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How Endurance Training Can Harm Your Teeth

BY Melissa Mantak

Taking care of your body is necessary for every endurance athlete. However, few consider the health of their teeth. Coach Melissa Mantak reveals how aspects of endurance training can be harmful to your dental health and what you can do to be proactive.

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

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. These issues can  become a performance limiter by negatively impacting whole body health.

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. However, the evidence is overwhelming that oral health is a crucial element in overall health, well-being and athletic performance at all levels.

Two Main Causes of Dental Erosion

There are two main reasons why endurance athletes are at increased risk for dental erosion: consuming sugary sports drinks and nutrition and heavy mouth breathing.

Sugary Sports Foods

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 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, periodontitis, etc.

However, sugary sports drinks were not the main cause of dental erosion.

Heavy Mouth Breathing

This type of 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 35 triathletes and 35 controls5, 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.

The conclusion is that dry mouth combined with sugary sports nutrition exacerbates the potential harm.

Full Body Effect

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.

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 you can take:

  • Brush and floss daily
  • See your dentist for check ups 2 to 3 times each 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 or coconut water. You can also add electrolytes.
  • Work on more nasal breathing. Breathing through your nose increases the production of nitric oxide that helps to increase your lungs’ oxygen absorbing capacity and kills bacteria, viruses and other germs. This may be the hardest one to change. It takes time and focus, but can be accomplished during easier and shorter training sessions.

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


  1. Saltmarsh, J. (2014, June 6). Great Legs, Gross Teeth: Endurance Runners and Tooth Decay. Retrieved from https://www.huffpost.com/entry/health-and-fitness_b_5412685
  2. Bryant, S.. et al. (2011, September). Elite athletes and oral health. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21590645/
  3. Needleman, I. et al. (2013, September 24). Oral health and impact on performance of athletes participating in the London 2012 Olympic Games. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24068332/
  4. Frese, C. et al. (2014, June 11). Effect of endurance training on dental erosion, caries, and saliva. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24917276/
  5. Reynolds, G. (2014, September 24). Is Exercise Bad for Your Teeth? Retrieved from https://archive.nytimes.com/well.blogs.nytimes.com/2014/09/24/is-exercise-bad-for-your-teeth/
  6. Barker, J. (2012, January 4). The Mouth-Body Connection. Retrieved from https://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection
  7. Brown, T. (n.d.). The truth about healthy teeth: at home dental care. Retrieved from https://www.soladentalspa.com/truth-healthy-teeth-home-dental-care/
  8. Scadding, G. (2007, August). Nitric oxide in the airways. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17620900/
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About Melissa Mantak

Melissa Mantak, MA is USAT Level III and USAC Level I certified coach and has a Masters degreed in Sports Science. Melissa presents at USAT Level I, II and III Coaching clinics as well as at the Coach Mentor program at the OTC in Colorado Springs. Coach Mantak is a former overall ITU World Cup winner, USOC Triathlete of the Year and USAT National Development Coach. In 2010, she was voted USAT National Coach of the Year. Coach Mantak is a full time professional coach currently working with athletes of all levels.
Contact her at Melissa@empoweredathlete.com or www.triathlontraining-coach.com

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