Dr Armstrong: Preventing dental problems

Dr Stuart Armstrong continues his great series on health topics relevant to Kiwi cyclists by discussing the prevention of dental problems.

There are a couple of different reasons why cyclists are more prone to these problems.

Sports drinks and gels 

Firstly, there has been a lot of controversial talk about the role of sports drinks in the development of dental cavities and erosion.

On one side you have the dentists saying they are bad, on the other side you have the beverage companies saying they don't cause any problems.

Personally, I think we can ignore the debate. If we don't take in sports drink then realistically it will be a pretty short and unpleasant ride on the weekend.

Tooth damage tends to happen with a drink pH of less than 5.5. The majority of sports drinks are around the 3-3.5 level.  

[Lower pH means higher acidity]

Soft drinks are even lower at 2.5-3. A lower pH is chosen as it makes the drinks more palatable, and gives them a longer shelf life. The pH doesn't affect the body's ability to absorb them.¹

The Stephan curve (left) demonstrates how the pH around your teeth enamel drops rapidly in response to a sugar load. The pH then normalises due to the action of saliva.

Mitigation strategies

There are a couple of different strategies we can employ to minimise the problem.

It is much better to take the sports drink in one big gulp every half hour or so than frequent sipping.

If you carry a bottle of water, then rinsing your mouth out with water after sports drink, and cleaning your teeth in the middle of the day after you return from your morning ride can help.

There are a number of gels that can be fairly acidic and avoiding these will also help protect your teeth.

It is also important to remain hydrated. If you become dehydrated through the day your saliva production dries up. Saliva is one of the best defences you have against dental problems.

On this note, I should mention the benefits of chewing gum. My dentist, who happens to be my father-in-law!, got me onto chewing a specific gum (Recaldent) which is especially good for protecting your teeth and hardening your enamel.

Unfortunately, this is not widely available in New Zealand currently. Other brands of chewing gum can also be of benefit, mainly due to increased saliva production.

Teeth sensitivity

Sensitive teeth are something that has troubled me considerably in the past. I would be especially troubled for a few days following a long race. After around 10 hours surviving on sports drinks and gels I would have pain on eating for days afterwards.

The sensitivity of teeth is due to microscopic pores opening in your teeth and teeth "softening" due to the sports drink and gels. In general it is nothing to worry about, but it is a signal that damage is being done.

With the above measures I undertook over the last couple of years, I can now tell you I haven't had any further problems and I am now confident in the strength of my teeth.

Regular check-ups

Regular dental check ups are a necessary expense to protect your teeth. Plan to have your own teeth around for a long time after you have jumped off your bike for the last time.

Another recently recognised problem is dental erosion. This has been widely recognised in bulimic individuals due to the acidity from making yourself vomit. There are a number of cases being identified in sports people.² This is thought to be due to a couple of unique factors. As mentioned previously, acidic sports drinks and dehydration can play a part. Another important factor can be chlorinated swimming pools.

When to brush your teeth

The current theories are that sports drinks combined with dehydration can combine to demineralise and soften the surface of your teeth.

If you then jump off the bike after your morning training session and vigorously clean your teeth, you then brush away the demineralised matrix before your body can repair the damage.

A good bit of advice is to wash your mouth out with a glass of water (or even better, milk) after training and wait around 30mins before brushing your teeth. This has been shown to be a good preventer of dental erosion.

A good investment

The money you save on dental visits can always be put towards renting a good set of wheels for your next race!!

Summary

• Have regular longer drinks rather than sips of sports drinks
• Rince your mouth out with plain water after drinking sports drinks
• Keep hydrated at all times
• Increasing saliva production is a good thing, try chewing gum
• Have a regular dental check-up
• Don't brush your teeth straight after a ride, leave it 30min

References

1 - Maughann RJ, Leiper JB (1999). Limitations to fluid replacement during exercise. Canadian J of Applied Physiology 24;173-187
2 - Sirimaharaj V, Brearley Messer L, Morgan MV (2002). Acidic diet and dental erosion among athletes. AustDentJ 47; 228-236

Any and all information obtained on roadcycling.co.nz should not be taken as a recommendation for treatment of any particular person or patient. Should you think that you, or any other individual, might require treatment for one of the conditions described here, please seek the advice of a qualified physician or doctor. Please be advised that using the information provided here in no way means that a doctor-patient relationship has been established between you and the author of the information provided on this website.

June, 2010

Other articles by Dr Armstrong

• Dr Armstrong: Winter ills
• Dr Armstrong - Salt and the athlete

About Dr Stuart Armstrong.......
Dr Armstrong qualified from Glasgow Medical School in 2002. He moved to NZ in 2003 and has spent the last 7 years working as an Acute Medical Registrar in numerous hospitals around NZ. He has recently passed his Sports Medicine Fellowship exams.

Dr Armstrong is an avid triathlete. He has completed 5 Ironman distance races to date, as well as representing NZ at the World Long Course Championships in 2009.

He is also the founder and owner of Elite Race Rentals which rents the latest Zipp race wheels and Powertap training wheels. Be prepared to rip up the road like the pros. Just think of those minutes melting off your bike time.

You can find out more at www.eliteracerentals.co.nz or email him at:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it