|Year : 2015 | Volume
| Issue : 3 | Page : 226-230
Assessment of dental erosion among sports personnel in central India
Vidhatri Tiwari1, Vrinda Saxena1, Utkarsh Tiwari2, Aishwarya Singh3, Binu Santha1, Vartul Diwedi4, Manish Jain1
1 Department of Public Health Dentistry, Peoples Dental Academy, People's University, Bhanpur, Bhopal, Madhya Pradesh, India
2 Department of Pedodontics, Peoples Dental Academy, People's University, Bhanpur, Bhopal, Madhya Pradesh, India
3 Department of Public Health Dentistry, People's College of Dental Sciences and Research Centre, Bhanpur, Bhopal, Madhya Pradesh, India
4 Department of Conservative and Endodontics, Peoples Dental Academy, People's University, Bhanpur, Bhopal, Madhya Pradesh, India
|Date of Web Publication||2-Sep-2015|
Department of Public Health Dentistry, Peoples Dental Academy, Peoples University, Bhanpur, Bhopal, Madhya Pradesh
Aim: To compare tooth erosion among contact and noncontact sports personnel. Materials and Methods: A cross-sectional study was conducted among all active professional sports players from Madhya Pradesh representing India at national and international. Information on demographic characteristics of participants along with oral health behavior such as their oral hygiene habits, frequency of beverages consumption during sports activity was collected by means of personnel interview administered by the examiner. Clinically erosion index was used based on a Survey of Children Dental Health in UK 1993 along with CPI probe to diagnose the erosion. Results: Statistically significant difference (<0.05) was noted among the type of beverages intake in contact and noncontact sports.
تقييم تآكل الاسنان في أوساط الرياضين بوسط الهند:
الهدف من الدراسة: مقارنة تآكل الاسنان في وسط الأشخاص الرياضيين وغير الرياضيين. المواد والطريقة : هذه دراسة مقطعيه تم إجراؤها وسط الأشخاص الناشطين في الرياضة واللاعبين المحليين والعالميين من (ماديا برادش ــ الهند) تم جمع المعلومات للصفات الدموغرافية للمشاركين والعادات الصحية لصحة الفم مثل ( عادات نظافة الفم - معدل تناول المشروبات اثناء الانشطة الرياضية من خلال مقابلات شخصية للمشاركين بواسطة المختبرين. تم استخدام معدل التآكل السريري للأسنان بناءً على مسح طبي أجري على صحة أسنان الأطفال بالمملكة المتحدة في سنة 1993 مع معدل مؤشر المآل التاجي لتشخيص التآكل. النتائج: إحصائياً لوحظ وجود فروقات ملحوظة اكثر من 0.05 > في انواع المشروبات المتناولة للاشخاص المرتبطين بالرياضة وغير الرياضين. الخلاصة: لوحظ أن تآكل الاسنان الحاد غير متوفر في عينة الدراسة الا أن ارتفاع نسبة التآكل يوجب اعادة ا النظر. لذلك يجب مراقبة البالغين مع وجود اعراض اولية لتآكل الاسنان مع الحوجة لرفع معايير الوقاية لدى المختصين بالاسنان.
Keywords: Attrition, dental erosion, sports players
|How to cite this article:|
Tiwari V, Saxena V, Tiwari U, Singh A, Santha B, Diwedi V, Jain M. Assessment of dental erosion among sports personnel in central India. Saudi J Sports Med 2015;15:226-30
|How to cite this URL:|
Tiwari V, Saxena V, Tiwari U, Singh A, Santha B, Diwedi V, Jain M. Assessment of dental erosion among sports personnel in central India. Saudi J Sports Med [serial online] 2015 [cited 2019 May 21];15:226-30. Available from: http://www.sjosm.org/text.asp?2015/15/3/226/164289
| Introduction|| |
Dental erosion is defined as "loss of tooth substance by chemical processes not involving bacteria." According to Pindborg dental erosion is defined as the acid dissolution of the tooth surface by chemical attack not involving plaque bacteria. Initially, the enamel demineralizes and dissolves without clinically detectable softening. In combination with abrasive processes, loss of substance can proceed quickly, especially after reaching the dentine. 
Dental erosion in athletes is a growing concern due to increased interest in "healthy" and "slimness" lifestyles that involve regular exercise and a healthy diet. A person engaged in strenuous sports may be at risk for dental erosion due to the frequent ingestion of acidic sports drinks that provide carbohydrate, electrolytes, and fluid replacement. The loss of body fluids and decreased salivary flow from exercise may increase the risk to the dentition when there is a high intake of low pH drinks. Unusual drinking habits, e.g., swishing or holding acidic drinks in the mouth for prolonged periods also have been linked to erosion.  Recently, new types of products have been developed, so called sports drinks, which contain around 5% sugars and are recommended for use before and during sports performance. 
There is considerable encouragement, in the form of advertising campaigns on television, adverts in specialized sports magazines and commercial sponsorship of sporting events, for professional and amateur athletes to use sport supplement drinks. These drinks are used by athletes before competing in long-distance events to boost energy levels, and during the race to prevent dehydration. Although the professional athlete will receive dietary advice from a trainer or dietician, the amateur athlete might not have access to this specific advice and therefore be more influenced by commercial pressures to use sport supplement drinks. Therefore, an endeavor of this study is to contrive to compare tooth erosion among contact and noncontact sports personnel.
| Materials and Methods|| |
General description of the study
A cross-sectional study was conducted to assess the oral health status and treatment needs among sportspersons in Bhopal city. All active professional sports players from Madhya Pradesh representing India at National and International Level comprised the study population.
Schedule of the survey
Detailed schedule was prepared for the collection of data. Totally, 20-25 subjects were to be examined per day. The study took place approximately for a period of 3 months from February 2014 to April 2014.
A preliminary test was conducted on 25 contact sports and 25 noncontact sports personnel's in the month of February, 2013. The study was done to assess the validity and accuracy of the predesigned proforma and the reliability of the examiner and to know the practical and communication difficulties while examining oral cavity of this group of subjects.
Sportspersons who had given their consent to participate in the study, trained for the purpose of participation in different competitions and present during the study period.
Sports person who did not give the consent to participate in the study.
List of sports personnel enrolled in the stadium was provided by Department of Sports and Youth Welfare. Of 345 sports players, 320 participated in the study. Study subject included sports personnel aged between 12 and 22 years; residing in both residential and nonresidential sports complexes.
The permission to conduct the study was obtained from the Director of Sports Department of Sports Youth and Welfare, Bhopal. Prior consent was obtained from the study subjects for the participation in the study. Ethical clearance for the study was obtained from the Ethics Committee, People's College of Dental Sciences and Research Centre, Bhopal.
Performa and method of data collection
Information on demographic characteristics of participants along with oral health behavior such as their oral hygiene habits, frequency of beverages consumption during sports activity were collected by means of personnel interview administered by the examiner. The dental team comprised of examiner assisted by a recording personnel. Each sports person received the thorough interview followed with the clinical examination for erosion index and Angle's classification of malocclusion was included in the clinical examination. Erosion index was used based on a survey of children dental health in UK 1993,  CPI probe was used to diagnose the erosion. Lower code was given when unsure as to which code was applicable. Labial and lingual surfaces of incisors and buccal, lingual and occlusal surface on molars were evaluated used for dental erosion.
| Results|| |
Demographic details are shown in [Table 1] and [Table 2], which include the age, gender and type of sports played. Distribution of subjects according to contact and noncontact sports persons. The available subjects are 166 (51.8%) from contact sports and 154 (48.1%) from noncontact sports out of total 320 sports players.
|Table 1: Distribution of the study population according to age groups and gender|
Click here to view
|Table 2: Distribution of the study population according to age groups and type of sports played|
Click here to view
Statistically significant difference was noted among the type of beverages intake in contact and noncontact sports. The majority of them consumed fruit juices that is, 153 (92.1%) and 128 (83.1%) contact and noncontact sports respectively. Once daily consumption was by 98 (59%) in contact sports and 90 (58.4%) in noncontact sports whereas twice daily 59 (33.7%) and 49 (31.8%) between type of sports respectively [Table 3].
|Table 3: Type of beverages and frequency of consumption according to type of sports played|
Click here to view
According to age groups, majority of them consume fruit juices that is, 157 (89.2%) and 124 (86.1%) among 12-17 years and 18-22 years, respectively but no statistically significant difference was noted.
[Table 4] shows mean number of loss of enamel due to erosion according to depth among age group 12-17 years was 0.52 ± 1.23 and 18-22 years 0.66 ± 1.40 similarly in contact sports it was 0.58 ± 1.26 and noncontact sports person was 0.59 ± 1.37. The corresponding values in gender were 0.52 ± 1.23 in male and female were 0.72 ± 1.48. There was no significant difference was seen among age groups, type of sports and gender.
|Table 4: Distribution of erosion among sports personnel according to depth involved|
Click here to view
[Table 5] shows distribution of area involved due to erosion due among age group 12-17 years was 0.49 ± 1.16 and 18-22 years 0.61 ± 1.36 similarly in contact sports 0.52 ± 1.15 and noncontact sports person was 0.57 ± 1.36. The corresponding values in gender were in male 0.50 ± 1.21 and female were 0.63 ± 1.5. There was no significant difference was seen among age groups, type of sports and gender.
|Table 5: Distribution of erosion among sports personnel according to area involved|
Click here to view
Attrition among type of sports played
Overall attrition were more prevalent among contact sports 28 (16.8%) as compare to noncontact sports 13 (8.4%) which is statistically significant as no difference was noted among age groups [Table 6].
| Discussion|| |
Some sportsmen have a high carbohydrate requirement (beyond that obtained from meals) to meet the energy needs of frequent and lengthy training sessions and require water and electrolytes to balance body fluids lost during and after exercise. In the present study, high consumption of acidic drinks was reported by the subjects regularly, the impact of which can be seen on the tooth structure; specifically on the enamel surface. However, no statistically significant differences were noted between the three groups. The finding of our study is not in agreement with the earlier studies conducted in US and Australia, where the prevalence of dental erosion was found to be 36.5% and 25.4% respectively. The higher prevalence of erosion in their studies may be due to consumption of sport drinks. ,
As these subjects are state or national representatives of the respected sports, their dietary habits are also supervised by the experts appointed by the government. Sports personnel's reported that as they have to maintain their fitness as per the recommendations of sports. Their dietary habits have to be controlled, and they are on the regular physical checkup for the same. These sports personnel's reported regular consumption of fruit juice once or twice daily which could be attributed to the common reason for erosion among them.
Clenching of teeth under stress is a common practice among sportsmen during sport activities which also being a common etiology for attrition. The results in the present study demonstrated 16.8% prevalence of attrition among contact sport subjects and 8.4% among noncontact sports subjects.
| Conclusion|| |
In our study population, severe tooth erosion was not found. However, the level of prevalence raises concern. Therefore, the monitoring of adolescents with initial signs of tooth erosion, as well as a high standard awareness on the part of dental professional, is needed.
| Recommendation|| |
Erosion can be prevented by educating the subjects about the risks associated with carbonated drinks, which is more common among sportsmen and young adults. In case if soft drink is taken, do not swish or froth drinks in the mouth, avoid sipping directly from the bottle instead straw can be used. Avoid brushing the teeth for 20 min after drinking. Drinking milk or water after acidic drinks neutralizes the deleterious effect. Preventive programs and dietary counseling for young adults should be conducted to control and reduce acidic beverages.
| References|| |
Pindborg JJ. Pathology of Dental Hard Tissues. Copenhagen: Munksgaard 1970;312-21.
Sirimaharaj V, Brearley M, Morgan MV.Acidic diet and dental erosion among athletes. Australian Dental Journal 2002; 47:228-36.
Guggenheimer J. Implication of smokeless Tobacco Use in athletes. Dent Clin N Am 1991;35:797-07.
Lang B, Pohl Y, Filippi A. Knowledge and prevention of dental trauma in team handball in Switzerland and Germany. Dent Traumatol 2002;18:329-34.
Berg R, Berkey DB, Tang JMW, Altman DS, Londeree KA. Knowledge and attitudes of Arizona high school coaches regarding oral-facial injuries and mouth guard use among athletes. J Am Dent Assoc 1998;129:1425-31.
Berg-Beckhoff G, Kutschmann M, Bardehle D. Methodological considerations concerning the development of oral dental erosion indexes: literature survey, validity and reliability. Br Dent J 2004;197:479-83.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]