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Poor Oral Health Affects Olympic Athletes' Performance

 

The training regimen for any Olympic athlete is intense, but getting oral health into shape is usually not part of the routine. However, new research examining the impact of 2012 Olympic athletes' oral health may now make the toothbrush as important as athletic shoes.

The study, led by Professor Ian Needleman of the University College London Eastman Dental Institute, was published in the British Journal of Sports Medicine.

He and his team recruited 302 athletes in total from the London 2012 athletes' village to take part in the study, which involved an oral health check-up and a personal assessment of the impact oral health had on their quality of life and athletic training and performance.

The majority of the athletes were from Africa, the Americas and Europe, and they represented 25 sports, with 34.9% from track and field, 14% from boxing and 11.4% from hockey.

Researchers found that 55% of the athletes had dental caries, which is tooth decay. Of this group, 41% of them had tooth decay into the dentine, which means it is reversible.

However, more than 75% of the participants had gingivitis, which is an early stage of gum disease, and 15% had signs of periodontis, which is an irreversible gum infection.

Prof. Needleman says:

"Oral health is important for wellbeing and successful elite sporting performance. It is amazing that many professional athletes - people who dedicate a huge amount of time and energy to honing their physical abilities - do not have sufficient support for their oral health needs, even though this negatively impacts on their training and performance."

The researchers note that many of the sportswomen and men who competed in the London 2012 Olympics had poor levels of oral health that were similar to the problems seen in the most disadvantaged populations.

Oral health impact on training and performance

Athlete running on an open road

The researchers found that 18% of the 2012 Olympic athletes surveyed said poor oral health affected their training or performance.

Almost half of the Olympic athletes who took part in the study had not attended a dental exam or hygiene appointment in the previous year, the researchers say, and 8.7% of them had never been to the dentist.

The proportion of athletes who said they were "bothered by oral health issues" totaled 42%, and 28% said it affected their quality of life.

Additionally, 18% of the athletes said they believed poor oral health was affecting their training or performance in a negative way.

Prof. Needleman believes that an oral health assessment should be part of every single athlete's normal medical care, adding:

"If we are going to help them optimize their level of performance, we need to concentrate on oral health promotion and disease prevention strategies to facilitate the health and wellbeing of all our elite athletes."

Everyday oral health

The researchers hypothesize that links between oral health, wellbeing and performance may be due to pain from oral disease, as well as inflammation and a decreased self-confidence.

They point to previous studies' findings that athletes have poor oral health, which could be linked to frequent carbohydrate intake and reduced immune function from intensive training.

Prof. Needleman told Medical News Today that the mechanisms behind the impact on the Olympians' performance could also be relevant for the general public:

"Clearly, pain and discomfort from tooth decay, dental erosion, periodontal (gum) disease or infected wisdom teeth will affect performance. We see psychological impacts from, for example, bleeding gums, bad odors and poor appearance.

These have well-documented effects on confidence. It has also been shown that infection in the mouth, for instance from periodontal disease, increases the levels of inflammation in the rest of the body and this can impair performance as well as increase risk of injury."

He also said that these conditions are preventable through regular dental care and general maintenance of the oral environment.

So, whether you are an athlete heading to Rio for 2016 or a member of the general public, picking up a toothbrush may improve your performance on the track or in the gym.

medicalnewstoday.com

Does Gum Disease Indicate Future Joint Problems?

Bacteria Responsible for Gum Disease Facilitates Rheumatoid Arthritis

Does gum disease indicate future joint problems? Although researchers and clinicians have long known about an association between two prevalent chronic inflammatory diseases -- periodontal disease and rheumatoid arthritis (RA) -- the microbiological mechanisms have remained unclear.

In an article published in PLoS Pathogens, University of Louisville School of Dentistry Oral Health and Systemic Diseases group researcher Jan Potempa, PhD, DSc, and an international team of scientists from the European Union's Gums and Joints project have uncovered how the bacterium responsible for periodontal disease, Porphyromonas gingivalisworsens RA by leading to earlier onset, faster progression and greater severity of the disease, including increased bone and cartilage destruction.

The scientists found that P. gingivalis produces a unique enzyme, peptidylarginine deiminanse (PAD) which then enhances collagen-induced arthritis (CIA), a form of arthritis similar to RA produced in the lab. PAD changes residues of certain proteins into citrulline, and the body recognizes citullinated proteins as intruders, leading to an immune attack. In RA patients, the subsequent result is chronic inflammation responsible for bone and cartilage destruction within the joints.

Potempa and his team studied another oral bacterium, Prevotella intermedia for the same affect, but learned it did not produce PAD, and did not affect CIA. 

“Taken together, our results suggest that bacterial PAD may constitute the mechanistic link between P. gingivalis periodontal infection and rheumatoid arthritis, but this ground-breaking conclusion will need to be verified with further research," he said.  Potempa said he is hopeful these findings will shed new light on the treatment and prevention of RA.”

Studies indicate that compared to the general population, people with periodontal disease have an increased prevalence of RA and, periodontal disease is at least two times more prevalent in RA patients. Other research has shown that a P. gingivalis infection in the mouth will precede RA, and the bacterium is the likely culprit for onset and continuation of the autoimmune inflammatory responses that occur in the disease.

sciencedaily.com

Healthy Diet Discourages Obesity Microbes in Gut

When you dine, you are never alone. Trillions of microbial guests, resident in your gut, eat with you. They help digest your food and convert it into energy and fat. Now, new research suggests changing the mix of gut microbes can prevent obesity, but only if combined with a healthy diet.

This was the conclusion of a study from researchers at Washington University School of Medicine in St. Louis, as reported in the journal Science on September 6th, 2013. The study reveals another clue about the intimate ties between gut bacteria and diet in the development of obesity.

'Lean' gut microbes and healthy diet

The researchers bred mice in a sterile environment so they had no gut microbes of their own. Then, they took gut microbes from human twins - where one twin was lean and the other obese - and transplanted them to the mice. Mice receiving the obesity-related gut microbes gained weight and fat, and developed obesity-related metabolic problems, while the mice that received the leanness-related gut microbes did not. Researchers then paired up the mice so that the ones with microbes from the lean human twin were put in the same cages as mice with gut microbes from the obese twin. Mice naturally eat each other's feces, so the researchers wondered if they would transfer gut microbes to each other, and if so, which set would end up dominating the gut: the leanness ones or the obesity ones?

The study suggests that eating a diet high in fruits and vegetables encourages leanness-related microbes to populate the gut, leading to better weight control.

They found the answer depended on the type of diet.

If the mice were on a healthy diet - one low in saturated fat and high in fruits and vegetables - then the leanness-associated microbes invaded the gut of the mice with the obesity-associated microbes, stopping them putting on weight and developing metabolic problems tied to insulin resistance.

In humans, significant weight gain can be linked to insulin resistance, which is the first sign of metabolic disorder that can lead to type 2 diabetes.

Senior author Professor Jeffrey I. Gordon, director of the Center for Genome Sciences & Systems Biology at Washington University, says:

"Eating a healthy diet encourages microbes associated with leanness to quickly become incorporated into the gut. But a diet high in saturated fat and low in fruits and vegetables thwarts the invasion of microbes associated with leanness."

He adds that the finding is important for the development of next-generation probiotics as a treatment for obesity.

Ties between gut microbe mix, diet and obesity

Prof. Gordon has been working on the link between gut microbes and obesity for a while. In 2006, he and his team reported two studies that found gut microbes influence how much energy is extracted from food and stored as fat.  They found the clue lies in the relative abundance of two major families of intestinal bacteria: Firmicutes and Bacteroidetes. In this latest study, they found weight gain, accumulation of fat and development of metabolic symptoms were prevented in mice carrying the obesity-related gut microbes when they followed the healthy diet. This is because their guts were invaded by Bacteroidetes bacteria from the mice carrying the leanness-related gut microbes. Bacteroidetes are efficient at harvesting calories and nutrients from food. In 2009, the team reported how a westernized diet leads to obesity via gut microbes. In that study, they transplanted human gut microbes into germ-free mice, then switched their diet from a low-fat plant-based one to a more westernized diet high in fat and sugars.  Within one day, obesity-associated microbes were thriving in the animals' guts, and the animals eventually became obese.

This latest study adds another clue to that finding: not only does following a westernized diet seem to encourage gut colonization by more obesity-related microbes, but it also appears to discourage colonization of microbes associated with leanness, leading to weight gain and development of metabolic problems.

Gut microbe mix in obese people is less diverse

The new study also confirms another finding from previous work: the mix of microbes in the guts of obese people is not as diverse as that of lean people, as Gordon explains:

"We think the lack of diversity leaves open niches - or jobs, if you will - that can be filled by microbes associated with leanness. Our results underscore the strong interactions between gut microbes and diet and help illustrate how unhealthy diets select against gut microbes associated with leanness."

Also, throughout the experiments in the new study, Gordon and colleagues found the results did not depend on whether the donor's gut microbes were first grown in the lab or came from a fecal sample: they still transmitted the body composition and metabolic characteristics of the donor.

This is good news for treatment developers: it should be easier to grow the human gut microbes in the lab (and presumably will make for a more palatable message to patients and consumers) than to keep harvesting them from feces samples.

medicalnewstoday.com

Reduce Snoring by Singing?

 

Are you - or your partner - a chronic snorer? Joining a choir or taking singing lessons could help. A UK study found that a program of vocal exercises designed by a singing teacher helped reduce snoring.  The clinical trial, by Exeter University and the Royal Devon and Exeter NHS Foundation Trust, showed that the singing exercises, which strengthen certain throat muscles, also alleviated symptoms of obstructive sleep apnea, a condition in which people stop breathing during deep sleep.  Snoring and obstructive sleep apnea can result from weak muscles in the soft palate and upper throat (the pharyngeal muscles). Serious singers improve the tone and strength of these muscles by practicing certain vocal exercises.

The study came about because singing teacher Alise Ojay contacted Malcolm Hilton, consultant otolaryngologist at the Exeter hospital and sub dean of the University of Exeter Medical School.

Dr. Hilton explains:

"Alise told me that one of her pupils had said that, since starting to sing, his snoring had become greatly reduced.

So, she devised a singing exercise program to strengthen the throat muscles. I then set up this trial and the results have been really interesting."

Hilton explains that snoring and obstructive sleep apnea affect millions of people. Snoring may not be a life-threatening condition, but it disrupts lives and sufferers often seek medical advice.  Obstructive sleep apnea (OSA), on the other hand, is potentially much more serious. It can cause people to stop breathing during deep sleep, and severely diminish sleep quality.

A recent study found that moderate obstructive sleep apnea may reduce sudden cardiac death. 

Dr. Hilton: "It is also believed that OSA may contribute to road accidents and hypertension."

For the trial, the team recruited 60 chronic snorers and 60 people with mild-to-moderate sleep apnea.

• The participants from each group were randomly assigned to either follow a program of singing exercises for three months, or no intervention.
• The self-guided exercise program was provided on a box-set of three audio CDs, and could be completed in around 20 minutes each day.

At the end of the trial, the results showed that the daily singing exercises reduced the severity, frequency and loudness of snoring, and improved sleep quality. There were no such changes in the participants who were not asked to do the exercises.

Hilton says the exercises were not difficult, and two thirds of the participants asked to do them managed this on most days over the three-month trial.

He adds that the findings open up a "whole new avenue" of possible treatments without the need for surgery, which is good news for snorers:  "I was open-minded about it. I had no expectations but it was an interesting concept.  There is not already a quick-fix treatment for snoring. It is a condition where, if you could find a non-invasive treatment, that would be very beneficial."

But Hilton suggests for best results, the exercises should be accompanied by lifestyle changes such as losing weight. Being overweight is the single biggest contributor to snoring.

medicalnewstoday.com

Why Do Sleepy Brains Crave Doughnuts?

We’re more likely to have an appetite for junk food when we’re sleep deprived and brain scans may help explain why.

Using functional magnetic resonance imaging (fMRI), researchers scanned the brains of 23 healthy young adults, first after a normal night’s sleep and then after a sleepless night. They found impaired activity in the sleep-deprived brain’s frontal lobe, which governs complex decision-making, but increased activity in deeper brain centers that respond to rewards.  When they were sleep-deprived, participants favored unhealthy snacks and junk food. 

“What we have discovered is that high-level brain regions required for complex judgments and decisions become blunted by a lack of sleep, while more primal brain structures that control motivation and desire are amplified,” said Matthew Walker, professor of psychology and neuroscience at the University of California, Berkeley. “High-calorie foods also became significantly more desirable when participants were sleep-deprived. This combination of altered brain activity and decision-making may help explain why people who sleep less also tend to be overweight or obese.

dentistrytoday.com

Are You Grinding Your Teeth?

Bruxism (BRUK-siz-um) is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day or grind them at night which is called sleep bruxism. 

Bruxism may be mild and may not even require treatment. However, it can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Because you may have sleep bruxism and be unaware of it until complications develop, it's important to know the signs and symptoms of bruxism and to seek regular dental care.

Signs and symptoms of bruxism may include: 

• Teeth grinding or clenching, which may be loud enough to awaken your sleep partner
• Teeth that are worn down, flattened, fractured or chipped
• Worn tooth enamel, exposing deeper layers of your tooth
• Increased tooth sensitivity
• Jaw pain or tightness in your jaw muscles
• Tired jaw muscles
• Earache — because of severe jaw muscle contractions, not a problem with your ear
• Headache
• Chronic facial pain
• Damage from chewing on the inside of your cheek
• Indentations on your tongue

mayoclinic.com