By Dr. Mercola
According to dental professionals, endurance athletes are at greater risk for dental problems than non-athletes, courtesy of their fitness regimen. Why would that be so?
As it turns out, there appears to be two primary culprits contributing to this phenomenon: consuming large amounts of sports drinks, and breathing improperly during training, causing dry mouth.1
Either of these can wreak havoc with your oral health, and the risks are amplified when you add them together.
Elite Athletes and Oral Health
According to a study published in the International Journal of Sports Medicine2 three years ago, elite athletes use training strategies that “coincide with risk factors for dental caries and erosion.”
The study, which aimed to identify specific risk factors for dental caries in elite triathletes, found that nearly 84 percent of them consumed sports drinks during training. Nearly half of them took “little sips often, from a bottle.”
Another more recent study3 included 35 triathletes and 35 non-exercising controls. After assessing oral status, and looking at the participants’ eating, drinking, and oral hygiene behavior, the researchers found that athletes had an increased risk for dental erosion, but not caries—although their risk for caries was significantly correlated with their cumulative weekly training time. The more they trained, the higher their risk for caries.
Other studies have found similar results. As noted by the New York Times:4
“In a study published last year in The British Journal of Sports Medicine,5 dentists who examined 278 athletes at the 2012 Summer Olympics in London reported that a majority displayed ‘poor oral health,’ including high levels of tooth decay, often in conjunction with gum disease and erosion of the tooth enamel.
The athletes came from the United States and Europe as well as less-developed parts of the world, and most had access to good-quality dentistry, although many had not visited a dentist in the last year.”
Sports Drinks are Not Ideal Hydration for Athletes (or Anyone Else)
Aside from their chronic use during athletic training, sports drinks are also a popular beverage choice during summer months.
Many believe they are necessary to restore your electrolyte balance during exercise or other outdoor activities, but while the theory is sound, commercial sports drinks are anything but healthy.
Sports drinks (Gatorade, Powerade, and others) basically “work” because they contain high amounts of sodium (processed salt), and other electrolytes, which are meant to replenish the electrolytes you lose while sweating. However, this processed salt is by no means ideal. (Below I’ll discuss healthier alternatives.)
One of the primary problems with sports drinks is related to the high amounts of sugar these drinks contain. The leading brands of sports drinks typically contain as much as two-thirds the amount of sugar found in sodas and many contain far more. They also contain processed high-fructose corn syrup (HFCS) and/or artificial sweeteners.
Sugar, as you probably know, is the enemy when it comes to maintaining optimal dental health. It’s very difficult to maintain caries-free teeth if you’re consuming high amounts of sugar, as sugar feeds bacteria that produce tooth decay and gum disease.
Previous research has also shown that sports drinks are up to 30 times more erosive to your teeth than water, courtesy of the corrosive activity of phosphoric or citric acid. Brushing your teeth won’t help because the citric acid in the sports drink will soften your tooth enamel so much it could be damaged by brushing.
Continuously sipping a sugary beverage is particularly harmful to your teeth, as with each sip you’re feeding caries-promoting bacteria in your mouth.
Aside from its detrimental effect on your teeth, processed fructose is also known to inhibit your body’s natural production of human growth hormone (HGH), also known as “the fitness hormone,” and should therefore be strictly avoided before, during and for at least two hours after high intensity exercise.
Granted, there is a small group of elite and highly competitive athletes for whom increasing growth hormone is not a primary goal. Since they're competing, they're less likely to be concerned about long-term growth hormone levels. But for most others, increasing HGH through high intensity interval exercise is an important factor for optimizing health.
Fructose also fools your metabolism and essentially tricks your body into gaining weight by turning off your body's appetite-control system. It also rapidly leads to weight gain and abdominal obesity ("beer belly"), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure -- i.e., classic metabolic syndrome.
Better Hydration Alternatives
Aside from competitive endurance athletes, it’s quite rare for exercisers to work out hard enough that electrolyte replenishment becomes necessary. Sports drinks typically are not even necessary during a marathon, let alone during most regular workouts. According to one study,6 many athletes actually drink too much water and sports drinks—to the point of hurting their performance due to overhydration...
That said, electrolyte replacement can be necessary if you’re training hard and sweating profusely. One of the best gauges at your disposal is your thirst. Drink as soon as you feel thirsty. Do avoid commercial sports drinks, however, as they contain a slew of ingredients your body does not need.
Ironically, while these drinks are often referred to as "energy" drinks, in the long run the sugar they contain does just the opposite. After causing a quick explosion of energy, your energy plummets as your pancreas and other glands do all they can to balance out the toxic stimulation to your blood sugar.
Instead of a sports drink, consider coconut water when you need to rehydrate during exertion or when sweating profusely. It’s a powerhouse of natural electrolytes, vitamins, minerals, trace elements, amino acids, enzymes, antioxidants, and phytonutrients. While being low in sugar, it’s still pleasantly sweet.
Coconut water also has anti-inflammatory properties, protects your heart and urinary tract, is a digestive tonic, improves your skin and eyes, supports good immune function, and can even help balance your blood glucose and insulin levels. Look for a brand that has no additives, or purchase a young coconut and drain the coconut water yourself.
Another healthy option is to add a small pinch of natural, unprocessed salt, such as Himalayan salt, to your water. You can also add a splash of lemon or lime juice if you like. Contrary to processed salt, this natural unprocessed salt contains 84 different minerals and trace minerals that your body needs for optimal function.
Mouth Breathing—Another Factor That Promotes Poor Oral Health
Most people, including elite athletes, tend to breathe heavily through their mouth during exercise. Mouth breathing reduces the flow of saliva and dries out your mouth. This too allows bacteria to thrive. Add sugary drinks with corrosive ingredients, and you have a recipe for dental caries. Aside from turning your mouth into a breeding ground for caries-producing bacteria, heavy mouth breathing also has other repercussions for your overall health and fitness. You may not realize that there is an optimal way to breathe to increase body oxygenation... In fact, about 80 percent of the Western population breathes incorrectly—especially during heavy exertion.
Mouth and nose breathing differ dramatically in terms of the depth of your breath, how the air is “prepared,” and the effects they produce in your body. Nasal breathing has a number of physiological advantages over mouth breathing.7 One important benefit is the production of nitric oxide (NO). NO is made by your nose and sinus mucous membranes, so when you breathe through your nose, you carry a small amount of this gas into your lungs.8, 9 NO is a potent bronchodilator and vasodilator, so it helps lower your blood pressure and significantly increases your lungs’ oxygen-absorbing capacity.10, 11, 12 NO also kills bacteria, viruses, and other germs.
Overbreathing, on the other hand, which results from hyperventilating during exertion, causes your CO2 levels to drop. This reduces blood flow to your heart and increases your risk for cardiac arrhythmias. Needless to say, this can be dangerous.13, 14, 15 Most athletes experiencing sudden cardiac arrest during exertion don’t fit the model of what you would normally expect, in terms of heart disease risk—they seem to be doing everything right. However, like the rest of us, they often breathe too deeply and quickly which is a risk factor by itself. Hyperventilation may play a significant role in some of those unexpected cardiac events in otherwise healthy athletes. It could also be the reason why extreme endurance exercise has been found to have more risks than benefits for your heart.
How the Buteyko Breathing Method Can Benefit Your Fitness
If you tend to hyperventilate or breathe through your mouth during exercise, there are simple techniques you can learn to gradually transition yourself back into nose breathing. Nose breathing will also help prevent the creation of an environment in your mouth that could promote caries and dental erosion. I have become a fan of the Buteyko breathing method, named after the Russian physician who developed it back in the 1950s. Patrick McKeown, featured in the video interview below, is now one of the world’s top Buteyko trainers.
Once I decided to implement the Buteyko breathing method, it took me a few weeks of persistent effort but I was eventually able to complete all of my Peak Fitness Exercises with my mouth closed, even when my heart rate is well above my calculated maximum of 162. Air hunger hurts, which makes it challenging, but it does get easier with practice.
Your Exercise Regimen Does Not Need to Affect Your Oral Health
I think an important take-home message here is that even if you’re going to great lengths to stay fit, as in the case of highly competitive athletes, even minor mistakes can still trip you up and have detrimental repercussions. Here, drinking sugary, corrosive sports drinks heightens your risk of dental caries and erosion. They also hinder HGH production, and promote metabolic dysfunction. By ignoring the basic health principle that says, “drink pure water,” you can nullify many of the health benefits of exercise. That surely seems like a huge waste of time and effort, doesn’t it?
Again, in instances when you need to replace electrolytes, adding a pinch of natural unprocessed salt to a large glass of water can get the job done. Coconut water is another excellent alternative to sports drinks. Then there’s the issue of breathing correctly during exertion. While it seems like that should be completely automatic, most people get this wrong, too.
Even if you are not an endurance athlete, it‘s important to control your breathing when you exercise. Ideally, you should be exercising only to the extent that you can continue breathing through your nose the vast majority of the time. If this means backing off on intensity, then that’s what you need to do, realizing that it’s only temporary until your body begins to adjust to your slightly increased CO2 levels. With practice, nose breathing during exercise will help improve your health and fitness—and it can help you maintain better oral health.