Background: The role of oral health in influencing athletic performance has been well documented. The use of sports drinks has been linked with an increase in poor oral health including dental decay. The aim of this study was to investigate the possible association between sports drinks and dental decay/pain amongst elite athletes and the incidence of dental decay/pain. Hypothesis: This study is looking at the hypothesis that the consumption of sports drinks leads to dental disease, particularly dental decay. Level of evidence: Local and current random sample; randomized trial; cohort study or control arm of randomized trial; inception cohort study. Methods: An opportunistic volunteer survey of elite athletes attending a varied international sporting competition. Analysis of the data was undertaken using descriptive statistics, mean values and standard deviations. Associations between demographic information and results were presented. A p value of <0.05 was considered to be statistically significant. Results: 458 completed questionnaires were distributed and received. The link between the frequency of sports drinks consumption and dental decay/pain was marginally statistically significant, (X2 , p=0.077). Isotonic sports drinks and sensitivity was statistically significant (X2 , p=<0.001). 197(43%) athletes reported drinking sports drinks at least once a week; 33 athletes (7%) reported consuming sports drinks a minimum of three times a day. n=175 (35%) athletes reported that they saw their nutritionist for advice about sports drinks, only n=21 (4%) sought advice from the dentist. One in four athletes reported seeing their dentist due to pain (n=116; 25.3%). Conclusion: This study covered a diverse group of elite athletes. It is unclear whether the use of sports drinks does result in more tooth decay, but dentists should educate athletes and their supporting teams about the potential risks from these drinks thus mitigating those potential risks. Clinical relevance: By understanding the magnitude of the challenge of dental decay facilitated by sports drinks, it is hoped that adequate preventative measures can be put in place. Thus, supporting the athletes towards better oral health and performance.