MONACO -- Faster, higher, stronger they may be, but Olympians wouldn't win many medals in a contest of dental health. Behind their buffed physiques lurks a dentist's nightmare.
"They have bodies of Adonis and a garbage mouth," Paul Piccininni says.
As dental director for the International Olympic Committee, Piccininni is intimately familiar with the broken teeth, abscesses, decay and other dental issues that force hundreds of Olympians into dentists' chairs at every games.
Among them Michael Jordan. At the 1984 Los Angeles Olympics, where basketball's superstar in the making was top scorer on the gold-medal-winning U.S. team, Jordan "had a significant dental problem that could have kept him out of a game," Piccininni told The Associated Press in an interview at a conference on sports injuries.
The AP sent Jordan a text message to ask about the tooth issue, but he didn't respond. Piccininni, bound by medical secrecy requirements, also wouldn't give details.
"I know, but I shouldn't say," Piccininni said. "We've seen the best of the best."
Honing their bodies through intense physical effort, athletes refuel with energy drinks, gels and bars and frequent meals, which teeth don't like. Dehydration from sweating can also cut the production of saliva needed to regenerate tooth enamel.
Some rowers, for example, have "huge amounts of decay" because they're training in boats for hours at a time, refueling with teeth-eroding acidic, sugary drinks, said Tony Clough, who set up the dental clinic for Olympians at the 2012 London Games. Located in the athletes' village, it had 30 dentists and 1,900 visits.
"We had patients coming in at 10:30 at night to have root canals and things like that," Clough said.
A study that looked at 278 of the clinic's visitors found that 55 percent had cavities and three-quarters diseased gums, mostly gingivitis but also 15 percent with more serious periodontitis. One-quarter said dental problems affected their quality of life. The British Journal of Sports Medicine published the study this past September.
"The oral health of athletes is worse than the oral health of the general population," Piccininni said. "Considerably worse."
An abscessed lower-left wisdom tooth threatened to keep British rower Alan Campbell from the 2008 Beijing Olympics. The infection spread to his shoulder, back and eventually settled in his right knee, requiring surgery two months before the Games and ruining his training. He placed fifth in the Olympic single-sculls final and feels he "certainly would have gone quicker" had the infected tooth not laid him so low, keeping him out of his boat for six weeks.
At the London Games four years later, Campbell won bronze. He's certain that taking better care of his teeth helped him row faster. He says he now flosses more, tends to drink water rather than sugary drinks, is "more aware of how important dental hygiene is to me and my body" and "if I thought I had any problems, I would just have a tooth removed."
"I'm not saying someone with perfect teeth is going to beat Usain Bolt," Campbell said in a phone interview with the AP. "But myself with good dental hygiene versus myself with bad dental hygiene: The version of me with good dental hygiene will be the one that comes out on top, I'm certain of it."
Generally, teeth are most at risk among people ages 16 to 25, when they fly the family nest, perhaps party more and brush less, Clough said. That's also the age group of many Olympians, which helps explain why so many have problem teeth.
But other suspected causes appear more athlete-specific. Frequent travel for competition or training can get in the way of regular dental checkups. The wear of long flights might also be a factor, because Olympic dentists see "a huge, big leap" in dental infections in the first week of the Games, Clough said.
Clenching teeth during strenuous effort, like lifting weights, can also grind them down.
"You could land the Space Shuttle" on some athletes' teeth, Piccininni said. "Flat as a pancake. They have worn it down so much."
Rowers breathe up to 80 times a minute in competition and burn through 6,000 calories and eat five times a day, Campbell noted.
"A lot of pressure is going through the mouth," he said. At the Athens Olympics in 2004, "I was grinding my teeth in my sleep, and I was waking up with a very sore jaw and sore teeth as well and I had a special gum shield to wear at night to sleep with.
"That was the stress. It was my first Olympics. I was quite young. I was 21. I think I was feeling the pressure."
The 2016 Rio de Janeiro Olympic clinic will have eight dental chairs, X-ray machines, root canal specialists and surgical facilities. There will be full-time dentists at field hockey, rugby and basketball events for any injuries. The clinic will also distribute mouth guards. It handed out 350 in London and 150 at the Sochi Olympics this past February, including to four Austrian hockey players after a teammate lost a tooth in the team's first game.
Treatment is free.
Some Olympians "know they've had a dental problem for three weeks or a month or three months, but they know if they can hold off until they get to the Games they get it treated for free," Piccininni said. "That's fine. That's one of the reasons that we're there is because athletes don't have the financial resources."