Abstract
BackgroundDental caries and periodontitis are associated with elevated levels of pro-inflammatory cytokines which may trigger muscle fatigue during exercise, a strong risk factor for sports injuries. Fixed orthodontic appliances (FOA) may cause poor oral health and may disturb proprioceptive inputs of the stomatognathic system. This study aims to explore associations of poor oral health and of use of a FOA with injury frequency and postural stability.MethodsOne hundred eighty seven Belgian elite junior male soccer players, aged 12–17 years, completed a self-report questionnaire asking about injuries in the past year, oral health problems, use of a FOA, demographics and sports data, and stood in unipedal stance with eyes closed on a force plate to assess postural stability.ResultsOrdinal logistic regression with number of injuries in the past year as ordinal dependent variable and dental caries and/or gum problems, age and player position as covariates, showed that participants who reported dental caries and/or gum problems and never had had a FOA reported significant more injuries in the past year compared to the reference group of participants who reported no oral health problems and never had had a FOA (adjusted OR = 2.45; 95% CI, 1.19–5.05; p = 0.015). A 2 (temporomandibular joint problems) × 2 (FOA) × 2 (age) ANOVA with postural stabilities as dependent variables, showed a significant FOA x age interaction for the non-dominant (standing) leg. Post-hoc t-tests showed a significant better postural stability for the non-dominant leg (and a trend for the dominant leg) for the older compared with the younger participants in the non-FOA group (p = .002, ES = 0.61), while no age differences were found in the FOA-group.ConclusionsThese results indicate that poor oral health may be an injury risk factor and that a FOA may hinder the development of body postural stability.
Highlights
Dental caries and periodontitis are associated with elevated levels of pro-inflammatory cytokines which may trigger muscle fatigue during exercise, a strong risk factor for sports injuries
We addressed the following research questions: (1) Are there associations of injury frequency during past year with gum problems and/or dental caries and with current or past use of a Fixed orthodontic appliances (FOA)? (2) Is postural stability associated with current or past use of a FOA and with Temporomandibular joint (TMJ) problems? We expect a higher frequency of sports injuries in the past year for players with gum problems and/or dental caries and, possibly to a lesser extent because of control of their oral health by the orthodontist, for players with current or past use of a FOA
Injury frequency in the past year (IFPY) A significant association was found between Injury Frequency in the Past Year (IFPY) and oral status (χ2(6 df ) = 19.87, p < 0.005)
Summary
Dental caries and periodontitis are associated with elevated levels of pro-inflammatory cytokines which may trigger muscle fatigue during exercise, a strong risk factor for sports injuries. Player position may be an extrinsic risk factor as Carling et al [4] found that strikers had a Periodontitis (gum problems) and dental caries, two aspects of poor oral health, may play a role in sports injuries because of their association with elevated levels of pro-inflammatory cytokines, like tumour necrosis factor (TNF-a) and interleukin-6 (IL-6) [9, 10]. These cytokines play an important role in the origin of muscle fatigue. Almost all FOA are followed by life time retention to maintain the improved tooth position
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