Júdice, A. et al. (2025) Elite Athletes’ overall oral health, values and related quality of life: A cross-sectional study, Nature News. Available at: https://www.nature.com/articles/s41598-025-10479-z#citeas (Accessed: 18 January 2026).
Background
Oral health is a fundamental component of general health, wellbeing, and quality of life, and may indirectly influence athletic performance through pain, systemic inflammation and psychological discomfort. Despite this, oral health remains under-recognised within elite sports medicine. Previous studies have suggested a high prevalence of oral disease among elite athletes, yet the relationship between objective oral health status and subjective measures such as oral health-related quality of life (OHRQoL) and oral health values (OHV) remains unclear. Standardised tools, including the universal protocol for dental examination in sports, the Oral Health Impact Profile-14 (OHIP-14) and the Oral Health Value Scale (OHVS), offer a structured approach to assessing these relationships.
Aim
This cross-sectional study aimed to determine the prevalence of oral health conditions in elite athletes and to explore associations between oral health status, oral health-related quality of life and oral health values.
Methods
A cross-sectional observational study was conducted at a university Sports Dentistry department in Portugal between July 2023 and November 2024. A total of 114 elite athletes aged 18 years or older were included following eligibility screening. Oral health was assessed using the European Association for Sports Dentistry / Academy for Sports Dentistry (EA4SD/ASD) universal protocol. Dental caries were evaluated using the International Caries Detection and Assessment System II (ICDAS II), erosive tooth wear using the Basic Erosive Wear Examination (BEWE), and periodontal status via a validated self-reported questionnaire alongside gingival assessment. Participants completed sociodemographic and behavioural questionnaires, the OHIP-14 to assess OHRQoL, and the OHVS to assess oral health values. Statistical analyses included descriptive statistics, sex-based comparisons and multivariable logistic regression to identify predictors of favourable oral health outcomes.
Results
The cohort was predominantly male (68.4%) with a mean age of 25.4 years, and most participants competed in football. Over half of the athletes (51.8%) presented with two or more pathological or functional oral health findings that could potentially compromise sports participation. Periodontal disease was the most prevalent condition (55.1%), largely due to gingivitis (51.8%), followed by dental caries (47.4%). Erosive tooth wear and temporomandibular joint (TMJ)-related symptoms were also common. Despite the high burden of oral disease, no significant associations were found between oral health status and either OHRQoL or OHVS scores. Age was the only factor significantly associated with a favourable (green) EA4SD/ASD outcome, suggesting better oral health among older athletes. Sex differences were observed in behaviours and symptoms, with males reporting higher sugary drink consumption and females demonstrating greater mouthguard use and higher prevalence of TMJ-related pain.
Conclusion
Elite athletes demonstrate a high prevalence of oral health conditions, particularly periodontal disease and dental caries. However, these conditions were not associated with poorer oral health-related quality of life or oral health values, possibly reflecting a low perception of oral health problems within this population. These findings highlight the need for improved oral health screening, education and preventive strategies within elite sports settings, alongside further longitudinal research to explore the impact of oral health on athletic performance.
Research Summary Written By: Amaani Adam, University of Manchester – BDS 3