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Dentists and athletes perspective on the consumption of sports performance aids: dental erosion in long-distance runners

By May 14, 2021Latest News

Running is known to be good for our general health, our mental health but what about our oral health?


For my study, I wanted to find out if long-distance runners have a higher risk of dental erosion due to the consumption of sports performance aids, and if dental professionals were aware of this relationship. This was most at interest to me since I’m a keen runner, I use sports performance aids and I’m in my final year at the University of Portsmouth Dental Academy to become a Dental Hygienist.

To achieve this, I conducted focus groups consisting of 10 members of an official running club and sent out a questionnaire to Dental Students from Kings College London Institute.


What is Dental Erosion?

Dental erosion is the loss of tooth surface due to acids you eat or drink, or acids from the stomach such as acid reflux and vomiting. These acids can dissolve the crystals that make up your teeth, which then leads to tooth surface loss1. It is important to note, dental erosion is an irreversible condition – once the process has started it can’t be undone!


The Signs of Dental Erosion

What Has Dental Erosion Got To Do With Running?


We know long-distance runners are generally supported by sports performance aids. Popular sports drinks chosen by runners include; Lucozade, Powerade and Tailwind. Popular sports gels include; SIS, High5 and Koumanu. Runners tend to have a love/hate relationship with these products (especially gels from their thick, sticky texture) but use them to increase performance and sustain energy levels. However, these products all contain acid.

Research suggests athletes are at higher risk of dental erosion from the frequency of sports performance aids used2. It is estimated between 36%-85% of athletes have clinical signs of erosion with usual diet and sports drinks and supplements being the main causes3.


Surprisingly in the UK, dental erosion is the third most reported oral condition which is becoming a growing concern for dental practitioners4, yet the condition is not routinely screened or monitored by dentists as part of routine check-ups4.


Lifestyle Choices

Lifestyle choices can include occupation, general work/life balance and any habits related to sporting activities such as the consumption of sports performance aids. Research explains that an individuals’ lifestyle can be the cause for up to 80% of dental problems related to dental erosion5.

This graph shows lifestyle choices that are related to the cause of dental erosion6.



Saliva Can Actually Help Reduce Dental Erosion


Saliva can repair the early stages of tooth erosion from its powerful natural defence mechanism that helps to repair the tooth crystals from acid attacks7. When we run, some of us get a reduced salivary flow resulting in having a dry mouth. Dry mouths can also increase your risk of dental erosion. So, it is important to keep hydrated with the help from water.


The Key Findings of My Research…


Focus Groups:

  • The majority of athletes (70%) would choose a sports drink over water on long-distance runs giving the reasons being they noticed sports drinks increase their energy levels and therefore performance.



  • 70% of athletes would use more sports drinks at an event and 80% would use more sports gels as shown in the graph below:

  • Dental erosion had been notified to 40% of the athletes at their routine check-ups.


  • 70% of athletes had some sort of awareness of the detrimental effects sports performance aids could have on the oral cavity. The assumptions were based on the sugar and sweeteners context of the sports drinks and gels.


The Questionnaire:

  • 60% of the Dental Students took part in running activity but, 0% consumed sports performance aids when out on a run.


  • During examination appointments, only 1 Dental Student asked their patients what their hobbies were and 0% asked if their patients participated in physical activity.


  • 61% of Dental Students were unlikely to ask their patients who suffered from dental erosion if they used sports drinks as shown in the graph below using a Linkert Scale:

  • Only 23% of Dental Students screened for dental erosion on examination.


  • 77% of Dental Students admitted there was none or not enough awareness in regards to sports performance aids and running activity… with a couple of the responses being;


No…it has never come up before this study”


“No I think that the questions asked in relation to diet advice are more focused on everyday food and drink…I do not hear many [dentists] ask about hobbies if dental erosion is detected.



Where do we go from here?


From the results of this study, I recommend that further education is required for Dental Students to prevent the occurrence of DE and to provide the most suitable treatment options to their patients’.


From an athletes’ perception, sports performance aids are used by a large population of athletes’, however, the focus groups reveal most athletes’ are aware of the detrimental effects sports performance aids can have on their oral health, but will continue to use them due to the positive effects they have on their running performance.


By dental professionals’ expanding their knowledge in this field, increases the likelihood that their patients’ who partake in running activity will also become more aware on the signs of erosion and therefore make small changes to their lifestyle.


What Can Runners Do To Prevent Dental Erosion?


  • Choose water over sports drinks to stay hydrated.
  • If using a sports gel, rinse the mouth out with water.
  • Chew sugar free gum to promote saliva flow.
  • Avoid the use of sipping sports drinks frequently – this causes the teeth to be hit with multiple acidic attacks. The use of a straw or ‘gulping’ is an alternative option.


Call for Action


For further reading on this subject, below is a list of links to previous research studies on this topic..