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Background Dental caries and periodontitis are associated with elevated levels of pro-inflammatory cytokines which may trigger muscle fatigue during exercise, a strong risk factor for sports injuries. Fixed orthodontic appliances (FOA) may cause poor oral health and may disturb proprioceptive inputs of the stomatognathic system. This study aims to explore associations of poor oral health and of use of a FOA with injury frequency and postural stability. Methods One hundred eighty seven Belgian elite junior male soccer players, aged 12–17 years, completed a self-report questionnaire asking about injuries in the past year, oral health problems, use of a FOA, demographics and sports data, and stood in unipedal stance with eyes closed on a force plate to assess postural stability. Results Ordinal logistic regression with number of injuries in the past year as ordinal dependent variable and dental caries and/or gum problems, age and player position as covariates, showed that participants who reported dental caries and/or gum problems and never had had a FOA reported significant more injuries in the past year compared to the reference group of participants who reported no oral health problems and never had had a FOA (adjusted OR = 2.45; 95% CI, 1.19–5.05; p = 0.015). A 2 (temporomandibular joint problems) × 2 (FOA) × 2 (age) ANOVA with postural stabilities as dependent variables, showed a significant FOA x age interaction for the non-dominant (standing) leg. Post-hoc t-tests showed a significant better postural stability for the non-dominant leg (and a trend for the dominant leg) for the older compared with the younger participants in the non-FOA group (p = .002, ES = 0.61), while no age differences were found in the FOA-group. Conclusions These results indicate that poor oral health may be an injury risk factor and that a FOA may hinder the development of body postural stability.

Background: Although it is well known that oral pathogens can enter the systemic circulation and cause disease, it is largely unknown if poor oral health increases the risk of sports injuries. The purpose of this study is to investigate the association between poor oral health and reinjuries in male elite soccer players, adjusted for psychosocial problems and player characteristics. Methods: 184 Players in premier league soccer clubs and 31 elite, junior soccer players in the Netherlands, Belgium and England, were enrolled in a retrospective cross-sectional study. The Sports Injury Risk Indicator, a self assessed questionnaire, was used to obtain information on reinjuries, age and player position, oral health and psychosocial problems. The number of different types of oral health problems was used as an indicator of poor oral health. (SumDental, range 0-2: 0 = no oral health problems, 1 = one type of oral health problem and 2 = two or more types of oral health problems). Multivariable logistic regression was used to investigate whether SumDental was associated with reinjuries, after adjustment for psychosocial problems and player characteristics. Results: 37% of the players reported no oral health problems, 43% reported one type of oral health problem and 20% reported two or more types of oral health problems. After full adjustment for age, player position and psychosocial problems (i.e. injury anxiety, psychophysical stress, unhealthy eating habits and dissatisfaction with trainer/team), poor oral health (SumDental) was positively associated with all kind of reinjuries whether analyzed as a continuous variable or as a categorical variable. The fully adjusted odds ratios for SumDental analyzed as a continuous variable were: in relation to repeated exercise-associated muscle cramps: 1.82(95% confidence interval (CI): 1.07, 3.12), in relation to muscle or tendon reinjury 1.57 (95% CI: 1.01, 2.45) and in relation to multiple types of reinjury 1.88 (95% CI: 1.19, 2.97). Conclusion: The results from this study justify a thorough examination of the effects of oral health problems on the injury risk of playing elite soccer.