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  1. P Ashley1,
  2. E Cole2,
  3. A Diorio1,
  4. A Tanday2,
  5. I Needleman1
  1. 1UCL Eastman, London, United Kingdom
  2. 2UCLH, London, United Kingdom


Background Data on the impact of oral health on sporting performance is missing and the epidemiology of oral diseases in the elite athlete population is poorly understood.

Objective To systematically review available evidence to determine the epidemiology of oral diseases in the elite athlete population and the impact of oral health on sporting performance.

Design Systematic review of the available literature. We searched Ovid MEDLINE, Ovid EMBASE, EBSCO SPORTDiscus and OpenGrey up to February 2013. Data extraction was carried out with a specially developed form. Data extracted related to the type of study (eg case control, cohort study etc.), methodological quality, sports included and oral health (including its impact on performance). Methodological quality was assessed using a modification of the Newcastle–Ottawa scale and CASP critical appraisal checklist.

Setting Elite division.

Participants Randomised controlled trials (RCTs) or observational studies with some measure of oral health used as an outcome. Studies assessing the impact of interventions on oral health were not included.

Main outcome measurements Oral health, methodological quality of included studies.

Results After screening 9208 citations, 38 studies remained. Most studies investigated trauma (n=31 papers, 82% of all included studies) with the remainder looking at oral health and other outcomes. Studies were subject to multiple methodological biases and use of a wide range of outcomes limited comparison between studies. In general head/face/dental trauma made up a very small proportion of injuries received by athletes during specific tournaments or over a fixed timespan with the exception of wrestling, ice hockey and football. Oral health as expressed by caries was poor in athletes. No studies to date had been designed to assess impact.

Conclusions There is a lack of data on the oral health of elite athletes and its impact on performance.

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    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine