Sports Nutrition5th September 2018
Rob Wakefield, one of our patients and owner of Propello cycle coaching, has asked me to produce a short guide to how sports drinks and foods can impact on your dental health and give some tips and strategies to help minimise that impact.
Let me start by saying I am a keen cyclist as many of you would have seen after my mammoth cycle ride this summer. Being asked to write this has given me an opportunity to look at the latest guidelines and will shape my own strategies as well.
London Olympics 2012 was used by some eminent dental researchers to study elite athletes’ dental health. Guess what – it was really bad! On the same levels as the most socially deprived groups in society. What they found was high levels of tooth decay, gum disease and dental erosion.
Allow me to bore you somewhat with an explanation of these disease processes and what can happen if they go on un-detected or un-treated.
Everyone’s mouths are full of bacteria – disgusting but true. If you give them fuel, sugar being their favourite, they process it and the bi-product is acid. This acid dissolves your teeth, making holes in them. Your saliva has an ability to neutralise the acid stopping the damage – but it takes a little time to do this. The more frequently you give the bacteria fuel, the longer your teeth are under attack. If you don’t brush properly then plaque forms on your teeth. This is a white sticky combination of undigested food and bacteria. It is very commonly seen on teenage boys teeth… When I see this on kids teeth I say “if your mum left your food out on the table for a week, would you eat it? Well that is what is on your teeth!’ Equally effective on the parents! Getting back to plaque – well this blocks the buffering effect of the saliva – so more damage is caused. It gets worse. If you don’t brush the plaque off regularly, it calcifies due to calcium salts in the saliva. Think of stalactites in caves – same process. This is caller tartar (dental name = calculus) and you can’t then brush this off, it has to be scraped off by your hygienist or dentist. It is a great environment for bacteria – a sort of stone city for them to live in – and they then cause gum disease. All sounds lovely doesn’t it? Finally we have erosion. This is the process where acidic foodstuffs and in certain conditions stomach acid dissolve the surface of the teeth.
What happens if these go untreated?
Dental decay leads to cavities in your teeth. These can be brown and unsightly, but also as they progress and will start to make the teeth sensitive to hot and cold. If the decay progresses further, it can cause the nerve of the tooth to die resulting in an abscess. Early treatment is less invasive and less expensive. Gum disease starts as gingivitis. This can be seen as bleeding gums – often, but not always, detected by blood in your spit after brushing. This then progresses to full-blown gum disease (periodontal disease) where the plaque has become tartar and you start to lose the attachment of the gum to the tooth. Untreated your teeth can become wobbly and drop out. This is the biggest cause of tooth loss in adults. Acid erosion is reported in 50% of elite athletes! I have to say though that it is much less seen a problem in general dental practice. That said, those affected, can be quite be debilitated by it – severe sensitivity – no more Hockings Ice Creams.
Ok I have the bad news out of the way, let’s talk about some coping strategies and preventive measures.
As a cyclist you are likely to be using gels and sports drinks. So you will be getting more than your fair share of sugar when you are out riding. Try and avoid it elsewhere in your life. Use it just for training and racing and avoid the cake shop on the way home. Sorry Bike Shed cafe! Remember rule #91 No food on training rides under 4 hours. As a general rule, processed sugars are worse than natural ones. Sticky foods are worse than non-sticky ones. Acidic fruit (oranges) are worse than non-acidic ones (bananas)
You can’t really avoid processed sugars when cycling – they release energy quickly when you are exercising – but the good news is that they will generally be consumed in a non-sticky format.
I will go through what you generally take out on a bike ride. I am not a sports nutritionist so you will need to find what works best for you and consult a nutritionist if you run into trouble. I use the app MyFitnessPal – you will put those naughty snacks down if you use the app to scan their bar codes!
These drinks include energy drinks (normally with a CHO concentration of >10%),
A bottle of Lucozade Energy Orange has 15 teaspoons of sugar in a 380ml bottle nicely wrapped in an acidic fruit wrapper. Avoid
Isotonic sports drinks such as Lucozade Sport or PowerAde have about 8 teaspoons of sugar
Hypotonic drinks such as Torq have less again and can be added in powder form.
Water – old school but if you are getting fuel from one of the other sources, this will better for your teeth. You can add electrolyte tablets to this which are available zero calorie.
As mentioned previously, your saliva is vital for protecting your teeth and a dry mouth is one of the first signs of dehydration. Keep hydrated at all times to reduce the effects of sugar consumption.
Gels: These come in varying degrees of sweetness and stickiness. Avoid the gloopier gels for the good of your teeth
Bars: Protein bars from about 3 teaspoons
Carbohydrate bars such as Clif have 11 teaspoons
Paleo bars – I make a cold-pressed bar made from brazil nuts, raisins, dates and a small amount of honey.
So eat before you go out with a slow release energy source – say porridge. Then brush your teeth – so there is less plaque on your teeth
Drink water to rinse your teeth
Don’t hold the drinks or foods in your mouth for longer than you have to
Fluoride is very effective at preventing tooth decay. As mentioned above, athletes are in the high-risk category for dental diseases, so it would be a good idea to maximise your fluoride exposure. Firstly, don’t rinse out your toothpaste with water – just spit it out. If you are consuming lots of sugary foods and drinks, it is advised you use a high Fluoride toothpaste. These are only available at the dentist, you can’t buy them over the counter. You may be able to obtain these on prescription, but the NHS is facing cuts so it might not be readily accessible.
Brush your teeth twice a day, once last thing at night and one other time.
Visit your dentist twice a year. Picking up problems early is vital to prevent running into difficulties later. Once the decay gets through the hard outer layer of the tooth (enamel) it will progress quite quickly. You won’t get many symptoms from teeth problems until really quite late.
Don’t smoke – I don’t need to elaborate on that.
As with all advice given by “experts” do as I say, not as I do…..