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...
Saved in:
Published in | Canadian Journal of Dental Hygiene Vol. 53; no. 3; pp. 166 - 171 |
---|---|
Main Authors | , , , |
Format | Journal Article Trade Publication Article |
Language | English |
Published |
Ottawa
The Canadian Dental Hygienists Association
01.10.2019
Canadian Dental Hygienists Association CJDH |
Subjects | |
Online Access | Get full text |
ISSN | 1712-171X 1712-1728 |
Cover
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 – name: Associate professor and biostatistician, Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA – name: At the time of this study, Ms Moore was a faculty member, Division of Dental Hygiene, University of New Mexico, Albuquerque, NM, USA |
Author_xml | – sequence: 1 fullname: Moore, Alexandra B – sequence: 2 fullname: Calleros, Christina – sequence: 3 fullname: Aboytes, Diana B – sequence: 4 fullname: Myers, Orrin B |
BookMark | eNpt0V1rFDEUBuBBKvZD_8NQQezFSr4mmbkRllJtoeiFCt6Fs8mZ2ZRMsp1kWv33RlraHZFcJJw8eU9CjquDEAO-qI6oomxFFWsPntb052F1nNINIQ3nVLyqDjlngvCmOarUOtSQEqY0Ysh17Guz9XFyAeuUwZXNYGsTvcfBQS7FezeOOKXX1csefMI3j_NJ9ePTxffzy9X1189X5-vr1cCFyCuLxPQGCOPWKtYA8o4DQG9IQ2wDUglppOgU7cxGUhAbayhTTWcpN4z1gp9UHx9yd_NmRGvKJSfweje5EabfOoLTy53gtnqId1qVt7ZElYDTx4Ap3s6Ysp5wF6ecNOMtI00rOS3o_T9odMmg9xAwzoUKKSSRHeOFvn2gA3jULvSxtDV_uV5L0rUFke6560KZnbvV--jDf1AZFkdnynf2rtQXqWeLA8Vk_JUHmFPSV9--LO27PbtF8Hmbop-ziyHtwz8iRqyw |
ContentType | Journal Article Trade Publication Article |
Copyright | COPYRIGHT 2019 The Canadian Dental Hygienists Association Copyright © 2019, CDHA | ACHD. Copyright Canadian Dental Hygienists Association Oct 2019 Copyright © 2019, CDHA | ACHD 2019 |
Copyright_xml | – notice: COPYRIGHT 2019 The Canadian Dental Hygienists Association – notice: Copyright © 2019, CDHA | ACHD. – notice: Copyright Canadian Dental Hygienists Association Oct 2019 – notice: Copyright © 2019, CDHA | ACHD 2019 |
DBID | ISN 7X8 3V. 4T- 7RQ 7RV 7XB 8FE 8FH 8FI 8FJ 8FK 8FQ 8FV ABUWG AFKRA AZQEC BBNVY BENPR BHPHI CCPQU DWQXO FYUFA GHDGH GNUQQ HCIFZ KB0 LK8 M7P NAPCQ PHGZM PHGZT PKEHL PPXIY PQEST PQGLB PQQKQ PQUKI PRINS Q9U U9A 5PM |
DatabaseName | Gale In Context: Canada MEDLINE - Academic ProQuest Central (Corporate) Docstoc Career & Technical Education Database Nursing & Allied Health Database ProQuest Central (purchase pre-March 2016) ProQuest SciTech Collection ProQuest Natural Science Journals ProQuest Hospital Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) Canadian Business & Current Affairs Database Canadian Business & Current Affairs Database (Alumni) ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central Essentials Biological Science Collection ProQuest Central Natural Science Collection ProQuest One Community College ProQuest Central Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student SciTech Premium Collection Nursing & Allied Health Database (Alumni Edition) Biological Sciences ProQuest Biological Science Nursing & Allied Health Premium ProQuest Central Premium ProQuest One Academic ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Applied & Life Sciences ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China ProQuest Central Basic PubMed Central (Full Participant titles) |
DatabaseTitle | MEDLINE - Academic ProQuest Central Student ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Central (Alumni Edition) SciTech Premium Collection ProQuest One Community College ProQuest One Health & Nursing ProQuest Natural Science Collection ProQuest Central China ProQuest Central CBCA Complete (Alumni Edition) ProQuest One Applied & Life Sciences Health Research Premium Collection Natural Science Collection ProQuest Central Korea Biological Science Collection CBCA Complete ProQuest Central (New) Career and Technical Education (Alumni Edition) ProQuest Biological Science Collection ProQuest Central Basic ProQuest One Academic Eastern Edition ProQuest Nursing & Allied Health Source ProQuest Hospital Collection Health Research Premium Collection (Alumni) Biological Science Database ProQuest SciTech Collection ProQuest Hospital Collection (Alumni) Nursing & Allied Health Premium ProQuest Career and Technical Education ProQuest One Academic UKI Edition Docstoc ProQuest Nursing & Allied Health Source (Alumni) ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) |
DatabaseTitleList | MEDLINE - Academic ProQuest Central Student |
Database_xml | – sequence: 1 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Dentistry |
EISSN | 1712-1728 |
EndPage | 171 |
ExternalDocumentID | PMC7533807 A609869209 |
Genre | General Information |
GeographicLocations | New Mexico United States--US |
GeographicLocations_xml | – name: New Mexico – name: United States--US |
GroupedDBID | 04C 29B 34H 36B 53G 5GY 6PF 7RQ 7RV 8FE 8FH 8FI 8FJ 8FQ 8R4 8R5 8RF AAWTL ABUWG ACPRK ADBBV ADFRT ADOJX AEODN AFKRA AHMBA ALIPV ALMA_UNASSIGNED_HOLDINGS BBNVY BENPR BHPHI BKEYQ BMSDO BPHCQ BVXVI CCPQU DWQXO E3Z EBS ECT EIHBH EJD EX3 FRP FYUFA HCIFZ IAO ICQ IHR IHW INH INR ISN ITC IVC LK8 M3F M7P NAPCQ PHGZM PHGZT PQQKQ PROAC Q2X RPM UCV UKHRP W2D WOW PMFND 7X8 PPXIY PQGLB PUEGO 3V. 4T- 7XB 8FK AZQEC GNUQQ PKEHL PQEST PQUKI PRINS Q9U U9A 5PM |
ID | FETCH-LOGICAL-g344t-de0cfca023dd725ae393aaafc050d5a6746c649719cb61a4bdc12759d13c22f43 |
IEDL.DBID | BENPR |
ISSN | 1712-171X |
IngestDate | Thu Aug 21 13:52:06 EDT 2025 Wed Aug 27 18:28:32 EDT 2025 Thu Sep 04 16:47:34 EDT 2025 Tue Jun 17 21:21:32 EDT 2025 Tue Jun 10 15:34:31 EDT 2025 Tue Jun 10 20:29:56 EDT 2025 Fri Jun 27 03:58:17 EDT 2025 Thu May 22 21:22:01 EDT 2025 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 3 |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-g344t-de0cfca023dd725ae393aaafc050d5a6746c649719cb61a4bdc12759d13c22f43 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
PMID | 33240355 |
PQID | 2382058631 |
PQPubID | 23479 |
PageCount | 6 |
ParticipantIDs | pubmedcentral_primary_oai_pubmedcentral_nih_gov_7533807 proquest_reports_2382058631 proquest_miscellaneous_2464606923 gale_infotracmisc_A609869209 gale_infotraccpiq_609869209 gale_infotracacademiconefile_A609869209 gale_incontextgauss_ISN_A609869209 gale_healthsolutions_A609869209 |
PublicationCentury | 2000 |
PublicationDate | 20191001 |
PublicationDateYYYYMMDD | 2019-10-01 |
PublicationDate_xml | – month: 10 year: 2019 text: 20191001 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | Ottawa |
PublicationPlace_xml | – name: Ottawa |
PublicationTitle | Canadian Journal of Dental Hygiene |
PublicationYear | 2019 |
Publisher | The Canadian Dental Hygienists Association Canadian Dental Hygienists Association CJDH |
Publisher_xml | – name: The Canadian Dental Hygienists Association – name: Canadian Dental Hygienists Association – name: CJDH |
SSID | ssj0053314 |
Score | 2.114666 |
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... |
SourceID | pubmedcentral proquest gale |
SourceType | Open Access Repository Aggregation Database |
StartPage | 166 |
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 |
URI | https://www.proquest.com/docview/2464606923 https://www.proquest.com/docview/2382058631 https://pubmed.ncbi.nlm.nih.gov/PMC7533807 |
Volume | 53 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1LTxsxELbacGhvlFI1QIOpkDhZXXu9dnyq0hYESERVKVJulp-Qy24gifj7jJ1Nmm2lXvawM_uQPZoZjz9_g9Apc0rGigkSlTKE22iJrawiLgaunDAymnRQ-GYsLu_49aSatAW3eQurXPvE7Kh941KN_AuEFlZUQ1HSr7NHkrpGpd3VtoXGa7TDEvFcD-18Ox___LX2xZDLZHZvKikjcJn863j_BkNuRZeLXdSHiOED3iqh4dFqRt-hV6HeQ29-JFBP6sv2HslRjc2GTxM3EbuHDKMLOJ-Fwqb22OV6AAw73Hye5uL0Prq7OP_9_ZK07Q_Ifcn5gvhQuOgMBFXvJatMKFVpjImuqApfGSG5cIIrSZWzghpuvUts7crT0jEWefkB9eqmDh8RVopZwXzwVEQOOYktlfHURhpMLGwl--g4DYtenb3cGL0eiUINhWKF6qPPWSNRRtQJk3JvlvO5vrodd5TOWqXYwFg600L84ScSy1RH87Cj6WbTR70lPepIweJd5-GT9ezpJEowsTo0y7lmXHBYkUHSCh_Y6LS7L_qPCfWR7Ey6nq2oPXQi2-5K6ulDJt2GZV3i5j_473sP0VtIqNQK7HeEeounZfgEScvCDlrLHOR60gvG__JN |
linkProvider | ProQuest |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1Lb9swDCa69NDd9sTSdqs2bNjJmC3LcnUYhqwPJGsbDFsL5Kbp2eZip0uCYn9qv3GUH2ncArv14oNFPyBSJEWRHwHeUyNyn1EeeSFUxLTXkc60iIx3TBiucq9CofDZmA8v2LdJNtmAv20tTEirbHVipahtaUKM_BOaFhpn-zxNvsyuo9A1Kpyuti00arE4cX9ucMs2_zw6RP5-oPT46PxgGDVdBaLLlLFFZF1svFFoq6zNaaZcKlKllDdxFttM8Zxxw5nIE2E0TxTT1gQQdGGT1FDqWYrvfQSbLFS09mDz69H4-49W96PvVKGJJ3lCI7xM7iv6u8mXa9bs-An00UJZR9ZCdmRQS9BT2HDFM9g6DElEoQ_cc8gHBVEr_E5SemKuqrQ9R6raK6IKS0wVf0A2482baRUMfwEXDzIxL6FXlIV7BUQIqjm1zibcM_SBdCqUTbRPnPKxzvI-7IVpkXWt52qRyQGPxT4XNBZ9eFdRBIiKIuTAXKrlfC5HP8cdoo8NkS9xLo1qSgrwJwKqVYdyp0NpZtNruTa62xnFFWY6D79tuSfDUEhLK1y5nEvKOMMdIDrJ-IEVTXPaI29Ftg95h-lyVkOJyADu3R0pplcVyDduI0MvgO3_vncPtobnZ6fydDQ-2YHH6MyJOtFwF3qL30v3Gh2mhX7TSCmBXw-9MP4BKTsu9Q |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=An+assessment+of+chlorine+stain+and+collegiate+swimmers&rft.jtitle=Canadian+Journal+of+Dental+Hygiene&rft.au=Moore%2C+Alexandra+B&rft.au=Calleros%2C+Christina&rft.au=Aboytes%2C+Diana+B&rft.au=Myers%2C+Orrin+B&rft.date=2019-10-01&rft.pub=Canadian+Dental+Hygienists+Association&rft.issn=1712-171X&rft.eissn=1712-1728&rft.volume=53&rft.issue=3&rft.spage=166&rft.epage=171 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1712-171X&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1712-171X&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1712-171X&client=summon |