Diet and Dental Caries in Elite Athletes in Ireland

This study assessed dental caries prevalence and dietary habits among elite athletes in Ireland, and analysed dietary intake with particular focus on potentially cariogenic foods and nutrients to determine associations between potentially cariogenic dietary factors and dental caries prevalence using cluster analysis.

A cross-sectional study was conducted on a convenience sample of elite athletes. Oral examinations were performed by calibrated examiners using validated indices, including the International Caries Detection and Assessment System (ICDAS) to assess dental caries at both individual and tooth levels. Demographics and lifestyle metrics were recorded using a web-based platform, while dietary information was collected using multiple 24-h dietary recalls (24HR) via FoodBook24. Clustering, profiling of clusters and and binary logistic regression were used to determine if associations exist between dental caries prevalence and potentially cariogenic food groups or nutrients.

Eighty-eight athletes from seven sports participated, with a mean age of 25.6 years (SD 5.7) and 63% male. The prevalence of untreated dental caries (ICDAS ≥ 3) was 90% at an individual level (presence of caries in any tooth in an individual) and 13% at tooth level (percentage of teeth affected in the population). The mean energy intake was 2678 ± 1352 kcal/day, mean sugar intake was 128 ± 94 g/day and mean starch intake was 169 ± 90 g/day. Cluster analysis identified two distinct groups based on caries prevalence, diet, age, gender, and ethnicity. Binary logistic regression revealed a significant association between cariogenic starch intake from snacks and cluster membership (p = 0.005).

The study found a high prevalence of untreated carious lesions in this cohort, exceeding previously reported levels for elite athletes. Cluster analysis revealed that nutrient consumption patterns, particularly the timing of starch intake, may provide insights beyond those offered by traditional food-group classifications for understanding dietary factors associated with caries risk. These findings underscore the need for prioritising dietary advice and caries prevention strategies in this population, with particular attention on snacking patterns rather than focusing solely on cariogenic food categories.