An assessment of chlorine stain and collegiate swimmers

Swimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have suggested that swimming pool chlorination is responsible for dental erosion, calculus formation, and stain in competitive and recreational sw...

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Published inCanadian Journal of Dental Hygiene Vol. 53; no. 3; pp. 166 - 171
Main Authors Moore, Alexandra B, Calleros, Christina, Aboytes, Diana B, Myers, Orrin B
Format Journal Article Trade Publication Article
LanguageEnglish
Published Ottawa The Canadian Dental Hygienists Association 01.10.2019
Canadian Dental Hygienists Association
CJDH
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ISSN1712-171X
1712-1728

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Abstract Swimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have suggested that swimming pool chlorination is responsible for dental erosion, calculus formation, and stain in competitive and recreational swimmers, a phenomenon known as swimmer's mouth. The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to determine if dental preventive practices affected chlorine stains.BackgroundSwimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have suggested that swimming pool chlorination is responsible for dental erosion, calculus formation, and stain in competitive and recreational swimmers, a phenomenon known as swimmer's mouth. The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to determine if dental preventive practices affected chlorine stains.Swimmers were recruited from the University of New Mexico Swimming and Diving Team for this IRB-approved study (#17-481). Participants completed a questionnaire regarding individual oral habits and frequency of preventive visits. Following the questionnaire, an oral screening was completed to evaluate for stain. Fisher exact tests, nonparametric Wilcoxon tests, and descriptive statistics were used to analyse the data. Additionally, a cross-sectional analysis was used to compare the chlorine stain between divers and swimmers.MethodsSwimmers were recruited from the University of New Mexico Swimming and Diving Team for this IRB-approved study (#17-481). Participants completed a questionnaire regarding individual oral habits and frequency of preventive visits. Following the questionnaire, an oral screening was completed to evaluate for stain. Fisher exact tests, nonparametric Wilcoxon tests, and descriptive statistics were used to analyse the data. Additionally, a cross-sectional analysis was used to compare the chlorine stain between divers and swimmers.Twenty-one females, with a mean age of 20.5 years, participated in the study. One hundred percent of these subjects had staining of the teeth, despite the fact that 85% of them reported brushing their teeth 2 to 3 times per day, and 81% reported receiving regular dental prophylaxis. All participants swam 5 or more times every week, with practice length ranging from 1 to 2 hours. There were no differences in stain between collegiate swimmers and divers.ResultsTwenty-one females, with a mean age of 20.5 years, participated in the study. One hundred percent of these subjects had staining of the teeth, despite the fact that 85% of them reported brushing their teeth 2 to 3 times per day, and 81% reported receiving regular dental prophylaxis. All participants swam 5 or more times every week, with practice length ranging from 1 to 2 hours. There were no differences in stain between collegiate swimmers and divers.Within this study sample, extrinsic staining of the teeth was identified on all swimmers and divers and the presence of stain was not prevented by the frequency of tooth brushing or professional stain removal. Additional oral hygiene regimens should be explored to facilitate the prevention or complete removal of swimmer stain.ConclusionWithin this study sample, extrinsic staining of the teeth was identified on all swimmers and divers and the presence of stain was not prevented by the frequency of tooth brushing or professional stain removal. Additional oral hygiene regimens should be explored to facilitate the prevention or complete removal of swimmer stain.
AbstractList Swimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have suggested that swimming pool chlorination is responsible for dental erosion, calculus formation, and stain in competitive and recreational swimmers, a phenomenon known as swimmer's mouth. The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to determine if dental preventive practices affected chlorine stains.BackgroundSwimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have suggested that swimming pool chlorination is responsible for dental erosion, calculus formation, and stain in competitive and recreational swimmers, a phenomenon known as swimmer's mouth. The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to determine if dental preventive practices affected chlorine stains.Swimmers were recruited from the University of New Mexico Swimming and Diving Team for this IRB-approved study (#17-481). Participants completed a questionnaire regarding individual oral habits and frequency of preventive visits. Following the questionnaire, an oral screening was completed to evaluate for stain. Fisher exact tests, nonparametric Wilcoxon tests, and descriptive statistics were used to analyse the data. Additionally, a cross-sectional analysis was used to compare the chlorine stain between divers and swimmers.MethodsSwimmers were recruited from the University of New Mexico Swimming and Diving Team for this IRB-approved study (#17-481). Participants completed a questionnaire regarding individual oral habits and frequency of preventive visits. Following the questionnaire, an oral screening was completed to evaluate for stain. Fisher exact tests, nonparametric Wilcoxon tests, and descriptive statistics were used to analyse the data. Additionally, a cross-sectional analysis was used to compare the chlorine stain between divers and swimmers.Twenty-one females, with a mean age of 20.5 years, participated in the study. One hundred percent of these subjects had staining of the teeth, despite the fact that 85% of them reported brushing their teeth 2 to 3 times per day, and 81% reported receiving regular dental prophylaxis. All participants swam 5 or more times every week, with practice length ranging from 1 to 2 hours. There were no differences in stain between collegiate swimmers and divers.ResultsTwenty-one females, with a mean age of 20.5 years, participated in the study. One hundred percent of these subjects had staining of the teeth, despite the fact that 85% of them reported brushing their teeth 2 to 3 times per day, and 81% reported receiving regular dental prophylaxis. All participants swam 5 or more times every week, with practice length ranging from 1 to 2 hours. There were no differences in stain between collegiate swimmers and divers.Within this study sample, extrinsic staining of the teeth was identified on all swimmers and divers and the presence of stain was not prevented by the frequency of tooth brushing or professional stain removal. Additional oral hygiene regimens should be explored to facilitate the prevention or complete removal of swimmer stain.ConclusionWithin this study sample, extrinsic staining of the teeth was identified on all swimmers and divers and the presence of stain was not prevented by the frequency of tooth brushing or professional stain removal. Additional oral hygiene regimens should be explored to facilitate the prevention or complete removal of swimmer stain.
The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to determine if dental preventive practices affected chlorine stains. Keywords: chlorides, chlorine, colouring agents, mouth, staining and labelling, swimming, tooth discolouration CDHA Research Agenda category: risk assessment and management INTRODUCTION A phenomenon called swimmer's calculus, or stain, is characterized by hard, brown tartar deposits commonly found on the front teeth. To clarify, staining takes place on the acquired enamel pellicle, the layer of proteins and peptides which have a thickness of 1 pm on the enamel surface.1 This staining is caused when antimicrobials from pool water, which naturally have a higher pH than saliva, contact salivary proteins and quickly break them down, resulting in organic deposits on the swimmer's teeth.2-4 Athletic swimmers expose their teeth to chemically treated water when they practise, with these exposures usually lasting over 6 hours per week.2 There is little known about swimmer's mouth although one of the first studies to be released on this topic appeared in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report more than 30 years ago.5 This study analysed data from 740 swimmers, including 452 frequent swimmers. The report suggested that 15% of frequent, or daily, swimmers had enamel erosion while only 3% of infrequent, or non-swimmers, experienced enamel erosion.5 A more recent case report described observations of a competitive swimmer who swam in a gas-chlorinated swimming pool and experienced notable dental erosion within 27 days.6 Several other studies have been published evaluating changes in salivary composition, dental erosion, calculus, and stain.23,5-14 One of these studies more specifically investigated staining of the teeth in competitive swimmers.
Audience Professional
Author Aboytes, Diana B
Myers, Orrin B
Calleros, Christina
Moore, Alexandra B
AuthorAffiliation Associate professor and biostatistician, Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA
Assistant professor, Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA
At the time of this study, Ms Moore was a faculty member, Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA
AuthorAffiliation_xml – name: Assistant professor, Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA
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Copyright COPYRIGHT 2019 The Canadian Dental Hygienists Association
Copyright © 2019, CDHA | ACHD.
Copyright Canadian Dental Hygienists Association Oct 2019
Copyright © 2019, CDHA | ACHD 2019
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Snippet Swimming is known worldwide as one of the healthiest, low-impact forms of exercise that promotes a strong body, heart, and mind. However, several studies have...
The purpose of this observational study was to assess chlorine stain on the dentition of competitive female swimmers and divers from a university team and to...
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SubjectTerms Antimicrobial agents
Chlorine
Dental enamel
Dental erosion
Dentition
Enamel
Females
Labeling
Morbidity
Mouth
Original Research
Pellicle
Prevention
Questionnaires
Risk assessment
Saliva
Stains & staining
Studies
Swimmers
Swimming
Swimming pools
Teeth
Toothbrushing
Title An assessment of chlorine stain and collegiate swimmers
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https://pubmed.ncbi.nlm.nih.gov/PMC7533807
Volume 53
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