Oral Health and Hormonal Balance

Another key insight from Huberman’s research is how poor oral health can affect testosterone and cortisol levels, two hormones that play a massive role in athletic performance. Chronic inflammation from gum disease or tooth infections raises cortisol levels, leading to higher stress responses and slower recovery times. At the same time, testosterone—a key hormone for strength, endurance, and muscle recovery—may be negatively impacted by chronic systemic inflammation originating in the mouth.

Why Athletes Are at High Risk for Oral Health Issues

1. Diet and High Sugar Intake

Sports drinks, energy gels, and carbohydrate-heavy diets are a staple for many athletes. These fuel sources may help performance in the short term, but they wreak havoc on oral health.

Why?

• Sports drinks and energy gels are highly acidic and erode tooth enamel over time.

• Sugar feeds harmful bacteria, leading to cavities and gum disease. It’s important to note: sugar does not cause cavities, but rather bad bacteria feed off of sugar, causing cavities.

• Many athletes sip drinks slowly over time, extending their teeth’s exposure to sugar and acid.

A study on triathletes found that 83.9% consumed sports drinks while training, often taking “little sips often” from a bottle. This prolonged exposure makes their teeth vulnerable to decay.

Beyond sports drinks, carbohydrate loading before competitions and frequent snacking between training sessions expose teeth to an increased risk of decay. Athletes who consume highly refined carbohydrates, including energy bars and meal replacements, may unknowingly be weakening their teeth over time.

2. Mouth Breathing and Dry Mouth

Athletes, particularly endurance runners, cyclists, and fighters, often breathe through their mouths during intense exertion. This leads to dry mouth, which reduces saliva production.

Why does this matter?

• Saliva helps wash away harmful bacteria and neutralizes acids.

• Without enough saliva, bacteria multiply, leading to bad breath, cavities, and gum disease.

• A dry mouth environment speeds up dental erosion and weakens teeth over time.

3. Bruxism (Teeth Grinding) Under Stress

High-intensity sports come with high levels of stress. Many athletes unconsciously clench or grind their teeth (bruxism), especially during competition or heavy lifts.

Effects of bruxism on oral health:

• Tooth fractures and premature enamel wear.

• Increased sensitivity and risk of cavities.

• Jaw pain and temporomandibular joint (TMJ) issues can affect concentration and overall comfort.

Some studies suggest that high cortisol levels—associated with stress—also impact oral health by increasing inflammation in the gums, making athletes more prone to periodontal disease.

4. Frequent Trauma to the Mouth and Jaw

Combat sports, motocross, football, hockey—any sport that involves impact or falls puts athletes at risk for dental trauma. Research suggests that up to 47% of athletes experience some form of dental injury. Without proper protection (like custom mouthguards), broken teeth, fractures, and nerve damage can quickly sideline an athlete.

5. Neglect and Lack of Awareness

Many athletes don’t prioritize oral health in the same way they do strength, recovery, and nutrition. Regular dental visits are often skipped, and symptoms like mild gum inflammation or tooth sensitivity are ignored until they become major issues.

How Oral Health Affects Sports Performance

Oral health is not just about cavities and fresh breath—it directly affects an athlete’s psychology, endurance, power output, recovery, and even sleep quality. According to Ian Needleman, professor of periodontology at UCL Eastman Dental Institute, oral health has both psychological and physiological consequences, many of which go unnoticed until they start impacting performance.

Needleman’s research highlights that oral health issues can lead to:

• Decreased confidence and focus
• Increased stress and anxiety
• Compromised sleep quality
• Higher systemic inflammation and slower recovery
• Reduced VO2 max and power output

Elite athletes often train every aspect of their body for peak performance, yet many neglect oral health, which can subtly degrade their ability to train, recover, and compete at their best.

1. Pain, Discomfort, and Psychological Effects

Oral pain can be a silent performance killer, distracting an athlete during competition and reducing their focus, reaction time, and mental resilience.

• Even a minor toothache can throw off concentration and make it harder to maintain mental clarity during high-pressure moments.
• Low-to-moderate chronic oral pain is common among elite athletes but is often ignored until it escalates into something serious.
• Psychological impacts include increased anxiety, stress, and reduced confidence, particularly in athletes who have self-reported negative effects on their training and performance due to oral discomfort.

Needleman’s studies show that athletes dealing with chronic gum disease, infections, or cavities often experience higher levels of stress and anxiety, which can impair performance just as much as physical pain. This aligns with other research showing that athlete confidence and mental resilience are key factors in achieving peak performance.

2. Inflammation and Injury Recovery

Poor oral health contributes to chronic inflammation, which slows muscle recovery, increases injury risk, and negatively impacts endurance and strength.

• Gum disease and chronic infections in the mouth act as a source of systemic inflammation, affecting muscles, joints, and overall physical resilience.
• Higher inflammation = longer recovery times and increased risk of overuse injuries.
• Needleman’s research suggests that the degree of gum inflammation is directly correlated with endurance loss and power output reduction, meaning that even minor gum disease could be limiting an athlete’s full potential.

Studies also indicate that athletes with poor gum health recover slower from injuries, as their immune system is constantly fighting low-level infections rather than directing resources toward muscle repair. This means that a neglected gum infection could be delaying an athlete’s ability to return to peak condition after intense training or competition.

3. Respiratory and Cardiovascular Health

Gum disease has been linked to an increased risk of respiratory infections and cardiovascular issues, which can significantly impact an athlete’s endurance, oxygen efficiency, and overall stamina.

• Harmful bacteria from the mouth can enter the bloodstream, leading to heart inflammation (endocarditis) and compromised oxygen transport to muscles.
• VO2 max (a key marker of endurance and cardiovascular efficiency) has been found to decrease in athletes with higher levels of gum inflammation, according to Needleman’s treadmill studies.
• Infections in the mouth have been associated with a higher likelihood of respiratory infections, which can limit lung function and overall athletic endurance.

For endurance athletes like runners, cyclists, and fighters, maintaining healthy gums could mean the difference between lasting through a grueling competition or fading out early due to compromised oxygen efficiency.

4. Reduced Power Output and Athletic Strength

Needleman’s research goes beyond endurance—it also suggests that gum health is linked to an athlete’s ability to generate explosive power.

• Athletes with more severe gum disease demonstrated lower maximum power output in jump tests, indicating that oral health may influence fast-twitch muscle function and explosive strength.
• Chronic oral inflammation may interfere with neuromuscular coordination, making athletes slightly slower and less reactive—an issue that could be critical in sports where split-second decisions determine victory.

For fighters, sprinters, and power-based athletes, neglecting oral health could mean losing a crucial edge in speed and strength.

5. Sleep Disruptions and Recovery

Athletes need deep, restorative sleep for muscle repair and peak cognitive function. Poor oral health can significantly interfere with sleep quality, leading to fatigue, slower reaction times, and reduced performance.

• Tooth pain and gum infections cause sleep disruptions, preventing athletes from achieving the deep REM sleep necessary for full recovery.
• Sleep apnea, often linked to poor jaw alignment and gum disease, reduces oxygen intake at night, leaving athletes less recovered and more fatigued the next day.
• Mouth breathing at night (caused by gum inflammation, allergies, or jaw issues) leads to dry mouth, increased bacteria growth, and morning dehydration—all of which further exacerbate oral health issues and inflammation.

Needleman’s findings align with Huberman Lab research, which emphasizes that consistent, high-quality sleep is just as critical as training itself. If oral health issues are interfering with deep rest, athletes are unknowingly sabotaging their own recovery.

6. Emergency Oral Health Crises: When It’s Too Late

While many oral health issues develop gradually, there are also cases where a single, sudden crisis can completely derail an athlete’s competition.

• Needleman cites cases from Olympic teams where athletes had to withdraw from major competitions due to sudden wisdom tooth infections, abscesses, or severe dental pain.
• These acute oral health emergencies can be devastating, forcing an athlete to sit out an event they’ve trained for years to compete in.
• Even if an emergency is treated quickly, the inflammation, stress, and pain can still negatively affect performance.

While these catastrophic cases are less frequent, the more common, everyday effects of poor oral health—chronic pain, inflammation, and psychological stress—gradually erode an athlete’s full potential.

Holistic Oral Hygiene Tips for Athletes

1. Upgrade Your Toothpaste and Mouthwash

• 

  Use a fluoride-free remineralizing toothpaste (look for hydroxyapatite, which strengthens enamel naturally).

• Avoid alcohol-based mouthwashes that dry out your mouth.

• Opt for natural mouth rinses with ingredients like xylitol, clove, and aloe vera.

2. Oil Pulling and Salt Water Rinses

• Oil pulling with coconut or sesame oil helps remove toxins, reduce harmful bacteria, and support gum health. Swish for 10–20 minutes before brushing.
• Saltwater rinses soothe inflammation, promote healing, and maintain a balanced oral microbiome—ideal for athletes dealing with mouth injuries or dry mouth.

3. Hydration and Saliva Stimulation

• Drink pure mineral water, not just sports drinks.

• Chew sugar-free xylitol gum to remineralize the teeth and stimulate saliva flow.

• Avoid sipping acidic drinks over long periods—drink fast and rinse with water after.

4. Nasal Breathing Training

• Mouth-taping at night can train nasal breathing, reducing dry mouth and protecting enamel.

• Proper nasal breathing improves oxygenation, recovery, and overall athletic performance.

5. Get a Custom Mouthguard

• Protects against bruxism and impact injuries.

• Custom-fit guards are far superior to store-bought versions.

6. Regular Flossing and Tongue Scraping

• Floss daily with plastic-free floss or a water flosser to prevent gum disease.

• Use a copper tongue scraper to reduce bacteria and improve your breath.

In Summary: Prioritize Your Mouth Like You Do Your Muscles

Elite athletes push their bodies to the limit, but neglecting oral health can sabotage performance in ways most don’t realize. By making oral hygiene a key part of recovery and wellness, athletes can protect their teeth, optimize their performance, and improve their long-term health.

Your mouth is an extension of your body’s health—treat it like it matters, because it does.