Friday, August 19, 2016

Cycling and Pondering Caries

I received my first 10-speed bicycle when I was 12 years old. I rode it everywhere. In the age when TV was still attached to antennas and personal computers did not exist, being outside and being active were the only ways to relieve boredom. It was a time when I could be gone all day and home for supper, and my parents seemed to be OK with it. (I don’t know how because I worry about my teenage kids when they are not at home now, and they’re good kids!) When you are out cycling for four to six or more hours, you cover a lot of distance, and I seemed to do it well without much thought. At least, that is what I think I remember.

And cycling back then was not so easy. No bike lanes, no helmets, cars did not give you any room, car and bus exhaust was dirty and smelly. It was terrible, and it was wonderful.

Now, I have a 21-speed mountain bike and an 18-speed touring bike, and I am happy to get out for 45 minutes to ride. I wear a helmet, I cycle on pathways restricted to pedestrians and cyclists, and it is great to get out there.

But I am also a fan of cycling. I have been a member of the Adventure Cycling Association for over 25 years, and I enjoy watching cycle racing, particularly road racing and, even more specifically, the Tour de France. Wow! Twenty-one days of racing in 23 days, where they cycle uphill faster than I cycle on flat ground. They race for four, five-, six-plus hours. Then they go to bed and get up the next day and do it again. Incredible. And when Briton Chris Froome wins the Tour for a third time in a row this year with a cumulative time more than four minutes faster than the guy in second place? Amazing.

Frank is another story. In his youth, he fancied the idea of being an international road-racing cyclist. He had the frame — tall, lanky, and lean, with a large chest and great lung capacity — and he could ride for hours at a high speed. Indeed, he did race competitively and was on Canada’s national team, but the pay was low, and there was not a great future in cycling as a career, so he became a teacher instead.

Frank loved teaching, and he loved dogs. (He loved his wife, too, but that is not what this story is about.) He would breed dogs, Shepherds and others. On his acreage, the dogs had lots of room to safely roam and run.

A few years ago, Frank rediscovered cycling. Like a kid in a candy store, he just glowed as he talked about his new bike (a Giant), the hours in the Alberta countryside, and the challenging foothills to the Rocky Mountains. Recently, he retired from teaching after 33 years and is returning to road racing again at the master’s level internationally. And he is winning, too!

But Frank has paid a heavy price. Hours on the road at high intensity depletes the body of nutrients, and the cycling world has come up with fast ways to replenish the body with these sticky, carbohydrate-laden energy gels (they are not even bars). In a relatively short time, Frank has developed rampant caries and has now lost several teeth. I recently fit him with a maxillary partial denture, and it looks, fits, and feels good, but I would rather have seen him with his own teeth.

And there is the dilemma. How can we, in dentistry, help these athletes fulfill their nutrition needs in these long, intense training and sporting endeavors so they do not destroy their dentitions? I don’t have the answers to these questions, but it is on my mind for every one of the 21 days of racing in the Tour de France.

I think I’ll go out for a bike ride and ponder this some more. If anyone else has ideas, I would love to hear about them in the comments section. And I think AGD would be the ideal organization to lead advocacy for oral health in sports like cycling as well.

Larry Stanleigh, BSc, MSc, DDS, FADI, FICD, FACD, FPFA


Ed said...

Very interesting story. I personally find it hard to believe that sipping on energy gels caused rampant decay since while bike riding, if you need to eat gels, you must be drinking a fair amount to help dilute and wash away the Gu. Give the guy a pack of floss and some OHI.

ivan paskalev said...

I am also quite active and cycle a lot, often wander what the high refined carb diet does on my own teeth.
Fluoride varnish, silver diamine fluoride, xylitol and so on, those can certainly help.
Recently heard about an ultra cyclist, Maria Parker, who owns a few women's distance records, has trained her body on ketogenic diet, allowing her to take only 40 grams! of food on a 24h event. This is controversial stuff, but her dentist is likely thanking her for that.

Unknown said...

Long distance runners are at risk for this problem too. 'Shot bloks"and other Jelly bean-like energy snacks to be consumed while running can be hazardous to the dentition. I used to use them for my long runs while in dental school and now don't go near them. The least athletes could do is to wash them down with plain water and rinse their mouth mid-run..I would think.


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