The Impact of Swimming on Oral Health: A Cross-Sectional Analysis of Prevalence and Correlates of Extrinsic Tooth Stains

Objectives: Swimmers are associated with various oral manifestations such as dental erosion, calculus formation and stain, a phenomenon which is referred to as swimmer's mouth. Extrinsic stains are the most frequently encountered presentation, which are attributed to the added antimicrobials (chlorine) in the pool water. Improper pool maintenance, leading to acidic pH, is the main contributory factor for organic deposits on the swimmer's teeth. Hence, the study planned to evaluate the association between the frequency of swimming on the prevalence of extrinsic stains among swimmers. Methods: Professional and recreational swimmers were identified and evaluated using a fourteen-item questionnaire. Oral screening and complete evaluation were done. The level of extrinsic stain was evaluated using the Lobene-stain-index. The results were tabulated using Statistical Package for Social Sciences (Version 17.0) software and subgroup analysis was done using Fisher's exact test for statistical significance. Results: Among the 150 participants, 74% were professional swimmers and 26% were recreational swimmers. 47% of the swimmers have been swimming for a period of more than 8 years. Extrinsic stains were more prevalent in tooth 33 (63% of the participants), followed by teeth 23 and 43 (61% of the participants). Swimmers who brushed more than once daily had fewer stains compared to those who brushed only once a day. Conclusions: The current study showed that maxillary and mandibular canines are more susceptible to stains. Improving pool maintenance and usage of fluoridated toothpaste and powered toothbrushes can aid in reducing the intensity of the stains.