# Regular Physical Activity and Dental Erosion: A Systematic Review
## 4 Discussion
Almost one-third indicated daily consumption of sports drinks, although no significant association was found with the occurrence of erosion lesions. However, in the study by [PERSON] et al. [26], among young competitive swimmers in India, dental erosion was observed in 90%. As the length of daily training and years of competitive swimming increased, the frequency of erosive lesions also increased. The authors indicated that the high prevalence of dental erosion among swimmers should prompt appropriate preventive measures in this group. Another group of studies focused mainly on the potential impact of sports drink consumption accompanying the training of professional athletes. [PERSON] et al. (2019) analysed if the consumption of acidic beverages, including energy drinks, could be associated with dental erosion in Portuguese athletes. In the cross-sectional study, the included participants were divided into four groups: swimmers who consumed or did not consume energy drinks, and non-swimmers (bodybuilders, football players, boxers, volleyball players, and runners) who consumed or did not consume energy drinks. Of the participants, 70% had been regularly involved in the sport for more than 2 years. Among them, 39 subjects consumed energy drinks, one-third of them during each training session. As many as 83.6% of the athletes in the study group had at least one erosion lesion. The teeth in the second and fifth sextants were the most frequently affected by erosive defects (69.1% and 59.1%, respectively). According to the BEWE index scoring, 43.6% of athletes demonstrated no risk of erosion, 49.1% low risk, 6.4% medium risk and 0.9% high risk. The authors evaluated the risk factors to be \"at least low risk\" of dental erosion, while considering the non-swimmers who did not use energy drinks as the control group. In the multivariate logistic analysis, the most statistically significant factor was the consumption of energy drinks in swimmers--the odds of erosion were more than 15 times higher than in the control group and more than 2 times higher than in the non-swimmers consuming energy drinks group. The findings suggested a complex influence of swimming as a sport and the habit of consuming energisers on the development of erosive defects, requiring regular dental check-ups. [PERSON] et al. (2019) investigated the impact of endurance training on oral health, regarding tooth erosion and dental caries. The study sample included 35 triatheltes and 35 non-exercising controls. Per week, the athletes spent the most time on cycling (4.5 h), then running (3.2 h), and swimming (1.8 h). During training, 51.4% consumed water, 45.7% sports drinks and 2.9% no drinks. Additionally, the consumption of sports nutrition was declared by 74% of the athletes but was without a significant influence on the determined oral health parameters. The triatheltes presented a medium risk level for dental erosion, whereas the non-athletes presented a low-risk level (mean cumulative BEWE scores of 9.6 and 7.3, respectively). Multivariate logistic regression showed no association between erosion risk in athletes and the type of beverage consumed during training, the amount of drinking during exercise, or the years of physical activity. On the other hand, the athletes did not differ from the non-athletes in dental caries prevalence. Additionally, as the cumulative exercise time per week increased, the DMFT values also increased. Surprisingly, in the study by [PERSON] et al. (2019), among the 10 competitive elite triatheltes who received oral examination, none had clinical evidence of erosion, while active caries was observed in 4 individuals. The study group consisted of 35 adult triatheltes who trained for at least 10 h a week. The most training time per week was spent on cycling (about 9 h), followed by swimming (about 6 h), and running (about 5 h). During exercise sessions, all athletes consumed water and 84% also consumed sports drinks. Moreover, [PERSON] et al.