• Poor dental health can limit athletic abilities to train and compete at their best performance. Dental abscess, bleeding gums, painful TMJ (Tempro-Mandibular Joint) or fracture of teeth and/or jaw are just examples. The Working Group on Dentistry of the International Olympic Committee (IOC) Medical Commission has recommended the following steps to the National Olympic Committees before attending Sydney Olympic Games:

• 1.      Establishment of a screening program for all athletes and mission staff prior to the Olympic Games.

• 2.      Arrangement for necessary dental care to be completed well in advance of the Olympic Games.

• 3.      All the requests for dental treatment would be submitted to the Sydney Olympic Games Organizing Committee on behalf of any athlete who had been unable to obtain required immediate and necessary dental care.

• 4.      An annual dental assessment for all elite national athletes was required.

• 5.      Development of a network of dentists to assist in the provision of dental care for athletes, and assist athletes with the financial or logistical aspects of obtaining necessary treatment.

• 6.      Achievement of an active role in educating athletes on issues relating to dental health.

• 7.      Improvement of event dental coverage for certain high-risk sports by having a dentist either on-site or immediately on-call.

• 8.      Creation of a program to provide top quality mouth guards to athletes competing in high-risk sports. A request for mouthguards would be submitted to the Sydney Olympic Games Organizing Committee on behalf of any athlete in a designated high-risk sport who had been unable to arrange for a mouthguard to be made prior to the Games.

• Most of these recommendations had been conducted in Gezira Sports Medicine Specialized Hospital, Cairo, Egypt since 1991. Now, the Dental Departments at the three (Hospitals) adopted the following Treatment Plan Sequence on dealing with Egyptian national athletes.

Treatment Plan Sequence:

Comprehensive general dental care should be provided to athletes. Treatment will in general be accomplished as follows:

•          Screening Evaluation (initial Appointment). The whole team is invited once a year and prior to the important Continental and International games.

•             Radiographs (X-rays) as necessary.

•             Diagnosis - determination of athlete’s oral and dental health status and the proposed plan of treatment including alternative treatment.

•             Start of the agreed treatment, which is financially covered by different Egyptian Olympic and Non-Olympic Federations for their teams. 

    Oral and Dental Diagnosis  

First appointment as a regular patient will be for a thorough dental examination that includes taking of each athlete’s medical and dental history, a detailed oral and dental examination and appropriate radiographs (X-rays) or laboratory investigations. The oral and dental examination like medical examinations, provide the information necessary for diagnosis and to develop a proper plan for treatment. Medical history is checked to see if there might be a connection between what is happening in athlete's mouth and general health and his/her performance.

  A clinical dental examination will include:

• Periodontal examination (gums and underlying bone structure). Some athletes are affected by sever periodontal diseases as loose teeth or bleeding gums on slightest touch and during heavy exercises.

An athlete who lost moderately loose lower anterior tooth due to athletic trauma.

• Mucous membrane examination (lips, cheeks, roof of the mouth and under the tongue). Dipping and chewing tobacco, which is popular with many athletes, may affect the area of tobacco usage that may vary from only slight irritation to premalignant lesions as leukoplakia or even malignant lesions as carcinomas.

• Oral cancer screening examination.

• Occlusion or bite is checked. The mode of occlusion could affect the decision of the dentist concerning many issues as susceptibility for trauma, the design of the mouthguard and the need for orthodontic treatment.

An athlete who has severely protruded upper anterior teeth with conducted orthodontic treatment.He is highly susceptible for trauma, and custom-made mouthguard should be constructed.

• Missing teeth are noted. Impacted canines or wisdom teeth tend to make athlete more prone to jaw fracture during competition.

• The teeth are checked for decay.  It may result from sport drinks or other athletic nutritional disorders.

• Teeth fractures and discolorations. These sometimes were associated with dental trauma.

An athlete suffering from discolored upper central incisor was caused by a previous trauma while ignoring to wear his mouthguard.

• Broken or deteriorating fillings are noted.

• All dental appliances are checked. (Mouthguards, scuba diving mouthpieces, night guards, orthodontic appliances, crowns, bridges, partial dentures or full dentures)

• Tempromandibular joint (TMJ) and chewing muscles are checked. They are always affected due to recurrent trauma and/or athletes' different stresses.

After completing the examination, the dentist will discuss with the athlete the results of the examination and status of his/her oral health. The dentist will outline specific treatment depending on the results of the examination, and will try to answer his/her specific questions and concerns. Then, a detailed report is sent to the athlete's federation for financial approval. 

The Check-Up

Ideally, regular dental checkups every six months are the best way to make sure that gums and teeth stay healthy, allows dentist to diagnose any problems, and to take preventive action to stop problems before they develop. The dentist may suggest that the visit more or less often depends on how well the athlete cares for his/her teeth and gums, problems he/she has that need to be checked or treated, how fast tartar builds up on teeth, his/her training and competitions schedule, athletic injuries, and so on. The goal is to catch small problems early.

So, sometimes this protocol of checkups is hardly achieved. Then, the athlete will be recalled automatically with his team before any upcoming important international championship.

Sports dentists are trained to look for anything unusual in athlete's mouth, throat and neck, including the oral manifestations of diseases, oral cancer, infections, early signs of gum disease, eroded fillings and dental decay.

They understand the treatment alternatives available to each athlete, doping rules, and can help him/her make informed decisions about dental care while still participating in both training and competitions.

There are a number of oral health conditions that only the dentist can see. Various medical conditions can also be detected during the dental checkup, often in their early stages. The sports dentist has been trained to identify the oral manifestations of these conditions, and can refer the athlete to other health professionals for treatment. Anorexia athletica, Anorexia nervosa and bulimia are just examples.