Background Oral health is important both for wellbeing and successful elite sporting performance. Reports from Olympic Games have found significant treatment needs; however, few studies have examined oral health directly.

Objective The aim of this study was to evaluate oral health, the determinants of oral health and the effect of oral health on wellbeing, training and performance of athletes participating in the London 2012 Games.

Design Cross-sectional study.

Setting Dental clinic within the London 2012 Polyclinic.

Participants Participating athletes able to understand the consent process. 302 athletes from 25 sports were recruited with data available for 278.

Interventions Following informed consent, a standardised history, comprehensive oral health clinical examination and questionnaire were conducted.

Main outcome measures Oral health status, determinants of oral health, impact of oral health on wellbeing, training and performance.

Results The majority of athletes were from Africa, the Americas and Europe. Overall, the results demonstrated high levels of poor oral health including dental caries (55% of athletes), dental erosion (45% athletes) and periodontal disease (gingivitis 76% athletes, periodontitis 15% athletes). More than 40% of athletes were ‘bothered’ by their oral health with 28% reporting an impact on quality of life and 18% on training and performance. Nearly half of participants had not attended for a dental examination or hygiene care in the previous year.

Conclusions The oral health of athletes attending the dental clinic of the London 2012 Games was poor with a resulting substantial negative impact on wellbeing, training and performance. As oral health is an important element of overall health and wellbeing, health promotion and disease prevention interventions are urgently required to optimise athletic performance.