For 80 minutes that really count, first tackle oral health

04 February 2022

Professional rugby players have poorer oral health than the general population, with international athletes at high risk of cavities and erosion

Athlete studies prove that poor oral hygiene causes training and performance to suffer

FDI Sports Dentistry Guidelines offer top tips for elite and amateur athletes to optimise oral health and performance

With rugby fans across Europe excited about the upcoming showpiece competition, the Six Nations Cup, few realise – from players to supporters – that healthy teeth and gums could help determine who dominates the scrum.

Poor oral health is proven to negatively impact training and performance amongst elite athletes (1, 2) – and with cavities more common in rugby union than almost every other sport (2), this match day preparation should start long before the mouthguards go in.

International oral healthcare company Sunstar, whose brands include GUM, Butler and Ora2, supported the original launch of the Sports Dentistry Guidelines with the FDI (World Dental Federation), and holds global events on the theme.

Poor oral health is prevalent in high performance sport. In one study of 302 elite athletes, almost half had not undergone a dental examination or hygiene care in the previous year. 55% presented with dental cavities, 45% with dental erosion, and 76% with gingivitis (1). Further research shows odds of cavities being 2.4x higher in team sports – and highest in rugby (2). Meanwhile, one recent study also suggests that professional rugby players have poorer oral health than the general population (3).

Male internationals have more to watch out for than females: not only is erosion is most prevalent in both male athletes and team sports (2), men are also more likely to ignore their oral health and neglect dentist visits (4). The impact of poor oral health is striking: 40% of athletes reported being ‘bothered by their oral health’, while 28% also reported an impact on the quality of life and 18% on their training and performance (1).

There are several factors behind top athletes’ significant risk of oral disease – from calorie intake to training intensity. Team nutritionists have previously revealed that rugby stars could require up to 6000 calories a day across multiple meals and supplements; frequent snacking, along with highly sugary and acidic energy drinks and protein bars, is a major source of enamel erosion and tooth decay. An intensive training programme, paired with pre-game nerves, can also lead to increased mouth breathing and ‘dry mouth’, which promotes bacterial growth as the protective benefits of saliva are lost.

How does oral health impact training and performance in rugby?

Top tips for elite and amateur rugby players to boost performance through better oral health:

  1. Make your oral health a priority, just like your training, nutrition, and physio. Visit your dentist at least twice a year for a complete check-up.
  2. Brush your teeth twice a day for at least two minutes with a fluoride toothpaste (ideally 30 minutes after eating), and clean between your teeth, using interdental brushes, picks, or floss. Chew sugar-free gum or rinse with water after meals and snacks when brushing isn’t an option.
  3. Accidents can happen whether training or playing, so always wear a mouthguard. A custom-made mouthguard is preferable – ask your dentist for advice.

Martijn Verhulst, Medical Liaison Manager, Sunstar Medical Affairs says: “As rugby union renews its commitments to becoming the most progressive sport on player welfare, a player-centric and holistic approach must include oral health – which goes beyond the mouth itself.

“From international to grassroots, players at all levels stand to benefit from a better awareness of the performance link. There is no better place to start than with the foundations: brush your teeth twice a day, clean between your teeth, and rinse your mouth after meals – and don’t forget your dental check-up twice a year.”

Dr Sophie Dartevelle, FDI Council member and Chair of the FDI Sports Dentistry Task Team adds: “Oral health is the next greatest challenge for rugby to tackle. No athlete would neglect a thorough warm-up or much-needed visit to the physio – our aim is to foster the same approach to oral care.

“Our Sports Dentistry Guidelines provide amateur athletes, professional athletes, dentists and sports physicians, and sports organisations with easily incorporated oral hygiene recommendations to optimise overall well-being and performance.”

Watch the FDI’s latest educational video, featuring top-of-the-table French Fédérale 2 team Stade Nantais Rugby, here. For a copy of the Sports Dentistry Guidelines with the FDI (World Dental Federation) supported by Sunstar, visit:



  1. Needleman I, Ashley P, Petrie A, Fortune F, Turner W, Jones J, Niggli J, Engebretsen L, Budgett R, Donos N, Clough T & Porter S. Oral health and impact on performance. British Journal of Sports Medicine.
  2. Gallagher J, Ashley P, Petrie A & Needleman I. Oral health and performance impacts in

elite and professional athletes. Community Dentistry and Oral Epidemiology.