Background Oral health can affect performance, including athletes who always need to be in their best conditions during training and competitions. However, oral health awareness has never been a priority among Malaysian athletes.

Objective This study primarily aimed to assess the association between oral health status and self-reported impact on athletes’ sports performance, using the Oral Health Screening Toolkit for Athletes developed by University College London, UK.

Design/Setting/Participants This is a cross-sectional study using convenience sampling. Data were collected among elite athletes registered under the National Sport Council (NSC), Malaysia.

Interventions/Outcome measures Demographic data, self-reported questionnaire and clinical oral examination were recorded and collected.

Result We recruited 249 athletes with the median age of 20 (range 13–43). Active caries (ICDAS code ≥3) was found in 66.8% athletes with periodontal diseases (BPE code ≥1) in 84.9%. A quarter of those with both diseases were youth athletes. Pericoronitis was also found in 4.7% athletes while 9% have pulpitis, abscess or ulcer (PUFA). Approximately 23.2% of athletes felt their oral health was not good during data collection with 32.5% reported moderate-to-severe impact of oral-related problems on their sports performance over the past 12 months: oral pain (10.5%), difficulty participating in training and competition (11.4%), performance affected (6.4%) and reduction in training volume (6.3%). Chi-square test of independence showed that there is a relationship between both diseases with ethnicity and sports type (individual-team or endurance-strength-mixed). Periodontal diseases were also seen related to age and education level. Approximately 5.5% of the athletes reported never seeing a dentist before.

Conclusion High levels of oral diseases were found in Malaysian elite athletes with common self-reported impacts on performance. This study hopes to create oral health awareness among Malaysian athletes and authorities so that it will be proportionately integrated into athlete health programmes in the future.