By Kate Kelland
LONDON (Reuters) - Winning athletes love to bite their medals and smile for the cameras as they hold their trophies aloft, but their teeth may actually be holding them back.
Around half of Britain's elite sports men and women have dental problems bad enough to affect their performance, according to a study published on Thursday.
Researchers at University College London (UCL) found high levels of gum disease and other oral health problems among athletes including rowers, rugby players and swimmers.
"Nutrition in sports is heavily reliant on frequent carbohydrate intakes, which are known to increase inflammation in the body and gum tissues," said Ian Needleman, a professor at the centre for oral health and performance at UCL's Eastman Dental Institute, who co-led the study.
"In sports where there is a lot of airflow, such as cycling and running, breathing hard can make the mouth dry so teeth lose the protective benefits of saliva".
He added that the stress of racing and performing was also an important risk factor: "Some athletes (report) vomiting before every race as a result of pre competition anxiety."
The study, the largest of its kind, looked at more than 350 sportsmen and women from nine GB Olympic teams, including swimming and rowing, as well as cycling's Team Sky, England Rugby and Reading soccer club.
The athletes underwent an oral health screening that assessed levels of tooth decay, tooth erosion and gum disease. They also completed questionnaires about the impact of oral health on their sports performance and on their quality of life.
Just over 49 percent were found to have untreated tooth decay, 77 percent had gingivitis, an early indicator of gum disease, and 39 percent self-reported having bleeding gums while cleaning their teeth, a sign of gum inflammation.
More than a third said these conditions had impacted negatively on their sporting performance, along with their ability to eat relax and sleep.
"Every sport examined revealed significant levels of oral ill-health with the overall risk of tooth decay being higher for an elite athlete than the general population," Needleman said, and this was despite athletes reporting frequent brushing.
Around 97 percent of athletes in the study said they brushed their teeth twice a day, and 40 percent said they flossed once a day. This is higher than the general population, with 75 percent brushing twice a day and 21 percent flossing once daily, the researchers said.
The research was presented at a Europe dental health conference in the Netherlands on Thursday and builds on previous studies of oral health in professional footballers in 2015 and in athletes at London 2012.
The researchers urged all athletes and coaches to think carefully about sports nutrition and to go for regular dental and oral health checks.
(Reporting by Kate Kelland; Editing by Alison Williams)