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Balancing High-Carb Nutrition Needs with Dental Health

BY Taylor Warren

In the modern age of sports, high-carb nutrition plans are essential for performance, but they pose significant risks to dental health. Learn how to mitigate these effects with practical tips and maintain your performance and dental health.

It isn’t necessarily news that cycling is bad for your dental health, but just how nasty are the implications of consuming enormous amounts of carbohydrates in this modern age of sport? Source Endurance sat down with Doctor of Dental Surgery (DDS) and avid cyclist Solomon Cantwell to shed light on the possible damage caused by high-carb consumption and how to do your best to mitigate the negative effects. Health and performance are not always the same thing.

High Carbs Equal High Decay

According to Dr. Cantwell, endurance athletes, from amateurs to pros, experience tooth decay and missing teeth, as well as a myriad of other dental problems at rates much higher than the general population. Cavities and tooth decay are caused by bacteria that feed on carbohydrate sources such as glucose and fructose. Bacteria eat sugars on the surface of your teeth and produce acid that wears away the enamel layer and causes cavities. High carbohydrates in training and racing have exploded over the last several years to the point where cyclists racing the Tour de France take in upwards of 120 grams of carbohydrates per hour daily. For reference, a two-liter bottle of Coke has about 220 grams of carbohydrates in the form of sucrose, so during a six-hour stage, the sugar intake is almost equivalent to drinking three two-liter bottles of Coke. It doesn’t take a lot of extrapolation to think that this is bad for your teeth. 

It’s All About the Balance

When it comes to high-carb drink mix, it’s actually a double whammy of adverse effects on dental health. Not only are there extremely high sugar levels, but almost every drink mix on the market has a low pH. Streptococcus Mutans are the primary bacteria responsible for tooth decay and enamel degradation. This bacteria thrives in an acidic environment at a pH of 5.5 and lower. For reference, drinking water has a pH of 6.5-8.5, coffee has a pH of 4.8-5.1, and Coke has a pH of 2.5, quite acidic. 

Sodium intake may also play a role in oral health. Everyone has different needs when it comes to salt intake, and sodium isn’t inherently bad for oral health, but in the proper context, it can play a harmful role. Some evidence suggests that an increase in sodium affects the body’s ability to use calcium, potentially leading to mineral loss in the teeth, especially if you are already prone to low bone density, as many cyclists are. Excessive sodium can also create a dry environment in the mouth, leading to unhealthy gums. 

Performance Implications of Periodontal Disease

In most cases, periodontal disease, or periodontitis, starts with plaque. Plaque is a thin, sticky film made primarily of bacteria. Plaque, if left untreated, can cause gingivitis or inflammation of the gums. This inflammation of the gums can lead to deep pockets between your gums and teeth. Plus, this ongoing inflammation can strain your immune system, causing other health problems and potentially harming cycling performance. There hasn’t been much scientific research on the topic, but correlating periodontal disease with decreased exercise performance doesn’t take too big of a step in logic. Suppose your body constantly releases inflammatory cytokines into the bloodstream from inflammation in your gums. In that case, this detracts from the recovery process, and everything adds up in this world of marginal gains.

Habits that Help Promote Dental Health

OK, so high-carb on the bike is advantageous for cycling performance and recovery but quite detrimental to oral and dental health. Like I said before, health and performance are not the same thing, but what healthy habits can we implement to mitigate the damage of high carbohydrate intake? Dr. Cantwell says a good first step is picking drink mixes with higher or neutral pH. Hammer Nutrition’s Heed can be a good option, as it has a neutral pH. 

Dr. Cantwell also recommends liquid carbs over solid, as the sticky, gummy foods (i.e., Shot Bloks) tend to stay on the surface of your teeth longer. Brushing your teeth 20 minutes post-ride is a good habit to get into. The acids in your mouth after eating soften your enamel, so brushing immediately is more likely to cause excess enamel wear. Using one bottle of concentrated carbs and one bottle of plain old water to swish in your teeth can also help mitigate damage. I have even seen some riders going as far as bringing a travel toothbrush with them on rides and brushing mid-ride to support their dental health. Choosing the right toothpaste is vital. Look for a paste with Hydroxyapatite, which can help remineralize your teeth. 

It doesn’t seem like high-carb is going anywhere, so being dental aware is important for the longevity of oral health. If you are a young rider, you may not have had any concerns yet, but you only have one set of teeth, so forming healthy habits early in your athletic journey will pay dividends. Start following these tips to reduce oral damage caused by high carbs!

References

Cantwell DDS, Solomon. Interview,  15 January 2024.

Carvalho, M. A. R. T. A., et al. “Dental caries incidence in a sample of endurance sports athletes.” Annals of Medicine 51.sup1 (2019): 138-138.

Raner, Elisabeth, et al. “pH and bacterial profile of dental plaque in children and adults of a low caries population.” Anaerobe 27 (2014): 64-70.

Cass Nelson-Dooley, M. S. “Natural Treatments to Remineralize Teeth, Balance Mouth pH, and Stop Tooth Decay.”

Merle, Cordula Leonie, et al. “The significance of oral inflammation in elite sports: a narrative review.” Sports Medicine International Open 6.02 (2022): E69-E79.

Cui, Yan, et al. “High-salt diet accelerates bone loss accompanied by activation of ion channels related to kidney and bone tissue in ovariectomized rats.” Ecotoxicology and Environmental Safety 244 (2022): 114024.

Martinon, Prescilla, et al. “Nutrition as a key modifiable factor for periodontitis and main chronic diseases.” Journal of Clinical Medicine 10.2 (2021): 197.

de la Parte, Alejandro, et al. “Differences in oral health status in elite athletes according to sport modalities.” Sustainability 13.13 (2021): 7282.

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About Taylor Warren

Taylor Warren has raced at the elite level since 2014 and graduated with a Bachelor’s Degree in Exercise Physiology from Colorado State University in 2015. Taylor continues to race at the elite level with CS Velo Racing, gaining experience and wisdom to help impart to the athletes he works with.

Taylor is also a student of the game with a passion for human performance and physiology; he can combine his race experience with an understanding of how the human body responds to training to deliver the best possible coaching experience. Taylor believes in a practical, holistic approach to coaching and training that values the athlete’s lifestyle and understands how to make the process approachable and enjoyable. Learn more about Taylor and Source Endurance here.

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