Abstract
BackgroundAlthough it is well known that oral pathogens can enter the systemic circulation and cause disease, it is largely unknown if poor oral health increases the risk of sports injuries. The purpose of this study is to investigate the association between poor oral health and reinjuries in male elite soccer players, adjusted for psychosocial problems and player characteristics.Methods184 Players in premier league soccer clubs and 31 elite, junior soccer players in the Netherlands, Belgium and England, were enrolled in a retrospective cross-sectional study. The Sports Injury Risk Indicator, a self assessed questionnaire, was used to obtain information on reinjuries, age and player position, oral health and psychosocial problems. The number of different types of oral health problems was used as an indicator of poor oral health. (SumDental, range 0–2: 0 = no oral health problems, 1 = one type of oral health problem and 2 = two or more types of oral health problems). Multivariable logistic regression was used to investigate whether SumDental was associated with reinjuries, after adjustment for psychosocial problems and player characteristics.Results37% of the players reported no oral health problems, 43% reported one type of oral health problem and 20% reported two or more types of oral health problems. After full adjustment for age, player position and psychosocial problems (i.e. injury anxiety, psychophysical stress, unhealthy eating habits and dissatisfaction with trainer/team), poor oral health (SumDental) was positively associated with all kind of reinjuries whether analyzed as a continuous variable or as a categorical variable. The fully adjusted odds ratios for SumDental analyzed as a continuous variable were: in relation to repeated exercise-associated muscle cramps: 1.82 (95% confidence interval (CI): 1.07, 3.12), in relation to muscle or tendon reinjury 1.57 (95% CI: 1.01, 2.45) and in relation to multiple types of reinjury 1.88 (95% CI: 1.19, 2.97).ConclusionThe results from this study justify a thorough examination of the effects of oral health problems on the injury risk of playing elite soccer.
Highlights
It is well known that oral pathogens can enter the systemic circulation and cause disease, it is largely unknown if poor oral health increases the risk of sports injuries
Positive associations were found between SumDental and age, between psychophysical stress and dissatisfaction with trainer/team and between injury anxiety and unhealthy eating habits
Support for this suggestion comes from studies showing that (1) poor oral health is associated with chronically higher levels of IL-6 and other cytokines [10,11,12,13], that (2) chronically higher levels of IL-6 and other cytokines are associated with fatique [12,13] and that (3) fatique is a serious risk factor forinjuries [14,15]
Summary
It is well known that oral pathogens can enter the systemic circulation and cause disease, it is largely unknown if poor oral health increases the risk of sports injuries. Gay-Escoda et al found in their study of 30 professional soccer players of F.C. Barcelona, that the Plaque Index and periodontal pocket depth were associated with muscle injuries [7]. The microbial composition is diverse and remains relatively stable over time When this microbial homeostasis breaks down oral disease can occur [8,9]. Oral disease cause elevated levels of cytokines, especially tumour necrosis factor (TNF-a) and interleukin-6 (IL-6). These cytokines play an important role in the origin of muscle fatigue during exercise and oxidative stress after exercise [10,11,12,13]. Oral disease is a potential risk factor for sports injury and reinjuries
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