USA Triathlon News Blogs Fuel Station How Endurance Traini...

How Endurance Training Affects Your Oral Health

By Melissa Mantak | March 26, 2019, 10:53 a.m. (ET)

Oral health for endurance athletes

Most of us take our teeth for granted. Yet, think about how important the functions your mouth performs for you: it’s the gateway for breathing, eating and drinking. The long digestive process begins in your mouth.

Heavy mouth breathing during tough, long training sessions is common. The demands of endurance training, as well as the substances you put in your mouth impact the healthy function of both your teeth and your entire body. Turns out that endurance athletes are particularly susceptible to dental erosion and its far-reaching effects on our bodies.

Performance limiter: I’ve been an endurance athlete my whole life and I experienced a lot of dental problems for a period of many years. I know countless triathletes and endurance athletes who have experienced the effects of how undetected, seemingly benign oral health problems can cause a ripple effect throughout the body — becoming a performance limiter by negatively impacting whole body health. 

Is regular brushing enough? We take for granted that regular brushing alone is enough to keep us healthy. Or, perhaps it’s too expensive or inconvenient to go to the dentist regularly. The evidence is overwhelming: Oral health is a crucial element in overall health, well being and athletic performance (at all levels).

Why are endurance athletes are at increased risk for dental erosion? Two main reasons:

  1. Consuming sugary sports drinks and nutrition
  2. Heavy mouth breathing

Frequent small sips of sports drink or other sugars while training, spares muscle glycogen, but negatively impacts your teeth. Sugar consumption increases acid producing bacteria that begins the cascade of potential problems. Most sports drinks also contain phosphoric acid or citric acid which further erode tooth enamel. A compromised tooth is now more susceptible to bacterial build up, leading to a list of potential dental problems: plaque, cavities, gingivitis, inflammation, unresolved infection, periodontal disease, etc.

Sugary sports drinks, however, are not the main cause of dental erosion.

Heavy mouth breathing during endurance training leads to dry mouth that reduces saliva flow, giving bacteria a bigger opportunity to grow and thrive. A 2014 study in The Scandinavian Journal of Sports Medicine looked at 35 triathletes and 35 controls (5), the athletes showed a significantly greater erosion of tooth enamel than controls. The triathletes had much lower levels of saliva and increased pH (more alkaline) during exercise. Saliva performs a very protective function for the teeth.  The longer the training session, the drier and more alkaline their mouths became. The more hours an athlete spent training, the greater the instances of dental erosion, tartar plaques and cavities.

Dry mouth combined with sugary sports nutrition exacerbates the potential harm.

If left unchecked, prolonged bacterial build up in your mouth will negatively impact how your whole body functions and performs. Advanced dental erosion has been implicated in many disease states, such as: osteoporosis, pneumonia, obesity, diabetes and heart disease.   Long, hard training for days, weeks and years can leave your immune system stressed. Add to this an increased bacterial load in the mouth and your immune system struggles to keep up with demand.

Action steps to improve your oral health. You can improve your oral health while continuing to enjoy and thrive with your endurance training and racing, even reverse or eliminate current problems. Here are action steps to take:

  • Brush and floss daily
  • See your dentist for check ups 2-3 times/year
  • If you have any nagging tooth pain or unresolved dental problems, get this taken care of right away
  • If you need ongoing specialized care, look for a sports dentist in your area
  • Using a Sonicare toothbrush, water flosser (Water Pik) and Listerine will improve your oral health dramatically (in addition to brushing and flossing)
  • Decrease your consumption of sports drinks and other sugary sports foods. Rinse your mouth with water after consuming sugars. There is a time and place for these foods during hard training blocks and races. Work to reduce them during easy and short sessions. Instead drink plain water, lemon water or coconut water. You can also add electrolytes.
  • Work on more nasal breathing. This may be the hardest one to change. It takes time and focus, but can be accomplished during easier and shorter training sessions.  (Nasal breathing increases the production of nitric oxide that helps to increase your lungs’ oxygen absorbing capacity and kills bacteria, viruses and other germs.)

Be proactive about taking care of your teeth and you will improve your training, overall health and performance for life.



1. Mercola. Online Newsletter Article:  Endurance Exercise Can Damage Your Teeth.  October 10, 2014; 2. Saltmarsh, Jason. Huffington Post Blog:  Great Legs, Gross Teeth: Endurance Runners and Tooth Decay. June 6, 2014; 3. Bryant, S., et al. Elite athletes and oral health. International Journal of Sports Medicine: 2011 September: 32(9)720-724; 4. Needleman, I. et al.  Oral health and impact on performance of athletes participating in the London 2012 Olympic Games. British Journal of Sports Medicine. 2013 November: 47(16) 1054-1058; 5. Frese, C. et al. Effect of endurance training on dental erosion, caries, and saliva. Scandinavian Journal of Medicine Science Sports. June 2014. (Epub ahead of print); 6. Reynolds, Gretchen. Is Exercise Bad for Your Teeth? The New York Times. September 24, 2014; 7.  Barker, Joanne. Oral Health: The Mouth-Body Connection.  WebMD. Archive; 8. Brown, Tracy.  The truth about healthy teeth: at home dental care.  WebMD. Feature; 9.  Scadding, G. Nitric oxide in the airways. Curr Opin Otolaryngol Head Neck Surg. 2007 Aug (15)4: 258-63.