Oral Health and Sports Performance: An Interdisciplinary Perspective

Abstract

Background. While oral health's link to systemic homeostasis is well-documented, its impact on objective athletic performance is a newer, developing research area. Despite growing awareness, athletes' oral health remains frequently marginalized in routine diagnostics. Aim. This review assesses associations between compromised oral health (particularly chronic periodontitis and advanced caries) and objective athletic performance parameters (e.g., VO2max, generated power), discussing the underlying biological mechanisms. Material and methods. A narrative review of recent literature (up to February 2026) was conducted, incorporating epidemiological, clinical, and cohort studies, systematic reviews, and RCTs in dentistry and sports medicine. Results. Evidence highlights a high prevalence of oral diseases (periodontitis, enamel erosion, caries) in athletes. Clinical tests show an inverse relationship between periodontitis indicators and both VO2max and power generation. Proposed mechanisms include chronic systemic inflammation, endotoxemia, impaired nutrition, oral microbiome dysbiosis affecting the nitric oxide (NO) pathway, psychological burden, and sensomotor disorders. Disrupting the oral microbiome impairs post-exercise vascular responses. However, current sports-specific literature is limited by a dominance of cross-sectional studies. Conclusions. Oral health is a crucial, yet overlooked factor in optimal physical performance. Integrating dental protocols (e.g., USPDES) into routine sports medicine screening is justified. Future research requires multicenter longitudinal designs using validated physiological indicators to establish causality, supported by evidence of periodontal therapy's cardiovascular benefits.