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DR. CARLOS DE TERESA GALVÁN SPECIALIST IN SPORTS MEDICINE

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27 Aug 2018

“Practicing sports should also be a good way to foster oral health” 

A member of the board of the Spanish Society of Sports Medicine (SEMED), Dr. Carlos de Teresa Galván explains the keys to understanding the relationship between good oral health and sports, whether professional or amateur. 

Dr. Carlos de Teresa Galvan is a renowned specialist in sports medicine who has extensive experience in the treatment of sports-related pain using electromagnetic waves. He currently directs the Centro Clinico Biotronic Salud and is a sports medicine advisor at the Junta de Andalucia regional government’s Centro Andaluz de Medicina del Deporte Sports Medicine Centre, as well as a member of the SEMED. He also combines clinical practice with teaching as a professor at the Physiology Department of the University of Granada. 

Is practising sports good or bad for oral health? 

Physical exercise and sports in general have been shown to be one of the best strategies to foster health and prevent the most prevalent chronic diseases we are exposed to. Practicing sports should thus also be a good means of fostering oral health, provided of course that the degree with which the sport is practised is appropriate for one’s physical condition and general health, and of course keeping to the specific protective and safety measures that sport might require. 

What are the potential risks of sports drinks to oral health? 

First of all, we must spell out how important sports drinks are in preventing dehydration and in providing the necessary nutrients in order to perform sports safely and in good health. 

But having said that, there are beverages that are very rich in certain types of simple sugars, which can be harmful, causing tooth decay to develop in circumstances where the relative dehydration during sport increases susceptibility to this condition even further. 

The biological plausibility of the relationship between performance in sports and periodontal disease equates over-training with periodontal disease. Are they really the same? 

They are not really the same pathologies, but they share common physio-pathological mechanisms. In over-training there is an immune dysfunction caused by repeated inflammatory processes from physical training, without there being full reversion to physiological homeostasis. This dysfunction causes a progressive energy deficit that leads to chronic muscle fatigue. In the case of periodontitis, the aetiology is a chronic infectious-inflammatory process, which causes structural damage perpetuating the clinical picture. 

However, both processes share a common pathophysiological alteration based on a low-grade chronic inflammatory response due to the immune dysfunction caused by the release of pro-inflammatory cytokines. 

We have a multitude of epidemiological studies and associations between periodontal disease and poor performance in sport. When will intervention studies confirm this hypothesis? 

Once scientific evidence relating periodontal disease with sport risk is available, collaboration between scientific societies and research groups in the field of sports medicine and dentistry will make it possible to design research projects that provide results on the value of dental intervention for the prevention of sports risks linked to periodontal disease. 

Fortunately, the good relations between the Spanish Society of Periodontics and Osseointegration (SEPA) and the Spanish Society for Sports Medicine (SEMED) augurs a very promising future in research and instruction in this common area. 

When we talk about athletes’ performance, we usually refer to top athletes. Is there any difference with amateur athletes? 

Evidently. The effort made to achieve peak performance in elite sport is much greater, with much greater demands in both physical and psychological terms. However, although physical demands in amateur sports are lesser, the need to coordinate working life and sports means that the planning for training must consider circumstances that are certainly complicated if you want to reach decent levels of performance. 

It is therefore even more important to protect amateur athletes from any factors that might affect their health, including oral health, since the stress in training is compounded by regular work and other types of stress that increase the risks for these athletes. 

How can loss of teeth affect performance in sport? 

One of the pillars of performance in sport is nutrition. And the process of digestion of food starts in the mouth, with chewing and salivation. Edentulism thus makes chewing difficult, and consequently digestion and assimilation of nutrients from the foods that make up the diet. This can establish a reduction in the supply of protein and carbohydrates in particular. 

The reduction of carbohydrate absorption decreases the synthesis of glycogen and therefore accelerates the onset of muscle fatigue and the risk of injury due to impaired neuromuscular coordination. The decrease in protein absorption curbs muscle recovery and increases the risk of muscle injuries. 

Therefore, good dental health is a great strategy to achieve good performance in sports and to prevent injuries. 

Are dentists included in the medical teams of sports clubs? 

The figure of the dentist is not yet included in the sports medicine teams of sports clubs, except in top professional soccer clubs. From my point of view, oral healthcare is an important issue in performance in sports, and awareness of this need is increasingly evident in all sports. This requires collaboration between all professionals who care for the athlete, whether amateur or professional. 

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