According to Dr. Cornelia Frese, a senior dentist at the University Hospital Heidelberg, who led the study, it was, instead, the changes in saliva during exercise that had the most impact on the athletes' oral health. The study assessed the saliva of 35 competitive triathletes and compared it to a control group of 35 healthy adults — with correlating ages and genders — who were not athletes.
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Saliva samples were taken alongside a full oral examination, in addition to a questionnaire about their diets, oral hygiene, and exercise habits. The athletes were also asked to run on an increasingly vigorous outdoor track for 35 minutes, during which time saliva samples were taken regularly.
The findings were surprising. When compared to the control group, the athletes were shown to have significantly more tooth enamel erosion. They also had more cavities, and their risk of accumulating them increased the longer that they trained. Furthermore, while saliva production lessened during runs, its chemical composition also shifted to become more alkaline … and too much alkaline in saliva has been known to cause a number of issues, such as tartar development.
Dr. Frese explains that saliva "has a very protective function" for teeth; therefore, having less of it, or a chemically different version during exercise, could be problematic. However, she also notes that the study was small and largely "unrepresentative" of the average person's exercise habits. All that can be concluded, she advised, is that "prolonged endurance training might be a risk factor for oral health."