Some academy footballers in England have been left unable to train because of dental problems, according to a new study which found three-quarters of participants are suffering with gum disease.
The study from researchers at University College London (UCL) asked 160 academy players representing 10 English football clubs from the Premier League, Championship and Women’s Super League to answer a questionnaire about their oral health and its impact on sporting performance, alongside a clinical assessment by a dentist.
It found young male and female players are more likely to have major problems with tooth decay and poor oral hygiene than non-footballers of a similar age.
Dr Saul Konviser, one of the authors of the study published in the British Medical Journal, told the BBC there now needs to be a “multi-factor” approach in order to deal with the issue, including greater education on the cardiovascular issues linked with oral diseases and more routine dental care for players.
“We feel this is a great opportunity to take this evidence so we can advise and support medical teams at clubs,” he said.
“I think it is an opportunity for sporting bodies to take action – we don’t want negative dental health to impact sporting performance. There needs to be greater understanding that mouth is part of the body.
“We had players at screenings complaining of dental pain, bleeding gums, saying they were unable to train at some points because of dental infections. Once there has been trauma there can be ongoing problems, including with their ability and willingness to compete.”
Factors identified included poor hygiene habits such as a lack of brushing and flossing, high levels of sugary sports and fizzy drink consumption, and stress – possibly due to a high-performance environment – which can cause teeth grinding and lead to decay.
The study also suggested some cases of tooth wear were related to gastric acids, with dental screenings revealing patterns similar to those from acid reflux and even in eating disorders like bulimia.
The study is the first to investigate oral health among footballers aged 16 to 18, and the first to include female players.
Dr Konviser said he was “surprised” by the comparatively high levels of decay and disorders, given these are athletes in elite sporting set-ups whose health is being constantly assessed.
“There are many possible causes of wear, and we are not there to diagnose anything but to flag problems to medical teams,” he said. “It was surprising to see the prevalence, especially among younger age groups.”
Only 76% of players confirmed that they brush their teeth twice a day, compared to 81% of 15-year-olds in England.
It found 76.8% of the players in the study had gingivitis – inflammation of the gums – compared to just 40% of 15-year-olds in England, with 22.5% showing signs of irreversible gum disease.
Visible decay that required treatment was present in 31.2% of players, compared to 24% of 15-year-olds across England, while moderate to severe levels of tooth wear was seen in 15.5% of participants.
The study found players were relying on a pre-season check-up rather than visiting the dentist regularly, with one in five having not attended the dentist in more than two years.
It said findings correspond to high levels of oral disease in male senior players identified in a previous UCL-led study in 2016, which found football players’ oral health was 10% worse than average for men of the same age.
Dr Konviser said clubs had been “very receptive” of the study – which was initially conceived in 2019 but delayed by the coronavirus pandemic, then took several years to come to fruition – and called on those clubs and the FA to take a “top-down approach” to making “sports dentistry routine among players”.
Among solutions suggested are players rinsing their mouths with water after consuming energy drinks, and being encouraged to go to regular dental check-ups.
