The effect of swimming on oral health status: competitive versus non-competitive athletes

Competitive swimming and dental staining among Australian children

BACKGROUND

Swimming has classically been associated with a distinctive type of extrinsic dental staining. However, its prevalence and characteristics have not been explored in Australia. This case controlled cross-sectional cohort study aimed to determine the prevalence and severity of dental staining among children who swim competitively compared to non-swimmers and its impact on oral health-related quality of life (OHRQL).

METHODS

Parents and children from Western Australian swimming clubs completed a survey assessing swimming routine, risk factors for staining and OHRQL. Intra-oral photographs were taken and staining of anterior teeth was assessed using a modified Lobene Stain Index. A Global Stain Score (GSS) was calculated and compared against age-matched non-swimmer controls.

RESULTS

Maxillary anterior teeth from swimmers (n = 400) and non-swimmers (n = 400) were analysed. Staining prevalence was greater in swimmers (83%) than non-swimmers (44%). GSS scores were positively correlated with both the total lifetime swimming hours and practice time (P < 0.05), with a significant difference in GSS between swimmers and non-swimmers (P = <0.001, OR: 6.21). Dietary factors for staining were not significantly correlated with GSS.

CONCLUSION

Swimmers had a greater risk of developing staining than non-swimmers, and this negatively impacted their OHRQL. The extent and intensity of staining were associated with the amount of swimming.

Twenty-first century knowledge mapping on oral diseases and physical activity/exercise, trends, gaps, and future perspectives: a bibliometric review

Maintenance and improvement of an individual's overall well-being require a multidisciplinary approach that encompasses everything from oral health care to regular physical exercise. The notion that poor oral health can influence general health and athletic performance has sparked an interest in this relationship. This study offers an overview of relevant research and a knowledge map,and discusses publication metrics and key topics concerning the relationship between physical activity or exercise and oral diseases. We searched the Web of Science database for articles published in the 21st century that addressed the relationship between physical activity and oral diseases. Under the stipulated inclusion criteria, a rigorous selection process yielded 276 from 3,883 retrieved articles. The articles were classified by what was assessed as follows: occurrence of oral diseases in athletes or sports enthusiasts (n = 174); impact of physical activity or exercise on the oral cavity (n = 59); effects of oral changes on sports performance and physical fitness (n = 31); and the connection between oral health status, physical activity or exercise, and systemic conditions (n = 12). Orofacial trauma has received the most attention among all investigated oral diseases. However, there is a need for greater attention of dysfunctional habits that can contribute to premature tooth wear, as well as oral inflammatory diseases that can have systemic implications. This mapping can encourage the development of new primary research.

Evaluation of Oral and Dental Health Results and Competition Stress Levels of Adolescent Athletes in Different Winter Sports Branches

BACKGROUND

 The aim of the present study was to examine the findings of the intraoral examinations of the 12-16 years old novice (control) and elite athletes across the winter sports branches, which were alpine discipline skiing, snowboarding, biathlon, ski jumping, and ice hockey. Besides, the study aimed to determine the intra- and inter-group relationships by comparing the athletes salivary stress biomarker levels at precompetition, during-match, and post-competition stages.

METHODS

 Ninety-one athletes (71 elite, 20 novice) participated in our study. Oral health status of the athletes were evaluated. In addition, cortisol levels in the saliva samples obtained at pre-competition (rested before the competition), during-match (just before the start), and post-competition (competition ending moment) stages were measured. The data were analyzed statistically with a significance level of 0.05.

RESULTS

 Ice hockey athletes were the most affected by untreated dental caries (27.3%). No signs of dental trauma caused by sports activities were found in the winter sports branches. Basic erosive wear examination scores of the ice hockey athletes were similar to the ski jumping athletes and lower than other groups (P=.034). The mean cortisol values between sports branches were listed as: biathlon alpine skiing < ice hockey < ski jumping (P < .001). Test results of the winter sports athletes' saliva samples revealed that their salivary stress levels might vary in accordance with the sports branches, and there was a negative relationship between the levels of salivary stress biomarkers in competitions and oral health.

CONCLUSION

 In winter sports activities, measures for improving oral health should be disseminated.

Dental Health Benefits of Swimming in Chlorinated Water

Poor oral health is an important concern for athletes, as it can affect both general health and athletic performance. The aim of this study is to investigate the effects of activity in chlorinated water on oral health in elite swimmers compared to non-swimming athletes. This cross-sectional study included 101 swimmers and 100 other athletes aged 13-26 years with a minimum training intensity of five hours per week (for at least the preceding two years). Oral health was assessed using the approximal plaque index (API) and the decayed/missing/filled teeth (DMFT) index. A DIAGNOcam was used to detect caries. Results show that swimmers were younger (15 years vs. 18 years), were more likely to be female (54% vs. 17%), and had a lower body mass index (20.1 kg/m2 vs. 21.9 kg/m2) and a lower juice consumption (9% vs. 24%). Non-swimmers had significantly more decayed, missing, or filled teeth due to caries and plaque. In conclusion, by comparing elite swimmers and athletes competing in different sports, we have shown that competitive swimmers have a lower incidence of dental caries and plaque. Further research is needed to test our findings and to understand this relationship in greater detail.

Sports Diet and Oral Health in Athletes: A Comprehensive Review

Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20-84%, dental erosion 42-59%, gingivitis 58-77%, and periodontal disease 15-41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes' dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes' health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.

Erosive tooth wear and salivary parameters among competitive swimmers and non-swimmers in Egypt: a cross-sectional study

INTRODUCTION

Competitive swimmers spend considerable time practicing their sport. Prolonged exposure to chlorinated water can alter salivary parameters and might compromise oral health. This study aimed to determine erosive tooth wear status and its related risk factors among competitive swimmers as compared to non-swimmers.

MATERIALS AND METHODS

A cross-sectional study consisting of 180 athletes (90 competitive swimmers versus 90 competitive rowers "non-swimmers") was conducted. Participants were interviewed on the common erosion risk factors. The Basic Erosive Wear Examination system was used to assess the status of erosive tooth wear. Stimulated saliva sample was collected before and after a training session and pool pH was evaluated using pH strips for 7 days. Data were analyzed using descriptive statistics and multivariable analysis.

RESULTS

The prevalence of dental erosion was significantly higher among competitive swimmers (60%) with higher BEWE scores compared to non-swimmers (25.6%). The salivary flow rate was reduced significantly after training sessions in both groups while salivary pH increased among swimmers. Evaluation of pool water revealed a continuous reduction in the pH level, reaching a very acidic pH level of 3.24.

CONCLUSION

Erosive tooth wear is more prevalent among competitive swimmers. Years of practice and regular consumption of acidic drinks increase the odds of developing erosive lesions. A high incidence of erosive lesions may be attributed to a reduction in swimming pool pH level. Salivary parameters showed variations between groups after training sessions.

The Impact of Competitive Sports on Oral Health: Exploring Their Relationship with Salivary Oxidative Stress in Children

This article explores the correlation between salivary biomarkers, such as glutathione peroxidase (GPX), total antioxidant capacity (TAC), and superoxide dismutase (SOD), and their association with oral health for children in competitive sports. Saliva has emerged as a valuable resource for evaluating physiological and pathological conditions due to its non-invasive collection method and easy storage. This study examines the potential of GPX, TAC, and SOD as salivary biomarkers for assessing the impact of competitive sports on children's oral health. It discusses the potential implications of increased oxidative stress due to intense physical activity and the role of antioxidant defense mechanisms in maintaining oral health. In total, 173 children aged between 6 and 17 were divided into three groups, 58 hockey players, 55 football players, and 60 in the control group, and examined to assess their oral hygiene and dental and periodontal health. Saliva was collected, centrifuged, and the supernatant was analyzed for the relevant biomarkers. The findings seem to suggest that salivary biomarkers, like GPX, TAC, and SOD, might serve as indicators of the physiological response to competitive sports in children, as well as indicators of oral health, especially dental cavities, and periodontal disease. Statistical analysis showed significant differences between the groups, with better values for athletes, regardless of age, sex, or activity type. Understanding the relationship between salivary biomarkers and competitive sports in children can have significant implications for monitoring and optimizing the health and performance of young athletes. Further research is needed to establish the specific associations between these biomarkers and the effects of several types and intensities of sports activities on oral health in children.

The Oral Microbiome Profile of Water Polo Players Aged 16-20

OBJECTIVES

Chlorine has a strong antibacterial property and is the disinfectant most frequently used in swimming pools. Therefore, the microbiota community in the oral cavity of those who practice water sports is assumed to be special due to their regular immersion in water. Adverse changes in the composition of oral cavity microbiota may have serious health consequences. We aimed to compare the oral microbiome between water polo players and non-athletes. We hypothesized that the oral cavity microbiota community differed between water polo players and non-athletes.

MATERIALS AND METHODS

Altogether, 124 water polo players (62 males and 62 females, aged between 9 and 20 years) and 16 non-athlete youths (control group, eight males and eight females, aged between 16 and 20 years, mean age + SD = 17.1 + 1.4 years) who participated in body structure examinations voluntarily agreed to participate in the study. In a randomly selected subsample of water polo players (n: 29, aged between 16 and 20 years, mean age + SD = 17.3 + 1.0 years), saliva samples were also collected. Saliva samples were collected from all non-athlete youths (n: 16, aged between 16 and 20 years). The oral microbiome was determined from a saliva sample, and DNA was isolated using the QIAmp DNA Blood Mini Kit. The 16S rRNA gene amplicon sequencing method was used to analyze the microbiome community. PCR primers were trimmed from the sequence reads with Cutadapt. R library DADA2 was used to process reads in the abundance analysis.

RESULTS

In general, Streptococcus, Veilonella, and Prevotella genera constituted more than 50% of the oral microbiome community in the two participant groups combined (n = 45). The oral microbial profile had significant sexual dimorphism and differed between water polo players and the non-athletes. Compared to females, males had a higher (p < 0.05) relative abundance of the Atopobium (medium effect size) and Pravotella_7 (very large effect size) genera and a lower (p < 0.05) relative abundance of the Fusobacterium (large effect size), Gemella (large effect size), and Streptococcus (large effect size) genera. Compared to non-athletes, water polo players had higher (p < 0.05, medium effect size) relative abundance of the genus Veillonella and lower (p < 0.05, large effect size) relative abundance of the genus Gemella.

CONCLUSIONS

The results suggest that regular water training can unfavorably alter the composition of the oral microbial community.

Effects of Malocclusion on Maximal Aerobic Capacity and Athletic Performance in Young Sub-Elite Athletes

Oral pathologies can cause athletic underperformance. The aim of this study was to determine the effect of malocclusion on maximal aerobic capacity in young athletes with the same anthropometric data, diet, training mode, and intensity from the same athletics training center. Sub-elite track and field athletes (middle-distance runners) with malocclusion (experimental group (EG); n = 37; 21 girls; age: 15.1 ± 1.5 years) and without malocclusion (control group (CG); n = 13; 5 girls; age: 14.7 ± 1.9 years) volunteered to participate in this study. Participants received an oral diagnosis to examine malocclusion, which was defined as an overlapping of teeth that resulted in impaired contact between the teeth of the mandible and the teeth of the upper jaw. Maximal aerobic capacity was assessed using the VAMEVAL test (calculated MAS and estimated VO_2max). The test consisted of baseline values that included the following parameters: maximum aerobic speed (MAS), maximal oxygen uptake (VO_2max), heart rate frequency, systolic (SAP) and diastolic arterial pressure (DAP), blood lactate concentration (LBP), and post-exercise blood lactate assessment (LAP) after the performance of the VAMEVAL test. There were no statistically significant differences between the two study groups related to either anthropometric data (age: EG = 15.1 ± 1.5 vs. CC = 14.7 ± 1.9 years (p = 0.46); BMI: EG = 19.25 ± 1.9 vs. CC = 19.42 ± 1.7 kg/m² (p = 0.76)) or for the following physical fitness parameters and biomarkers: MAS: EG = 15.5 (14.5-16.5) vs. CG = 15.5 (15-17) km/h (p = 0.47); VO_2max: EG = 54.2 (52.5-58.6) vs. CG = 54.2 (53.4-59.5) mL/kg/min (p = 0.62) (IQR (Q1-Q3)); heart rate before the physical test: EG = 77.1 ± 9.9 vs. CG = 74.3 ± 14.0 bpm (p = 0.43); SAP: EG = 106.6 ± 13.4 vs. CG = 106.2 ± 14.8 mmHg (p = 0.91); DAP: EG = 66.7 ± 9.1 vs. CG = 63.9 ± 10.2 mmHg (p = 0.36); LBP: EG = 1.5 ± 0.4 vs. CG = 1.3 ± 0.4 mmol/L (p = 0.12); and LAP: EG = 4.5 ± 2.36 vs. CG = 4.06 ± 3.04 mmol/L (p = 0.60). Our study suggests that dental malocclusion does not impede maximal aerobic capacity and the athletic performance of young track and field athletes.

The Significance of Oral Inflammation in Elite Sports: A Narrative Review

Recently, there has been intense discussion about sports dentistry and potential interactions between oral health and athletes' performance. This narrative review aims to provide a comprehensive overview of the available literature about oral inflammation in sports. For this purpose, it presents the most common types of oral inflammation (gingivitis, periodontitis, pericoronitis, apical periodontitis), and their prevalence in athletes. Both the impact of oral inflammation on performance and causes for oral inflammation in athletes are discussed by presenting current literature. Finally, international recommendations for dental care in sports are presented. Several studies stated a high prevalence of oral inflammation in athletes, especially of gingivitis (58-97%) and periodontitis (41%). Also, many athletes report oral pain (17-30%) and a negative impact of oral health on training (3-9%). Besides this, a systemic impact of oral inflammation is discussed: In periodontitis patients, blood parameters and physical fitness are changed. In athletes, associations between muscle injuries and poor oral health are reported. There are deficits in oral health behavior. Furthermore, systemic changes due to physical stress could influence oral tissues. Overall, complex bidirectional interactions between competitive sports and oral inflammation are possible. Regular dental examinations and prevention strategies should be implemented in sports.

Saliva testing as noninvasive way for monitoring exercise-dependent response in teenage elite water polo players: A cohort study

Excessively increased training volume and/or intensity and competition can lead to development of overtraining syndrome, causing a performance decrement in athletes. Tracking individual response to exercise intensity is crucial for establishing recovery strategies.We assessed the exercise intensity-dependent variability of stress response biomarkers, namely cortisol (C), testosterone (T), s-IgA, and advanced oxidation protein products (AOPP), in saliva samples of teenage elite water polo players. Saliva was collected on a day of training match (T1) and a day of competitive match (T2), at morning, before and after match.Cortisol/proteins and testosterone/proteins concentrations decreased throughout day T1, whereas increased throughout day T2. The highest values were measured after match on day T2 (2.5 ± 0.5 vs 14.6 ± 6.3 ng/mg; 0.061 ± 0.024 vs 0.371 ± 0.15 ng/mg, respectively). sIgA/proteins and AOPP/proteins concentrations increased throughout both days, and were higher after T2 match than T1 one (respectively, 1073.0 ± 438.2 vs 71.0 ± 17.3 μg/mg; 78.05 ± 24.2 vs 15.98 ± 3.16 nmol/mg, P = .003). Significant differences between concentrations of different biomarkers recorded on T1 and T2 were found only for AOPP, suggesting an increased oxidative stress on day T2. Free testosterone/cortisol ratio on day T2 was lower than that at morning (0.053 ± 0.021 vs 0.107 ± 0.031), indicating an increased catabolic response after competitive match.A highly significant positive correlation was found between Cortisol/Proteins and Testosterone as well as s-IgA/Proteins on day T1, and between Cortisol/Proteins and AOPP on day T2.In conclusion, we found that different types of activities, such a training or competitive session can affect the hormonal response, immunity, and oxidative stress, thereby modulating athletic performance.Our findings also confirm the usefulness of saliva testing as noninvasive way for monitoring the individual response to changes in exercise intensity in teenage elite water polo players.

Differences in Oral Health Status in Elite Athletes According to Sport Modalities

Oral health status may affect physical and sports performance. The purpose of this study was to assess the oral health status and oral health habits of elite athletes according to the performed sports type. A sample of 186 elite athletes divided into individual sports (n = 74; 53 men and 21 women; 24.9 ± 9.3 years) and team sports (n = 112; 97 men and 15 women; 24.5 ± 4.8 years) participated in the study. The decayed, missing, and filled teeth index (DMFT), the oral health impact profile (OHIP), and the diet assessment of caries risk (DACR) were evaluated to assess their oral health status. Athletes in individual modalities had a lower number in total teeth, healthy teeth, and restoration index (p < 0.05). Furthermore, this group showed a greater number of missing (p < 0.001) and decayed teeth (p < 0.05) and a greater DMFT index (p < 0.001). A relationship between sports modality and prevalence of malocclusions (p < 0.01), periodontal plaque (p < 0.05), and the habit of consuming energy drinks (p < 0.05) was also highlighted. Elite athletes who compete in individual sports presented a worse oral situation.

The Impact of Sport Training on Oral Health in Athletes

Athletes' oral health appears to be poor in numerous sport activities and different diseases can limit athletic skills, both during training and during competitions. Sport activities can be considered a risk factor, among athletes from different sports, for the onset of oral diseases, such as caries with an incidence between 15% and 70%, dental trauma 14-70%, dental erosion 36%, pericoronitis 5-39% and periodontal disease up to 15%. The numerous diseases are related to the variations that involve the ecological factors of the oral cavity such as salivary pH, flow rate, buffering capability, total bacterial count, cariogenic bacterial load and values of secretory Immunoglobulin A. The decrease in the production of S-IgA and the association with an important intraoral growth of pathogenic bacteria leads us to consider the training an "open window" for exposure to oral cavity diseases. Sports dentistry focuses attention on the prevention and treatment of oral pathologies and injuries. Oral health promotion strategies are needed in the sports environment. To prevent the onset of oral diseases, the sports dentist can recommend the use of a custom-made mouthguard, an oral device with a triple function that improves the health and performance of athletes. During training, the sports dentist must monitor the athletes and the sports examination protocol must be implemented with the inclusion of the clinical examination, quantitative and qualitative analysis of saliva and instructions on the use, cleansing and storage of the mouthguard.

Tusks, the extra-oral teeth

OBJECTIVE

The present review aims to: a) describe the features that support tusks in extra-oral position, and b) represent distinctive features of tusks, which provide insights into tusks adaptation to ambient conditions.

DESIGN

A comprehensive review of scientific literature relevant to tusks and comparable dental tissues was conducted.

RESULTS

The oral cavity provides a desirable condition which is conducive to tooth health. Therefore, it remains questionable how the bare (exposed) tusks resist the extra-oral conditions. The common features among tusked mammals indicate that the structural (e.g. the peculiar dentinal alignment), cellular (e.g. low or lack of cell populations in the tusk), hormonal (e.g. androgens), and behavioral traits have impact on a tusk's preservation and occurrence.

CONCLUSIONS

Understanding of bare mineralized structures, such as tusks and antlers, and their compatibility with different environments, can provide important insight into oral biology.

EVALUATION OF THE ORAL HEALTH CONDITIONS OF VOLLEYBALL ATHLETES

ABSTRACT Introduction Dental care can improve athletes’ performance, promoting oral health and preventing changes that could disrupt their sports routine. Objective To evaluate the dental conditions, habits, and oral health care of volleyball athletes, and their knowledge of the importance of oral health in sports performance. Methods Sixty-four male athletes participated in the study: 40 from the basic categories (16 ± 3 years) and 24 professionals (25 ± 5 years). For the assessment of oral conditions, changes in the temporomandibular joint, history of facial and dental trauma, and the presence of malocclusions and orthodontic treatment were verified. Hygiene was measured by the visible plaque index. To determine the athletes’ oral hygiene, they were asked how many times per day they brushed their teeth, flossed their teeth, or used oral mouthwash. Finally, we evaluated the athletes’ opinions concerning the importance of oral health and sports performance. Data analysis was performed using the Mann-Whitney and Fisher’s Exact tests, with a significance level of 5%. Results For most of the parameters evaluated, similar results were found between professional and baseline athletes (p> 0.05). However, for the parameters “flossing” (p = 0.0027) and “facial/dental trauma” (p = 0.0444), significant differences were observed (p <0.05) between the categories of athletes. Conclusion We conclude that professional athletes are more prone to facial/dental trauma, and that the presence of a dental surgeon to assist the team improves athletes’ overall oral health. Level of evidence II; Retrospective study.

Microbial Contamination and Disinfection of Sport Mouthguard: In Vitro Study

Mouthguards in Ethylene Vinyl Acetate (EVA) should be sanitized to prevent alteration of oral microbiota. The present study determined, in vitro and by SEM observation, the decontaminating effect of different substances on EVA mouthguards previously contaminated with saliva and broth culture of Enterococcus faecalis ATCC 29212 and Candida albicans CH 34 (clinically isolated). Subsequently, the mouthguards were subjected to the following treatments: (A) Untreated; (B) 5 min with sterilized distilled water (H₂O d); (C) 5 min with H₂O₂; (D) 5 min with a physiological solution; (E) toothbrush and fluoride toothpaste; (F) 5 min with 0.5% NaOCl; (G) 5 min with Oral Care Foam™; (H) 5 min with Bite Sept™. The highest efficacy against E. faecalis was demonstrated by H₂O₂ (84.19% bacterial load reduction). H₂O₂ and Oral Care Foam™ showed a greater reduction of salivary cell load. The highest efficacy against C. albicans was demonstrated by 0.5% NaOCl which caused a 92.95% reduction of cell load. In conclusion, hydrogen peroxide, 0.5% sodium hypochlorite and the solution Oral Care Foam™ allowed to obtain an optimum disinfection of the mouthguard. SEM observation showed that different substances demonstrated a decontaminating effect decreasing the microbial communities on the EVA surface.

Physical Activity Reduces the Prevalence of Periodontal Disease: Systematic Review and Meta-Analysis

Background: Regular physical activity boosts several physical capacities and reduces many inflammatory markers of several diseases. In this sense, periodontal disease is a multifactorial inflammatory disease of tooth supporting tissues that has been claimed to trigger processes of systemic alterations. The aim of this systematic review and meta-analysis was to assess the effects of physical activity on periodontal disease.

Methods: Observational studies published until August 2018 were searched in online databases (PubMed, Scopus, Web of Science, The Cochrane Library, LILACS, OpenGrey, and Google Scholar) after developing a PECO statement that focused on the comparison between adults that followed a routine of exercises or presented a sedentary lifestyle and its effects on periodontal disease. Searching and data extraction were conducted by following PRISMA guidelines. Registration protocol: CRD42016049661. Quality assessment and risk of bias were analyzed by following Fowkes and Fulton protocol.

Results: A total of 512 references were retrieved, while only seven were considered eligible. Two meta-analysis involving the prevalence of periodontal disease and unadjusted/adjusted Odds ratio were performed. One of studies did not find association between clinical periodontal parameters and physical activity. Six articles suggested an association between periodontal disease and regular practice of physical activity since a reduction of periodontal prevalence was observed. Moderate level of evidence was demonstrated on GRADE analysis.

Conclusion: Physical activity was associated as a potential tool for reduction of periodontal disease prevalence. The frequency of physical activity is directly related to a low occurrence of periodontitis. However, it is important that further investigations evaluate the effects of other exercise variables, such as volume and intensity, on the periodontal disease prevalence.

Prevalence of Dentinal Hypersensitivity and Dental Erosion among Competitive Swimmers, Kerala, India

Background

Professional swimmers face a hidden occupational hazard due to improper maintenance of pool. Ill maintained pools can lead to erosive effects on dental health and thus needs to be evaluated.

Methodology

Fifty-six competitive swimmers from two training centers were contacted and surveyed for swimming exposure and oral health. A visual analog scale was used to rate the tooth sensitivity. Dental erosion and dental caries were recorded according to WHO oral health assessment criteria (2013). The dentinal hypersensitivity experience was assessed using the dentine hypersensitivity experience questionnaire - 15 (DHEQ-15). Data were analyzed using Chi-square test and multivariate analysis.

Results

The prevalence of dentinal hypersensitivity and dental erosion was found to be 69.6% and 48.2%, respectively. The common surfaces affected by dental erosion were palatal surfaces of maxillary anterior, followed by lingual surfaces of mandibular anterior. There was a direct association between duration of the stay in pool and dental erosion. The DHEQ-15 questionnaire revealed that more than 80% of the participants never felt these sensations had any serious long-term effects on oral health.

Conclusions

Oral health professional must understand dental erosion among competitive swimmers as an occupational oral health hazard and provide early counseling and necessary invasive and noninvasive care.

Single leg squat performance in physically and non-physically active individuals: a cross-sectional study

BACKGROUND

Single-leg squat (SLS) is a functional test visually rated by clinicians for assessing lower limb function as a preventive injury strategy. SLS clinical rating is a qualitative evaluation and it does not count objective outcomes as kinematics data and surface electromyography (sEMG) assessment. Based on the SLS rating, the aims of this study were (i) to determine the clinical rating agreement among six raters and (ii) to assess kinematic and sEMG predictors of good SLS performance in physically and non-physically active individuals.

METHODS

Seventy-two healthy adults, divided in physically active and non-physically active groups, performed three SLSs on their dominant leg. Clinical ratings, kinematic data and sEMG were acquired. By using a validated clinical scale, six expert clinicians rated each SLS watching a video at three different time points. Intra and inter-rater agreement of clinical ratings were undertaken and a binary logistic regression analysis was used to determine kinematic and sEMG as predictors of SLS performance.

RESULTS

The weighted kappa coefficient for intra-rater reliability within each rater ranged between moderate and almost perfect agreement (0.55-0.85) whereas the weighted kappa coefficient for inter-rater reliability among raters was fair (0.34, time point 0; 0.31, time point 1; 0.30, time point 2). SLS analyses of physically active compared to non-physically active group showed a statistically significant difference in knee flexion and hip flexion (p = 0.041 and p = 0.023 respectively) and no difference in clinical ratings (p = 0.081). Greater knee flexion can predict the good SLS performance taking into account the belonging group (p = 0.019).

CONCLUSIONS

Physically active individuals seemed to be at less risk to perform a non-good SLS and they had greater knee and hip flexions kinematics than non-physically active individuals. Knee flexion can predict the SLS performance quality therefore a greater knee flexion might also be considered a protective element from injuries.

TRIAL REGISTRATION

ClinicalTrials.gov identifier (trial has been registred retrospectively: NCT03203083. Date registration: June 21, 2017.