Canadian ultrarunner and dentist Dr. Arden Young discusses how endurance athletes, including ultrarunners, can protect their oral health from acid wear while fueling their long runs—some lasting up to 13 hours—with high-carb intake. She highlights the importance of education in safeguarding athletes’ oral health and how sports companies are now developing products to help them.
Read the audio transcript below:
Dr. Luisa Schuldt (LS): Hi everyone! And welcome to Brush Up, presented by Oral Health Group, the dental podcast, where we chat with industry experts about everything from technology and finance to practice management. I’m your host, Dr. Luisa Schuldt, a periodontist and prosthodontist based in Fonthill, Ontario.
In this episode, we’re taking a closer look at endurance sports and their impact on oral health. Joining us today is Dr. Arden Young, a dentist who finds both inspiration and strength in Alberta’s beautiful mountains. She’s not just scaling peaks for the view, she’s also an accomplished Ultra runner, blending two seemingly unlikely passions, dentistry and endurance racing. Dr. Young has an impressive track record. In 2023, she placed 10th among women at the CCC race in Chamonix, France, one of the most prestigious events in the trail running world, completing the 100-kilometer course in just over 13 hours. That same year, she was the highest placed Canadian woman at the World Mountain and Trail Running Championships in Innsbruck, Austria, finishing the 87.1-kilometer-long event, and also in about 13 hours. Now, ultra runners, these athletes who race distances starting from 50 kilometers to well over your average marathon, and going all the way up to 3100 miles, they rely heavily on carbonates to sustain that energy. But this carb loading, along with exposure to sports drinks and dry mouth, can take a toll on oral health. In fact, one study found that nearly half of elite endurance athletes had untreated tooth decay. Many showed early signs of gum disease as well. Dr. Young, welcome to the show. Thank you for joining us today. We’re so excited to have you.
Dr. Arden Young (AY): Thanks for having me. It’s really fun. It’s rare that I get to blend both these big components in my life, trail running and dentistry. So, this is a treat.
LS: Yeah, when thinking about athletics, I immediately thought like sports guards and trauma to the teeth. But this is a totally different avenue we’re going to chat about, which is, you know, endurance athletics, which has that long term need for carbohydrates to keep energy up, and slightly different implications.
AY: Yeah, and there’s a real trend right now in endurance sport, where people are realizing just how many grams of carbohydrates you can take in per hour, like people are aiming for 80 to 120 grams of carbs an hour. So, I mean, you’re constantly sipping and eating as you go, and you’re out there for, you know, 10, 20, more hours. It’s a lot of exposure for your teeth. And I just raced 100 kilometers on Saturday. And let me tell you, when I’m brushing my teeth right now, I can feel the sensitivity, like you can feel that acid damage.
LS: That’s amazing. I’m also thinking that with, you know, I know you’re focused on breathing through your nose and keeping the oxygenation, but I’m assuming you also get dehydrated, which means high sugar and a dry mouth combined during the races and during your training. It’s not just a one-off thing. I find that your background is going to give us some really interesting information, like the dentistry and the athletics. How does this give you an edge when we talk about prevention and the care that these athletes should have?
AY: I mean, my own knowledge, I floss daily. I use a fluoridated toothpaste. I wear a night guard, because the other thing that comes with this sport is often a lot of muscle pain, a lot of soreness, and so I do clench and grind at night, especially with the anxiety pre-race that I get. And so, I put my teeth through a lot, but I’ve never had a cavity, so I have a pretty good track record. And what really surprises me is, you know, yes, I have this background, but when I bring this up to my running community, it’s amazing how limited awareness that other athletes have on how the sport affects your teeth. You know, we think of all the other parts of your body functioning to perform these amazing feats and the mouth is pretty important. I mean, we need to be taking in this fuel in order to do these events. And people just don’t think about the damage on their teeth. So that always kind of surprises me.
LS: Now, you we were chatting a little bit before starting the recording about, like, weight training as well. I’m sure that’s really important in, you know, protecting your body from injury as your muscles get worn after this much time of an effort. And I’m sure there’s a lot of, like, clenching and tightening when you’re doing that type of, you know, training and preparation for your races. Protecting your teeth from wear as a night guard, but potentially also while you’re doing that weight training could be beneficial.
AY: Yeah, I mean, there’s a lot of aspects to it. And so, I think educating people on how to take some preventative measures when they’re training for these races and doing the races can help people long term. Like the number of people, friends, competitors that I’ve had say, oh yeah, when I started endurance sports, when I started doing these Ultra Trail races, all of a sudden, I needed a root canal, or I went to the dentist and I had four cavities, and so they’re kind of seeing that post damage. And so the preventative measures, if we can get people more educated and taking some measures to protect their teeth, I think that’ll be beneficial.
LS: Would you have some easy, practical steps that some of our people listening can, you know, if they’re endurance racers themselves, they can put it to use. But if they have patients that are doing this, easy steps that they can share with them to start protecting their oral health.
AY: Yeah, and while living in Canberra, Alberta, I mean, I’m in a pretty big mountain sports town, and so I do have a lot of athletes as patients. We have the national cross country biathlon teams here and a lot of ultra runners and cyclists. So, I do recommend to my patients that when they’re ingesting the carbs, the sports drinks and the gels we do, we take in a lot of sticky, sweet, acidic things that after they ingest, that they at least rinse their mouth with plain water. So typically, like when I’m racing, I’ll have 500 milliliters of sports drink or electrolytes and 500 milliliters of plain water, so that I can at least be rinsing my mouth, diluting the acid and the carbs, and trying to get that pH back to neutral faster. Patients that are struggling with sensitivity or finding they’re having an increase caries rate, I recommend a higher fluoridated toothpaste or hydroxyapatite toothpaste if they prefer flossing regularly. Regular dental checkups, and then, of course, considering a night guard, if we’re seeing the wear from clenching and grinding.
LSL I’m happy you brought up the hydroxyapatite, because, well, I’m in a non-fluorinated area, and there are people in my area that are not always super open to the idea of a high fluoride toothpaste. So, it’s good they have another option.
AY: Yeah. And I find changing the toothpaste, I find that a lot easier for patients, rather than adding a step like a mouth rinse. You know, if I’m not adding a step to the routine, it’s more likely to stick if I’m just changing one of the products that they’re already using.
LS: They kind of keep on their same routine, just with a little pivot. So, you’ve raced all over the world. We mentioned the race in France, but you’re obviously probably running quite a bit in Alberta as well. You’ve interacted with other communities, people from other nationalities. How do you see we do here through education and policy, compared to other countries or are other countries doing better? Is there something we can learn from them?
AY: Oh, I’d say, like overall, in comparison, oral health in Canada is pretty good. We’re pretty lucky. I mean, we have great dental schools, dentists, and a high level of education in our population. But like I said before, it still shocks me how many people in the sport have limited knowledge about how sport and how ingesting carbohydrates affect their oral health. And even I put on my Instagram probably about a month ago, I just made a note about one of the sports drink products that is doing something beneficial for oral health. And the number of comments I got that were like, oh, I’ve never even thought of this. This makes so much sense. Why didn’t anyone ever bring this up? And so that was really interesting. I think there’s a lot of room for education in the sport area.
LS: Sounds like you just also came up with something really great that the sports drink companies could think of more, especially for athletes like yourself that are high endurance and training a lot and consuming their products frequently.
AY: Yeah, well, when I saw this, the product is Maurten, and it’s a very popular product for, you know, everywhere from track runners, marathoners, ultra distance runners, cyclists, triathletes. And so most sports drinks that we’re ingesting are on pH three. So, you know, we’re adding acid to acid and, so Maurten added sodium bicarb to their drink mix very recently, and so it’s bringing the pH up to about six, seven. And so having that neutral pH to the sports drink is just, you know, it’s one less acid attack. And I found that really interesting, because Maurten also has a product that’s sodium bicarb in really higher dose that is used to buffer lactic acid in muscles. So, it’s supposed to keep your legs fresher longer, and so a lot of people thought this addition of the bicarb to the drink was for that, but it’s actually not in a big enough quantity. It’s truly meant just to help protect oral health.
LS: That’s amazing. And of course, being with your dental background, you understood that much more quickly than some other people consuming the product may have realized.
AY: Yeah, because a lot of people were like, oh, isn’t that just for your muscles? No, that’s not the purpose this time. And I just, I really found that interesting, that that company took that step.
LS: They’re probably noticing the complaint or the issue in a lot of their consumers, which it’s great that they’re thinking about this more thoroughly. Is there anything else you wish that athletes knew or understood more clearly about oral health, any mistakes you see athletes doing over and over again that are detrimental for their oral health?
AY: Not so much. I mean, when you’re racing this long, you have to be taking in the sugars, you have to be taking in the carbohydrates. It just doesn’t work not to, but I think the awareness, you know, the preventative measures outside of sport, are really important. And so as long as people are paying attention to that, as well as the rest of their body, I think that’s a big success. One of the most prominent ultra runners in our sport, Courtney Dauwalter, who actually raced a month ago in Phoenix. That was really fun to cross paths with her, but one of her claims to fame is that she actually puts a toothbrush and toothpaste in some of her drop bags or with her crew in her big 100-mile races. So, she actually brushes her teeth during the event, and so that’s always stood out to me.
LS: Yeah, just goes to show how important it is.
AY: Yeah, she’s one of the best of the best. That’s a really good influence.
LS: That’s a great preventive measure, I’m assuming, staying on top of, you know, hygiene visits, treating decay relatively early on, are probably also important things to be doing. And informing your dentist that, you know, this is something you’re doing, you’re consuming a lot of these beverages because of sport. Or us, as dentists, asking our patients, if we identify athletes, to make sure all their bases are covered.
AY: Yeah, I think so. I mean, yeah, some of my national Nordic team member patients, you can definitely see the acid wear, and so just having that awareness and trying to take those steps, especially because they’re often really young too. So, you know, this damage is occurring early in life.
LS: And what is lost is gone forever. When we see the wear on their teeth due to acid or clenching, parafunction, grinding, what’s gone is gone, and we have to manage it and prevent further loss.
AY: Yeah, for sure. And then also in this community, I mean, it’s not just endurance athletes that I see, but ice climbers and climbers, they put so many things in their mouths. Like they’re always putting metal things, carabiners, ice axes, in their teeth. And so, I mean, we think about the acid and the carbohydrate damage, but then there’s also in those aspects of mountain sports, there’s also, like traumas that I’ve seen and chipped teeth, broken teeth, things that happen accidentally. So, it’s one thing I always tell my ice climbers, don’t put it in your mouth.
LS: I think we’ve seen that in in other patients, at least, there’s no mountains around here. So, seamstress, carpenters, they do the same, right? They’ll hold a needle or a nail in their teeth, and they’ll have that perfectly fitted groove where it fits just right. And it totally makes sense what you’re mentioning that carabiners and other tools would cause the same type of damage.
AY: Oh, for sure. Yeah, you just need a rope to hit that ice ax or something, and there can be a lot of damage.
LS: And how do your patients generally take the information, like, are they surprised by what you introduced to them about the acidity of what they’re drinking and the damage. I’m sure many of them have no idea.
AY: Yeah. I mean, they are often surprised. But I think, you know, one of the things I love about living in the mountain town and having these patients is I can talk to them on an athlete level, rather than just a dentist level. So, I can share my own experiences, and I think that helps. It’s something I love, that there’s always some sort of common ground. And so, to share that experiential information can also be beneficial.
LS: Of course, and I’m sure these people are also very invested in their overall health, so receiving something that is going to help protect their dental health, you might be, you know, quite open to learning more about it and take the steps to prevent further damage.
AY: I agree. I agree. As long as the resources are there, a lot of people are willing to take steps to improve.
LS: Especially if you let them know what happens if they don’t. That education you’re mentioning again.
AY: Nobody wants the surprise root canal. Nobody needs that.
LS: Are there any changes that you’d like to see in the endurance sports community? Kind of looking ahead, whether it is from the race organizers or sponsors, from us as dental professionals, anything else we can do to better protect our athletes’ oral health?
AY: I mean, I think education is the most important. When people are aware, then they can take steps to prevent damage and trauma and all that sort of thing. I don’t know if organizations can do much. One thing that was kind of interesting, I got a race belt recently. And so, you carry your water and everything in either a vest or belt. And so, this came from a company in California called Raide (R, a, i, d, e) and with that belt, they actually sent a three-gram toothpaste tube. So, like, you know, a tiny tube, because we all go ultra-light, and we try to carry as little as possible. So, I just felt, you know, there are some companies taking awareness and just taking some measures with spreading better oral health, and I think that’s really cool.
LS: Yeah, how big did you say it is? So, it’s smaller than average travel size?
AY: Oh, yeah, it’s tiny. It’s like, you know, you might get a couple pea-sized uses out of it. But for people that are going on, like big endurance adventures, trying to limit your weight of everything is really important. And so, I thought that was a really cool addition that I’ve never seen before. And so, seeing these companies like Maurten, like Raide, starting to just bring oral health awareness a little bit into that community, that’s what will spread. And, yeah, I think those little improvements can make a big difference.
LS: Yeah, it’s amazing. Sometimes small changes pay big benefits. How do you balance the discipline of training with maintaining oral health, especially when training for a tough race, and when you’re traveling, which I’m assuming for these races, you travel quite a bit.
AY: Yeah, how do I balance the discipline of everything? I mean, dentistry takes a lot of time, training for these events, wanting to compete at the level that I want to be competing at. I mean, a lot of the women I’m racing are full time athletes at this point, and so to juggle my professional career is really interesting. But I think it’s, you know, I always think it’s like dedication over motivation. Get in the habits of doing it, and that’s what sticks. So, I wake up for 5am runs before work during the week, flossing is just part of my routine. I don’t feel like a day is complete without brushing, flossing my teeth, wearing my night guard. They’re just—habits stick. And so, once you get in the habit of doing these things, whether it’s training or oral health measures or going to work at all, yeah, it just becomes a routine.
LS: It seems like you’re also in, like, the perfect place to be able to combine mountain running with a career in dentistry.
AY: Almost. Winter is really long here, so I wish the dry dirt trails were around for more of the year. I’m not much of a winter athlete, but that said, our few months of summer, there’s nowhere else I’d rather be. Yeah, it’s a great community, too.
LS: Yeah, and how has the amount of time, effort, discipline, everything you put into endurance, athleticism, how has that shaped your approach to dentistry, your clinical practice?
AY: I mean, I think it makes me a better dentist. I think running makes me a better person. You know, when I go for a run in the morning, I go to work more focused, more energized, and more alert. And it also, you know, my identity is not just in one thing, which I think helps if I have a bad day at work or if I have a bad day on the trails, I have something else to go to where I have goals and motivation and interest and feel satisfaction in my day. So, I think having my identity in more than one basket is just a good thing for life in general.
LS: That is amazing. I think we all as dentists, as humans, we all need to have multiple interests and things that make us feel, you know, rewarded. I can’t imagine how rewarding it is after 13 hours of trekking up and down the hills and, you know, stoney paths and potentially not great weather. Sometimes the reward of getting to that finish line, and just then, you know, refocusing and getting ready for the next one.
AY: Oh, yeah, it’s really nice to not run after running for that long. But I think, going back to the question about, you know, how does it take my practice? We’re also in a really stressful, stressful profession, and I think I have a lot of mental health awareness and having those other outlets like you said. Really, really important to have other interests, other outlets and things that just bring you joy.
LS: Yeah, I’m sure that the 13-hour track and your training must be quite intense, even when you’re not doing very long tracks. For us normal humans, just 20-30 minutes that we can squeeze in to, you know, focus on self and care for our physical wellbeing and mental health are so valuable. Our backs take a toll. Our necks take a toll. It’s really good to find something that make us feel better and stronger and have long-standing careers where we can continue to support our patients without paying the price ourselves.
AY: I fully agree with that.
LS: Yeah, yeah. Have you seen any athletes that maybe you’ve seen? Well, we talked about a few of your own patients, but have you chatted with others that you’ve noticed, who have made the change, people you cross paths with, who’ve learned interesting things from you on the trail or before?
AY: Yeah, it’s the questions of, you know, like, oh, I know you’re not working right now, but I have a tooth question to ask, something like wisdom teeth. Or my dentist told me I need this. So yeah, I do have…it’s funny. It’s a small community, and so I do have people that, you know, they know I’m a dentist, and so I’ll have those random questions pop up, and I’m always so happy to share my knowledge. And yeah, the other funny thing too, is when patients going through Invisalign or clear aligners are doing these events. I’ve had a few questions about that, because they’re like, yeah, my dentist has me doing these clear liners, and I’m eating carbs on my run. So often times, I mean, they’re just eating them with their trays in and like, yeah, just make sure you’re, you know, taking them out, flossing, brushing, have good oral hygiene around your training, and you should be okay. Because there’s some things that in this weird sport are just unavoidable.
LS: I don’t think it’s a weird sport. I think it’s fascinating. And I’m very impressed that you can, you know, find the discipline and effort that you have to put in pretty much every day to do this and to do it at the level you do it at. Arden, thank you so much for joining us and for sharing that amazing information, which hopefully will benefit quite a few patients that our listeners are caring for, and if they’re athletes as well, they can put it to good use right away.
To our listeners, thank you so much for joining us. Be sure to sign up for Brush Up Podcast alerts or subscribe on Spotify and YouTube to be notified every time we post a new episode. Keep brushing up!