral Health ‘Disadvantaged’ - GDP Led Research
- Details
- Published: Tuesday, 20 May 2025 14:03
- Written by Peter Ingle
- Hits: 462
Reduction of inequalities is a key ambition for UK healthcare, and is very much expected to be a major part of any updated NHS dental contract. A recently published paper investigating the oral health of academy footballers underlines the embedded nature of these inequalities.
Titled ‘Disadvantage starts early’ the paper published in BMJ Sports and Medicine has a GDP as lead author.
Saul Konviser is a GDP based in Marylebone with a particular interest in Sports Dentistry and an exponent of the ‘General Health through Dental Health’ philosophy. The recent paper follows previous studies that have reported that the oral health of elite and professional athletes is worse than comparable national population survey data. Saul has also worked with some of the UK’s leading elite sportspeople to help them to understand how maintaining good oral hygiene is essential to building a successful career at the highest possible level.
It had previously been reported that 37% of footballers presented with dental caries requiring treatment and self-reported impact on performance from oral diseases was present in 7–30% of all athletes.
The aim of the new study was to investigate the oral health of a representative sample of academy footballers in England, and to explore possible influences on their oral health.
Data collection was from clinical dental screening and a questionnaire. Caries, periodontal health and erosive wear were measured using standard indices. The questionnaire examined demographics, oral health behaviours, current dental issues and oral health routines, including brushing or the use of floss, consumption of sports/energy and fizzy drinks. There was also a section to record the respondent’s assessment of the impact of oral health and trauma on their training or performance.
Recruitment was via medical teams at academy football clubs in England. Female and male players were included in the study and players had to be aged 16–18 years to be eligible to participate. Ten clubs were involved and 160 subjects completed the screening.
The results showed a high level of dental disease. 56% of participants had at least one tooth decayed, missing or filled. 42% required one or more restorations of carious teeth. For periodontal health, 22.5% of participants had grade 3 or 4 scores in their BPE, and only one participant achieved a complete set of 0 scores. An assessment of wear and erosion via the BEWE score showed 13% had moderate wear of tooth structure, including dentine exposure. Nearly 2% had tooth wear affecting over 50% of the tooth surface, which would require professional management and intervention.
Just over a third of those examined had trauma to their incisors and none reported wearing a mouth guard during sport.
Just over 10.6% of subjects said that they were currently experiencing dental pain at the time of assessment, with reports of bleeding gums and broken or fractured teeth and fillings.
Over 13% of participants reported a negative impact on their sporting performance from either oral health issues or dental trauma.
Following statistical analysis, observations were that, flossing was associated with dental attendance, and in turn attendance was associated with periodontal health. There was also a positive association between a higher BPE and a higher BEWE. In terms of variation, only periodontal health differed significantly by club.
Use of mouthwash was associated with a perceived importance of oral health to sporting performance. Paradoxically, perceived importance of oral health to sporting performance was positively associated with DMFT. It may be that these players had experienced the negative consequences of poor oral health, and so now understood its impact on their sporting performance.
Poor oral health is disproportionately associated with levels of deprivation and levels of dental attendance are linked to socioeconomic status. This might be an important factor in explaining the oral health of the academy players. While no data was collected on player socioeconomic status within the study, it is an important area for future research.
There were high levels of tooth wear for such a young population. With clear patterns of tooth wear identified during the study on the palatal surfaces of the upper front teeth, it would suggest a role for acid reflux and possible eating disorders. At present these issues can go undetected until becoming problematic for the player, and will affect both their dental health and general health and well-being.
The part played by sports drinks may be a contributing factor to the amount of wear and erosion seen. It is postulated that increased length of training sessions leads to reduced buffering capacity of saliva due to oral dehydration during physical exercise, resulting in more tooth wear through dental erosion.
These findings call strongly for early preventative dental screening programmes and more regular dental examinations to help identify both basic dental health needs and the additional risk factors that academy footballers face. These young athletes are dependent on support and guidance from others, and oral health should be integrated into overall athlete health and well-being.
It is recommended that oral health screening at clubs for these players should take place annually, and further, that academy players also have regular dental examinations in a dental surgery with appropriate dental radiographs and professional hygienist services, followed by ongoing assessments on a risk based frequency. In many cases, the participants of this study would be classified as high risk, with a recommended 3 monthly dental recall for both check-ups and professional hygiene appointments.
The original articla can be read at https://bmjopensem.bmj.com/content/11/2/e002245 .
You need to be logged in to leave comments.
Report
My comments