The Impact of Sports on Oral Health in Adolescents: A Cross-Sectional Study of 2025 Participants

The Impact of Sports on Oral Health in Adolescents: A Cross-Sectional Study of 2025 Participants | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Impact of Sports on Oral Health in Adolescents: A Cross-Sectional Study of 2025 Participants Hatice Özyılmaz, Serdar Bağlar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9438136/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background This study aimed to evaluate oral health among adolescents aged 14–16 years using the DMFT index in relation to sports-related lifestyle factors, oral hygiene practices, and dietary behaviors. Methods This cross-sectional study was conducted in 14–16-year-old high school students. Oral examinations were performed by a single calibrated examiner, and dental caries were recorded using WHO standards. Oral health status was assessed with the DMFT index. Height and weight were measured to calculate BMI. Students completed a validated questionnaire evaluating oral hygiene behaviors, sports participation, and consumption of energy-boosting products and between-meal sugary snacks. Statistical analyses were performed using SPSS v26.0 (p < 0.001). Results Licensed athletes had significantly higher DMFT scores than non-licensed students (8.02 ± 4.95 vs. 5.55 ± 4.53; p < 0.001), mainly due to higher D (5.87 ± 3.87 vs. 4.06 ± 3.68) and F (1.95 ± 2.98 vs. 1.10 ± 2.17) components. DMFT values differed significantly according to licensure duration and weekly sports participation; however, the relationship between them was not linear. Frequent consumption of energy-boosting products and sugary snacks was significantly associated with higher DMFT (p < 0.001). Conclusion Higher DMFT values among licensed athletes, primarily driven by the D component, suggest that sports participation alone may not be protective. The non-linear relationship between sports duration and caries experience, together with multivariable analyses, indicates that behavioral factors may be more influential than sociodemographic variables. Trial registration: Not applicable. Adolescent Oral Health DMFT Youth Sports Energy Drink Oral Hygiene DMFT Background Oral and dental health is an integral component of overall health and represents a major public health domain that directly influences individuals’ nutrition, speech, social interaction, and quality of life [ 1 ]. Global burden of disease analyses reveal that oral diseases demonstrate high prevalence from childhood and adolescence onward and are distributed unequally both between and within societies, highlighting that they constitute a significant public health problem, particularly among adolescents [ 2 , 3 ]. Adolescence is a critical period in which health behaviors established in childhood are consolidated and carried into adulthood [ 4 ]. Hormonal changes, irregular diets, increased intake of free sugars and acidic beverages, and poor oral hygiene increase adolescents’ susceptibility to dental caries [ 5 ]. Thus, this stage offers a key opportunity for preventive and risk-based caries interventions. Recently, the oral health of individuals engaged in sports has also gained attention. Current studies provide that oral diseases are common among athletes and may negatively affect both performance and quality of life. School-aged adolescents who participate in sports may be more vulnerable to these risks due to their ongoing growth and development [ 6 ]. To better clarify the contribution of dietary habits, oral hygiene behaviors, and lifestyle factors emerging during adolescence to caries development, comprehensive studies integrating clinical findings with behavioral variables are needed. Another important contribution of this study is that it extended beyond generating epidemiological data by integrating clinical oral examinations and adolescent interviews with oral health education and, when necessary, referral for treatment. In this respect, the study also functioned as a preventive and educational public health intervention. The literature indicates that comprehensive, behavior-oriented interventions delivered during adolescence may yield positive long-term oral health outcomes. [ 7 ] The aim of this study was to evaluate the association between dental caries experience and sports participation status and intensity among adolescents aged 14–16 years and to examine how this relationship is shaped by oral hygiene behaviors and the consumption of between-meal sugars and energy products. By addressing clinical caries indicators alongside lifestyle and behavioral factors in a mid-adolescent sample, the study seeks to contribute to the existing literature. The findings are expected to support the development of risk-based preventive oral health strategies for adolescents and to inform public health policies. Two null hypotheses were tested in this study. H₀₁: There is no statistically significant difference in DMFT scores between adolescents who participate in sports and those who do not. H₀₂: Among adolescent athletes, there is no statistically significant association between duration of sports participation or weekly training intensity and DMFT scores or oral health behaviors. Methods This cross-sectional study was approved by the Non-Interventional Clinical Research Ethics Committee of Ordu University (No. 65 / 28.06.2024). Permission to conduct the study in schools was obtained from the Ordu Provincial Directorate of National Education (Application No: MEB.TT.2025.020210.01). This study was conducted between March 17 and November 28, 2025, in 10 high schools located in Ordu Province, which ranks 28th in population size in Türkiye. To ensure adequate representation of high school students in Ordu, 10 schools were selected using a stratified cluster sampling method. The sampling unit was defined as the school, while the unit of analysis was the student. The study was carried out in accordance with the principles of the Declaration of Helsinki. Prior to the clinical examination, informed consent forms and parental permission documents were distributed to both students and their parents. Students who returned signed consent forms, personally agreed to participate in the study, and had no systemic disease or pathological condition that could affect growth and development were included. Students who were unable to cooperate during the examination or who submitted incomplete or incorrectly completed questionnaires were excluded from the study. Examinations were conducted under standardized conditions, ensuring confidentiality and anonymity. Students requiring treatment were referred to public dental clinics. No identifiable personal data were collected, and all records were kept anonymous. Oral examinations were performed by a single calibrated dentist in accordance with the American Dental Association (ADA) Type III examination criteria, using disposable sterile mouth mirrors, gloves, and a portable light source. Third molars were excluded from the evaluation. Dental caries were diagnosed based on the epidemiological diagnostic criteria recommended by the World Health Organization (WHO). Oral health status was assessed using the DMFT (Decayed, Missing, and Filled Teeth) index. The DMFT score was calculated as the sum of decayed (D), missing due to caries (M), and filled (F) permanent teeth (DMFT = D + M + F). Examiner calibration was performed through a pilot study involving 50 students who were not included in the main study (κ = 0.82). Height and weight were measured under standardized conditions, and BMI was calculated as kg/m². After the measurements, students completed a structured questionnaire form. The questionnaire included items on demographic and anthropometric characteristics, oral hygiene habits, sports participation status, and the consumption of energy drinks and between-meal sugary snacks. Content validity was evaluated by a six-member expert panel consisting of a dietitian, a public health specialist, a dentist, a school counselor, a sports coach, and a biostatistician. DMFT and its components (D, M, and F) were analyzed separately as dependent variables. Gender, BMI classification, oral hygiene behaviors, sports participation status, duration of sports licensure, weekly duration of sports activity, frequency of energy drink consumption, and frequency of between-meal sugary snack consumption were included in the model as independent variables. In this study, a “licensed athlete” was defined as an individual who reported holding a valid sports license for at least one year and regularly participating in training within the framework of a competition or league system organized by the Ministry of Youth and Sports or relevant sports federations. Licensed athlete status was assessed based on self-report. The specific sport branch and level of competition were not included within the scope of the study. Duration of licensure was recorded in years, and weekly sports activity duration was recorded in hours, both based on self-report. Energy-boosting products (energy drinks, sports drinks, and energy bars) were grouped as a single variable and classified by consumption frequency. These products were classified according to frequency of consumption. Due to concurrent use, product types were analyzed as a single variable. In this study, “between-meal sugary snack consumption” was defined as the intake of high free-sugar snack products and sugar-sweetened beverages consumed outside the main meals (breakfast, lunch, and dinner). The frequency of consumption of energy-boosting products and between-meal sugary snacks was assessed using a questionnaire adapted from the NHANES Food Frequency Questionnaire (FFQ), modified to include products commonly consumed in Türkiye. Internal consistency was assessed using Cronbach’s alpha, with α values ranging between 0.69 and 0.83 across subscales. Since the items represented different thematic domains, reliability analyses were conducted separately for each subscale. Values between 0.70 and 0.90 are generally considered indicative of good internal consistency [ 8 ]. Additionally, test–retest reliability was evaluated in a pilot group of 100 participants by re-administering the questionnaire after a two-week interval. The Pearson correlation coefficient for the total questionnaire score was r = 0.863. A correlation coefficient between 0.70 and 0.90 is considered to reflect good test–retest reliability [ 9 ]. The questionnaire used in this study is provided as Appendix A in the online supplementary materials. Reporting followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guideline. Power Analysis An a priori power analysis was performed using G*Power software (version 3.1.9.7). Assuming a medium effect size (Cohen’s f = 0.25), a significance level of α = 0.05, and a statistical power of 0.90 (1 − β), the minimum required sample size for a two-way ANOVA (fixed effects, main effects, and interaction) was calculated as 247 participants [ 10 ]. Statistical Analysis Statistical analyses were performed using IBM SPSS Statistics v26.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were presented as mean ± standard deviation for continuous variables and as frequency (n) and percentage (%) for categorical variables. The distribution of continuous variables was assessed using the Kolmogorov–Smirnov test. Since DMFT and related numerical variables did not demonstrate normal distribution, nonparametric tests were preferred. Comparisons between two independent groups were conducted using the Mann–Whitney U test (effect size: r). For comparisons involving three or more groups, the Kruskal–Wallis test was applied; the test statistic (H) and effect size (η²) were reported. When statistically significant differences were identified, Dunn–Bonferroni-adjusted post hoc analyses were performed. Associations between categorical variables were evaluated using the chi-square (χ²) test, and effect size was reported using Cramér’s V coefficient. To assess the independent relationships between oral health indicators in adolescents (DMFT and its components: D, M, and F) and sociodemographic characteristics as well as behavioral factors, multiple regression analysis was performed. The level of statistical significance was set at p < 0.001 for all analyses. RESULTS A total of 2,025 adolescents aged between 14 and 16 years were included in the study. Of the participants, 48.35% were female (n = 977) and 51.65% were male (n = 1,048). The mean age was 15.03 ± 0.71 years (95% CI: 15.00–15.06). The primary criteria evaluated in the study were sports-related characteristics of the students. The distribution of licensed athlete status, duration of licensure, and weekly time allocated to sports according to gender is presented in Table 1 . Table 1 Sports participation characteristics of adolescents according to sex Licensed athlete status (n = 2025) Total n (%) Girls n (%) Boys n (%) p 0.845 No 1207 (59.60) 585 (59.88) 622 (59.35) Yes 818 (40.40) 392 (40.12) 426 (40.65) Duration of sports (n = 818) < 0.001 5 years 397 (48.53) 160 (40.82) a 237 (55.63) b Weekly time spent on sports (n = 818) < 0.001 10 hours 183 (22.37) 88 (22.45) a 95 (22.30) a Table 1 . Data are presented as counts and percentages [n (%)]. The total sample size was 2025. Duration of sports license and weekly time spent on sports were reported only for licensed athletes (n = 818). Percentages were calculated based on the total number of individuals within each relevant subgroup. Values indicated with different superscript letters within the same row represent statistically significant differences between girls and boys, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ²) test. Statistical significance was accepted at p < 0.001. No statistically significant difference was observed between female and male students regarding licensed athlete status (χ²(1) = 0.038, p = 0.845; V = 0.004). However, when evaluated according to duration of licensure, a statistically highly significant difference was identified between genders (χ²(3) = 52.61, p < 0.001; V = 0.253). Although overall sports participation rates were similar, male students demonstrated longer continuity in sports participation. A statistically significant difference was also found between genders in terms of weekly time allocated to sports (χ²(4) = 36.84, p < 0.001; V = 0.212). Female students were more concentrated in the low and moderate weekly sports duration categories, whereas male students were more frequently represented in the 3–5 hours and higher weekly sports duration groups. The proportion of very intensive sports participation (more than 10 hours per week) was similar between female and male students. Another main criterion evaluated in the study was students’ oral hygiene behaviors, which are presented in Table 2 . Table 2 Oral health behaviors according to sports participation characteristics among adolescents Tooth Brushing Frequency n (%) Dental Floss Use n (%) Regular Dental Visit n (%) Never Once Daily Twice Daily ≥ 3 Times Daily Yes No Yes No Licensed athlete status (n = 2025) No 24 (1.99)ᵇ 146 (12.10)ᵃ 922 (76.39)ᵇ 115 (9.52)ᵇ 68 (5.63)ᵇ 1139 (94.37)ᵃ 99 (8.20)ᵇ 1108 (91.80)ᵃ Yes 8 (0.98)ᵃ 292 (35.70)ᵇ 470 (57.46)ᵃ 48 (5.87)ᵃ 55 (6.72)ᵃ 763 (93.28)ᵇ 120 (14.67)ᵃ 698 (85.33)ᵇ p < 0.001 < 0.001 < 0.001 Duration of sports (n = 818) < 1 year 0 (0.00) 68 (38.86)ᵇ 95 (54.29)ᵇ 12 (6.86)ᵃᵇ 0 (0.00)ᶜ 168 (100.00)ᵃ 0 (0.00) 55 (100.00) 1–3 years 8 (3.36) 52 (21.85)ᵃ 167 (70.17)ᶜ 11 (4.62)ᵃ 8 (6.30)ᵇ 119 (93.70)ᵃ 35 (14.71)ᵇ 203 (85.29)ᵃ 3–5 years 0 (0.00) 28 (20.29)ᵃ 90 (65.22)ᶜ 17 (12.32)ᵇ 20 (6.52)ᵇ 287 (93.48)ᵃ 41 (11.14)ᵇ 327 (88.86)ᵃ > 5 years 0 (0.00) 144 (53.33)ᶜ 118 (43.70)ᵃ 8 (2.96)ᵃ 27 (12.50)ᵃ 189 (87.50)ᵇ 44 (28.03)ᵃ 113 (71.97)ᵇ p < 0.001 < 0.001 < 0.001 Weekly time spent on sports (n = 818) < 1 hour 0 (0.00) 0 (0.00) 8 (100.00) 0 (0.00) 0 (0.00) 15 (100.00) 0 (0.00) 8 (100.00) 1–3 hours 0 (0.00) 68 (40.72)ᵇ 80 (47.90)ᵃ 19 (11.38)ᵇ 8 (5.00)ᵇ 152 (95.00)ᵃ 25 (15.53)ᵃᵇ 136 (84.47)ᵇ 3–5 hours 0 (0.00) 92 (41.26)ᵇ 118 (52.91)ᵃᵇ 13 (5.83)ᵃ 8 (3.72)ᵇ 207 (96.28)ᵃ 40 (18.60)ᵃ 175 (81.40)ᵇ 5–10 hours 0 (0.00) 76 (31.80)ᵃ 149 (62.34)ᵇ 14 (5.86)ᵃ 23 (9.39)ᵃ 222 (90.61)ᵇ 31 (12.70)ᵇ 213 (87.30)ᵃ > 10 hours 8 (4.42) 56 (30.94)ᵃ 115 (63.54)ᵇ 2 (1.10)ᵃ 16 (8.74)ᵃ 167 (91.26)ᵇ 24 (12.63)ᵇ 166 (87.37)ᵃ p < 0.001 < 0.001 < 0.001 Table 2 . Data are presented as counts and percentages [n (%)], with a total sample size of 2025. Analyses related to duration of sports license and weekly time spent on sports were performed only among licensed athletes (n = 818). Percentages were calculated base d on the total number of individuals within each relevant subgroup. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ²) test. The p values presented in the table correspond to comparisons of the distributions of dental floss use according to sports-related variables. Statistical significance was accepted at p < 0.001. According to licensed athlete status, tooth brushing frequency differed significantly between groups (χ²(3) = 164.72, p < 0.001; V = 0.285). Brushing once daily was more common among licensed athletes. Brushing frequency was also significantly associated with duration of licensure (χ²(9) = 78.41, p < 0.001; V = 0.309) and weekly duration of sports participation (χ²(12) = 92.66, p < 0.001; V = 0.336). In terms of dental floss use, licensed athletes demonstrated a lower rate of flossing compared to non-licensed students (χ²(1) = 10.94, p < 0.001; V = 0.074). The proportion of regular dental check-ups was higher among licensed athletes (χ²(1) = 27.83, p < 0.001; V = 0.117). Regular dental attendance was higher among licensed athletes and remained significantly associated with licensure duration and weekly sports time (p < 0.001). The highest rate of regular dental visits was observed in the group engaging in 3–5 hours of sports per week. Other criteria evaluated in the study included the frequency of energy-boosting product consumption and the frequency of between-meal sugary snack consumption. Their distribution according to licensed athlete status, duration of licensure, and weekly sports participation is presented in Table 3 . Table 3 Frequency of energy-boosting product and snack consumption according to sports participation characteristics Energy-Boosting Product Consumption Frequency n (%) Snack Consumption Between Meals n (%) Never A Few Times per Month A Few Times per Week Daily/Multiple Times per Day Never A Few Times per Month A Few Times per Week Daily/Multiple Times per Day Licensed athlete status (n = 2025) No 966 (80.03)ᵇ 163 (13.50)ᵇ 78 (6.46)ᵃ 0 (0.00)ᵃ 208 (17.23) a 443 (36.70) a 197 (16.32)ᵃ 359 (29.74)ᵃ Yes 495 (60.51)ᵃ 76 (9.29)ᵃ 159 (19.44)ᵇ 88 (10.76)ᵇ 8 (0.98) b 12 (1.47) b 224 (27.38)ᵇ 574 (70.17)ᵇ p < 0.001 < 0.001 Duration of sports (n = 818) < 1 year 42 (62.69)ᵃ 8 (11.94)ᵃᵇ 17 (25.37)ᵇ 0 (0.00)ᵃ 0 (0.00) 0 (0.00) 7 (14.00)ᵃ 43 (86.00)ᵇ 1–3 years 106 (63.47)ᵃ 11 (6.59)ᵃ 37 (22.16)ᵇ 13 (7.78)ᵇ 0 (0.00) 1 (0.54) 31 (16.67)ᵃ 154 (82.80)ᵇ 3–5 years 260 (58.43)ᵃ 47 (10.56)ᵃᵇ 74 (16.63)ᵃᵇ 64 (14.38)ᶜ 8 (1.76) 7 (1.54) 154 (33.85)ᵇ 286 (62.86)ᵃ > 5 years 87 (62.59)ᵃ 10 (7.19)ᵃ 31 (22.30)ᵇ 11 (7.91)ᵇ 0 (0.00) 4 (3.15) 32 (25.20)ᵇ 91 (71.65)ᵃ P < 0.001 < 0.001 Weekly time spent on sports (n = 818) < 1 hour 0 (0.00) 0 (0.00) 8 (100.00) 0 (0.00) 0 (0.00) 0 (0.00) 8 (100.00) 0 (0.00) 1–3 hours 144 (90.57)ᵈ 7 (4.40)ᵃ 8 (5.03)ᵃ 0 (0.00)ᵃ 0 (0.00) 2 (1.27) 56 (35.44)ᵇ 100 (63.29)ᵃ 3–5 hours 152 (70.70)ᶜ 24 (11.16)ᵇ 15 (6.98)ᵃ 24 (11.16)ᵇ 3 (1.40) 1 (0.47) 52 (24.19)ᵃ 159 (73.95)ᵇ 5–10 hours 127 (50.40)ᵇ 29 (11.51)ᵇ 56 (22.22)ᵇ 40 (15.87)ᶜ 5 (2.06) 1 (0.41) 73 (30.04)ᵃᵇ 164 (67.49)ᵃᵇ > 10 hours 72 (39.13)ᵃ 16 (8.70)ᵃᵇ 72 (39.13)ᶜ 24 (13.04)ᵇᶜ 0 (0.00) 4 (2.11) 35 (18.42)ᵃ 151 (79.47)ᶜ p < 0.001 < 0.001 Table 3 . Data are presented as counts and percentages [n (%)], with a total sample size of 2025. Analyses related to duration of sports license and weekly time spent on sports were conducted only among licensed athletes. Percentages were calculated based on the t he total number of individuals within each relevant subgroup. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ²) test. The p values presented in the table correspond to comparisons of the distributions of energy-boosting product consumption frequency according to sports-related variables. Statistical significance was accepted at p < 0.001. Energy-boosting product consumption differed significantly by licensed athlete status (χ²(3) = 233.07, p < 0.001; V = 0.339). Energy-boosting product consumption differed significantly by licensed athlete status, licensure duration, and weekly sports time (all p < 0.001). Sugary snack consumption also differed by licensed athlete status (χ²(3) = 16.02, p < 0.001; V = 0.089). Licensed athletes more frequently reported weekly or daily consumption, whereas non-licensed students reported lower or no consumption more often. Sugary snack consumption showed similar significant associations with sports-related variables (all p < 0.001). The distribution of DMFT and its components (D, M, F) according to licensed athlete status, licensure duration, and weekly sports participation is presented in Table 4 . Table 4 DMFT and its components according to sports participation characteristics Licensed athlete status DMFT D M F No 5.55 ± 4.53ᵇ 4.06 ± 3.68ᵇ 0.30 ± 0.88 1.10 ± 2.17ᵇ Yes 8.02 ± 4.95ᵃ 5.87 ± 3.87ᵃ 0.20 ± 0.53 1.95 ± 2.98ᵃ p a < 0.001 < 0.001 0.214 < 0.001 Duration of sports (n = 818) 5 years 6.90 ± 4.31ᵇ 6.20 ± 3.92ᵃᵇ 0.19 ± 0.53 0.50 ± 1.07ᶜ p b < 0.001 < 0.001 0.087 < 0.001 Weekly time spent on sports (n = 818) < 1 hour 7.00 ± 3.01ᵇ 6.00 ± 2.93ᵃᵇ 1.00 ± 0.21 0.00 ± 0.00ᶜ 1–3 hours 7.67 ± 5.26ᵇ 5.42 ± 4.09ᵇ 0.14 ± 0.47 2.11 ± 3.31ᵇ 3–5 hours 8.41 ± 4.94ᵃ 6.40 ± 4.22ᵃ 0.41 ± 0.74 1.60 ± 2.74ᵃᵇ 5–10 hours 8.65 ± 4.60ᵃ 5.95 ± 3.16ᵃᵇ 0.16 ± 0.45 2.54 ± 3.00ᵃ > 10 hours 7.39 ± 5.02ᵃᵇ 5.77 ± 4.06ᵃᵇ 0.04 ± 0.21 1.57 ± 2.90ᵃᵇ p b < 0.001 < 0.001 0.062 < 0.001 Table 4 . Data are presented as mean ± standard deviation (Mean ± SD) (n = 2025). Because the continuous variables did not meet the assumption of normal distribution, the Mann–Whitney U test (ᵃ) was used to compare two independent groups, and the Kruskal–Wallis te t (ᵇ) was used to compare three or more groups. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Each p value corresponds to the separate comparison of the relevant variable (DMFT, D, M, or F) across groups. Statistical significance was accepted at p < 0.001. In analyses by licensed athlete status, DMFT scores were significantly higher in licensed athletes compared with non-licensed students (Mann–Whitney U, p < 0.001, r = 0.24). This difference was mainly driven by the D (decayed) and F (filled) components, whereas no significant difference was observed for the M (missing) component (p = 0.214). According to licensure duration, DMFT, D, and F values differed significantly (Kruskal–Wallis; DMFT: H(3) = 149.34, η² = 0.071; D: H(3) = 118.04, η² = 0.056; F: H(3) = 134.73, η² = 0.064; p < 0.001). No significant difference was found for M (p = 0.087). Similarly, weekly sports duration was significantly associated with DMFT, D, and F (DMFT: H(4) = 139.29, η² = 0.067; D: H(4) = 114.45, η² = 0.054; F: H(4) = 100.50, η² = 0.047; p < 0.001), but not with M (p = 0.062). DMFT, D, and F differed significantly across licensure duration (DMFT: H(3) = 149.34; D: H(3) = 118.04; F: H(3) = 134.73; all p < 0.001) and weekly sports time (DMFT: H(4) = 139.29; D: H(4) = 114.45; F: H(4) = 100.50; all p < 0.001), whereas M did not differ (p = 0.087 and p = 0.062, respectively). Analyses showed that students licensed for 1–3 and 3–5 years had significantly higher DMFT and D values than those licensed for ≥ 5 years (p < 0.001). Regarding weekly sports duration, students exercising 3–5 and 5–10 hours per week had significantly higher DMFT scores than those exercising 1–3 hours (p < 0.001). For the F component, students exercising 5–10 hours per week had more filled teeth than those exercising 1–3 hours (p < 0.001). Multivariable regression analysis was conducted to examine the associations between oral health indicators (DMFT and its components: D, M, F) and sociodemographic as well as behavioral factors. Regression coefficients and corresponding p-values are presented in Table 5 . Table 5 Association of demographic, behavioral, and sports-related factors with DMFT and its components Sex DMFT D M F 0.68 p < 0.001 0.77 p < 0.001 0.46 p < 0.001 0.48 p < 0.001 BMI 1.56) p < 0.001 1.59 p < 0.001 1.21 p < 0.001 1.24 p = 0.085 Tooth brushing frequency 0.82 p < 0.001 0.89 p = 0.002 0.41 p < 0.001 0.76 p = 0.001 Dental floss use 1.34 p < 0.001 1.21 p < 0.001 0.91 p = 0.796 1.80 p < 0.001 Regular dental visit 0.90 p = 0.012 0.83 p < 0.001 1.01 p = 0.935 1.05 p = 0.632 Licensed athlete 1.59 p < 0.001 1.58 p < 0.001 0.54 p < 0.001 1.66 p < 0.001 Duration of sports license 0.94 p = 0.083 0.95 p = 0.270 0.88 p = 0.445 0.91 p = 0.399 Weekly time spent on sports 1.03 p = 0.379 1.02 p = 0.655 0.74 p = 0.091 1.07 p = 0.575 Energy-boosting product consumption 0.99 p = 0.789 1.02 p = 0.728 1.03 p = 0.822 0.93 p = 0.421 Frequency of energy-boosting product consumption 2.06 p < 0.001 2.05 p < 0.001 1.2 p = 0.179 2.24 p < 0.001 Type of energy-boosting product 1.25 p = 0.040 1.19 p = 0.192 2.33 p = 0.036 1.49 p = 0.098 Frequency of snack consumption between meals 2.31 p < 0.001 2.40 p < 0.001 1.28 p = 0.313 1.70 p 1 indicates that the variable is associated with an increased level of caries indicators, and an IRR < 1 indicates a decreasing (protective) effect. Each estimate presented in the table is adjusted for all other variables included in the model and represents the independent effect of the corresponding variable. In multivariable regression ( Table 5 ) , gender and BMI were independently associated with higher DMFT. Tooth brushing showed a protective effect, whereas energy-boosting products and sugary snack consumption were positively associated with DMFT, particularly the D component. Licensed athlete status remained significant after adjustment. Discussion In this study, oral health in adolescents was evaluated using the DMFT index and its components (D, M, F), and their potential associations with sports participation and behavioral factors were examined. Adolescents were selected as the study population because the literature reports that health-related behaviors established during this period influence health outcomes later in life [ 11 ]. Moreover, oral health behaviors are shaped by socioeconomic and environmental factors, and adolescents are therefore emphasized as an important age group for epidemiological studies [ 12 ]. The mean DMFT value identified in this study was higher than those reported in some studies conducted in similar age groups across different countries [ 13 – 15 ]. However, comparable or even higher DMFT levels have also been reported in adolescent populations [ 16 – 18 ]. These differences may be explained by contextual factors such as sample characteristics, access to preventive oral health services, fluoride exposure, socioeconomic conditions, and behavioral patterns. DMFT values were higher in licensed adolescent athletes compared with non-athletes. The low M component in both groups indicates that tooth loss is limited in this age range. The higher D and F components among athletes suggest a greater active caries burden and increased restorative treatment need. Overall, the first null hypothesis was partially rejected. The association between licensure duration and DMFT was not linear. Adolescents licensed for 1–3 years exhibited higher caries experience, whereas those licensed for longer periods showed relatively lower values. This finding suggests that sports participation alone may not be protective; rather, sports-related consumption habits and increasing health awareness over time may jointly influence outcomes. Similarly, weekly sports duration showed a non-linear pattern. DMFT values increased in the 1–3 hour group but declined in those exercising more than 10 hours per week, indicating that the relationship between physical activity and caries experience may not be linear. Several studies report that physical activity may have a protective role in oral health [ 19 , 20 ]. Associations between physical inactivity and dental caries in adolescents have also been documented [ 21 , 22 ]. Moreover, higher levels of physical activity have been linked to better oral health indicators in this age group [ 23 , 24 ]. While some of these findings partially align with the present results, other studies have found no consistent or direct association between physical activity and DMFT, which is also partly consistent with our findings [ 25 , 26 ]. One possible explanation is the higher frequency of energy-boosting product and sugary snack consumption among athletes, which may partly account for their higher DMFT values and active caries burden. Carbohydrate-rich dietary patterns in sports settings may lower plaque pH and increase enamel demineralization, thereby elevating caries risk [ 27 ]. Sugar intake is a major determinant of dental caries, and physical activity alone may not counteract this effect [ 28 ]. The association between high soft drink consumption and increased DMFT further supports this mechanism [ 29 ]. In the multivariable regression analysis, the frequency of between-meal sugary snack and energy-boosting product consumption showed strong positive associations, particularly with the D component. This finding supports the role of consumption frequency in active caries development and is consistent with previous research emphasizing its importance in caries risk [ 30 ]. Although some studies report no increase or only weak associations between high sugar intake and caries experience in athletes, these studies emphasize that timing of consumption and accompanying oral hygiene practices may be decisive factors [ 31 ]. The multivariable regression findings in the present study, showing no significant associations between licensure duration, weekly sports time, or mere presence of energy-boosting products and DMFT components, are partly consistent with this perspective and highlight the importance of qualitative rather than purely quantitative preventive strategies. Current evidence also suggests that the non-linear relationship observed between licensure duration and DMFT in this study may be shaped by oral hygiene behaviors. Community-based studies in adolescent populations indicate that oral health outcomes tend to cluster with dietary and hygiene patterns [ 32 ]. Additionally, previous research has reported that intensive training schedules in adolescent athletes may reduce the time allocated to oral hygiene, potentially contributing to increased DMFT levels [ 33 ]. Comparison of oral hygiene behaviors showed no consistent overall advantage for either group. Non-athletes reported higher brushing and flossing rates, whereas athletes had more regular dental visits. Thus, sports participation does not define a uniformly better or worse oral hygiene profile. Low floss use across all groups and modest differences in dental visits suggest generally limited preventive behaviors. Cariogenic dietary patterns related to training may indicate insufficient nutrition and oral hygiene education for athletes. Given the cross-sectional design, reverse causality must be considered; adolescents with caries experience may attend dental visits more frequently [ 34 ]. Therefore, differences in DMFT—mainly in D and F—should be interpreted cautiously, as dental attendance may reflect treatment need rather than preventive care. Some studies report better hygiene behaviors among physically active adolescents, yet without a significant reflection on DMFT [ 35 ]. Higher physical activity has also been associated with twice-daily brushing, although such relationships vary by population and are shaped by sociodemographic clustering [ 23 , 36 ]. Overall, the impact of sports on adolescent oral health appears multifactorial and inconclusive in the literature. In our data, higher DMFT values in the 3–10 hour activity range may be better explained by accompanying dietary and care behaviors rather than sports itself. Thus, the second null hypothesis was partially rejected. Multivariable regression showed a clear hierarchy of factors influencing DMFT and its components. Behavioral variables demonstrated stronger and more direct effects, whereas sociodemographic factors acted more as structural determinants. BMI showed a significant positive association with DMFT. Although BMI is not a direct oral health behavior, it may be indirectly linked to caries risk through sugar intake, snacking frequency, and lifestyle patterns. However, inconsistent findings in the literature regarding the BMI–caries relationship indicate its multifactorial nature [ 37 , 38 ]. Gender also independently influenced DMFT. As a non-modifiable factor, it is mainly relevant for identifying risk groups. Mixed or non-significant associations reported in previous studies suggest that caries experience is shaped more by behavioral and sociocultural factors than by biological differences alone [ 39 , 40 ]. These findings should be interpreted considering methodological limitations. The cross-sectional design precludes causal inference. Self-reported behavioral data may introduce measurement bias. The absence of radiographic assessment may have led to underdetection of proximal or early lesions. Sports participation was not analyzed in detailed subcomponents, and factors such as dehydration, fluoride exposure, and detailed socioeconomic indicators were not evaluated, leaving potential residual confounding. Within these limitations, licensed athletes had higher DMFT values than non-athletes, yet the relationship between sports duration and caries experience was non-linear. Frequent consumption of energy-boosting products and between-meal sugary snacks emerged as key behavioral factors associated with increased caries burden. Sports participation itself did not demonstrate a consistent protective effect through oral hygiene behaviors. Overall, the effect of sports on adolescent oral health should be evaluated together with accompanying dietary and hygiene habits. Preventive strategies should target nutrition and oral hygiene practices in both school and sports settings. Declarations Ethics approval and consent to participate This cross-sectional study was approved by the Non-Interventional Clinical Research Ethics Committee of Ordu University (No. 65 / 28.06.2024) Consent for publication Not applicable. Competing interests Not applicable. Funding Not applicable. Author Contribution HA and SB contributed equally to this work. Both authors made substantial contributions to the conception and design of the study; methodology, investigation, data curation, formal analysis, and validation. HA and SB were equally involved in drafting the original manuscript and substantively revising it, as well as in funding acquisition and project administration. Both authors have read and approved the final submitted version of the manuscript and have agreed to be personally accountable for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Acknowledgements Not applicable. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request. References Botelho-Filho CR, Bordin GM, Paula ICSF, et al. Impact of dental caries on the quality of life of adolescents: a systematic review and meta-analysis. 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BMC Oral Health. 2023;23:845. https://doi.org/10.1186/s12903-023-03566-y . Sun S, Lou Y, Weng X, et al. Dental caries prevalence and caries-associated risk factors of students aged 12–15 in Xide County of Liangshan Prefecture, China: a cross-sectional study. BMJ Open. 2024;14:e082922. https://doi.org/10.1136/bmjopen-2023-082922 . Akbeyaz Şivet E, Sezer B, Atmaca N, et al. Evaluation of the effect of dental caries, oral hygiene, and treatment need on oral health-related quality of life among Turkish orphan children and adolescents. BMC Oral Health. 2025;25:134. https://doi.org/10.1186/s12903-025-05492-7 . Klarić Puđa I, Goršeta K, Jurić H, et al. A cohort study on the impact of oral health on the quality of life of adolescents and young adults. Clin Pract. 2025;15:76. https://doi.org/10.3390/clinpract15040076 . Obradović M, Dolić O, Milovanović V, et al. Caries experience in primary and permanent dentition in children up to 15 years of age from Bosnia and Herzegovina: a retrospective study. Child (Basel). 2023;10:754. https://doi.org/10.3390/children10040754 . Olczak-Kowalczyk D, Krämer N, Gozdowski D, et al. Developmental enamel defects and their relationship with caries in adolescents aged 18 years. Sci Rep. 2023;13:4932. https://doi.org/10.1038/s41598-023-31717-2 . Patinen P, Tanner T, Huttunen M, et al. Correction: caries experience and erosive tooth wear in Finnish men conscripts 2021: a cross-sectional study. Dent J (Basel). 2022;10:197. https://doi.org/10.3390/dj10110197 . Popa PȘ, Onișor D, Nechita A, et al. Study on the influence of regular physical activity on children's oral health. Child (Basel). 2023;10:946. https://doi.org/10.3390/children10060946 . Zhang Q, Bai X, Jin H, et al. Combined effect of dietary calcium consumption and physical activity on dental caries in children and adolescents: a study of the NHANES database. BMC Oral Health. 2024;24:281. https://doi.org/10.1186/s12903-024-03969-5 . Farsi DJ. Diet quality and physical activity and their association with BMI and dental caries among high school adolescents: a cross-sectional study. Child (Basel). 2024;11:1282. https://doi.org/10.3390/children11111282 . Virtanen JI, Muikku T, Similä T, et al. Physical activity, BMI and oral health behaviour among adolescents: Finnish School Health Promotion Study. Eur J Public Health. 2019;29:296–302. https://doi.org/10.1093/eurpub/cky193 . Das A, Menon I, Kumar G, et al. Impact of physical activity on oral health: a systematic review. J Family Med Prim Care. 2025;14:1161–8. https://doi.org/10.4103/jfmpc.jfmpc_1124_24 . Peres MA, Sheiham A, Liu P, et al. Sugar consumption and changes in dental caries from childhood to adolescence. J Dent Res. 2016;95:388–94. https://doi.org/10.1177/0022034515625907 . Khan K, Qadir A, Trakman G, et al. Sports and energy drink consumption, oral health problems and performance impact among elite athletes. Nutrients. 2022;14:5089. https://doi.org/10.3390/nu14235089 . Ashley P, Di Iorio A, Cole E, et al. Oral health of elite athletes and association with performance: a systematic review. Br J Sports Med. 2015;49:14–9. https://doi.org/10.1136/bjsports2014-093617 . Moynihan PJ, Kelly SA. Effect on caries of restricting sugars intake: systematic review to inform WHO guidelines. J Dent Res. 2014;93:8–18. https://doi.org/10.1177/0022034513508954 . Hassan HI, Othman SM. Sugar-sweetened beverage consumption and its association with dental caries among adolescents in Erbil, Iraq: a cross-sectional study. Cureus. 2024;16:e58471. https://doi.org/10.7759/cureus.58471 . Ng TC, Luo BW, Lam WY, et al. Updates on caries risk assessment: a literature review. Dent J (Basel). 2024;12:312. https://doi.org/10.3390/dj12100312 . Hughes A, O’Sullivan M, Winning L, et al. Diet and dental caries in elite athletes in Ireland. J Hum Nutr Diet. 2026;39. https://doi.org/10.1111/jhn.70203 . Epub ahead of print. Burns RD. Public health implications of replacing screen time with physical activity and sleep in Brazilian children. J Pediatr (Rio J). 2024;100:121–3. https://doi.org/10.1016/j.jped.2023.11.004 . Mielle B, Júdice A, Proença L, et al. Dental caries, tooth erosion and nutritional habits in a cohort of athletes: a cross-sectional study. Nutrients. 2025;17:543. https://doi.org/10.3390/nu17030543 . Gomes AC, Vettore MV, Quadros LN, et al. Does using the sociodental approach in oral health care influence use of dental services and oral health of adolescents living in deprived communities? A one-year follow-up study. BMC Health Serv Res. 2023;23:605. https://doi.org/10.1186/s12913-023-09596-0 . Tubert-Jeannin S, Pichot H, Rouchon B, et al. Common risk indicators for oral diseases and obesity in 12-year-olds: a South Pacific cross-sectional study. BMC Public Health. 2018;18:112. https://doi.org/10.1186/s12889-017-4996-y . Fernandez de Grado G, Ehlinger V, Godeau E, et al. Changes in tooth brushing frequency and its associated factors from 2006 to 2014 among French adolescents: results from three repeated cross-sectional HBSC studies. PLoS ONE. 2021;16:e0249129. https://doi.org/10.1371/journal.pone.0249129 . Bhoopathi V, Ortega-Verdugo P, Wells C, et al. Difficulty with dental caries among adolescents who are underweight: a nationwide study. J Pediatr Clin Pract. 2024;14:200136. https://doi.org/10.1016/j.jpedcp.2024.200136 . Li LW, Wong HM, Gandhi A, et al. Caries-related risk factors of obesity among 18-year-old adolescents in Hong Kong: a cross-sectional study nested in a cohort study. BMC Oral Health. 2018;18:188. https://doi.org/10.1186/s12903-018-0657-5 . Chapain KP, Rampal KG, Gaulee Pokhrel K, et al. Influence of gender and oral health knowledge on DMFT index: a cross-sectional study among school children in Kaski District, Nepal. BMC Oral Health. 2023;23:59. https://doi.org/10.1186/s12903-023-02755-z . Ferizi L, Bimbashi V, Kelmendi J. Dental caries prevalence and oral health status among 15-year-old adolescents in Kosovo. Acta Stomatol Croat. 2022;56:42–9. https://doi.org/10.15644/asc56/1/5 . Additional Declarations No competing interests reported. Supplementary Files SupplementalMaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 05 May, 2026 Editor invited by journal 17 Apr, 2026 Editor assigned by journal 16 Apr, 2026 Submission checks completed at journal 16 Apr, 2026 First submitted to journal 16 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9438136","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":634570961,"identity":"656667f5-5d1b-41d0-9c67-7d2b9d0b3e6c","order_by":0,"name":"Hatice Özyılmaz","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIiWNgGAWjYBACAx4QeYBBho29sfEBkMnDR6wWHjaew80GIC1sRGthkHBvkwCxCWox5zlj+JnnjB0PnwRjW+XXHDsZNgbmh49u4NFi2dtjLM1zI5mHTbqx7bbsNiCDgc3YOAefw87zmDHzfGDmYZM52HZbchuQAfSONBFa6nnYJBLbiiW31ROh5WwPUMuNw2AtjB+3HSZCy5ljxZJzzhwHBvLBZmnGbUAGMyG/nEne+OHNsWo5+fb2hx9/bqu252dvfvgYnxYUwAyOJGZilYMA4w9SVI+CUTAKRsGIAQAW2kKH745gPAAAAABJRU5ErkJggg==","orcid":"","institution":"Ordu University","correspondingAuthor":true,"prefix":"","firstName":"Hatice","middleName":"","lastName":"Özyılmaz","suffix":""},{"id":634570962,"identity":"a20fe6a0-c417-461a-a481-eb232885b2cf","order_by":1,"name":"Serdar Bağlar","email":"","orcid":"","institution":"Ordu University","correspondingAuthor":false,"prefix":"","firstName":"Serdar","middleName":"","lastName":"Bağlar","suffix":""}],"badges":[],"createdAt":"2026-04-16 12:23:56","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9438136/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9438136/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109193159,"identity":"177a75ee-b4a6-4b3f-ad5e-1bc1d2dffcd1","added_by":"auto","created_at":"2026-05-13 12:29:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":575960,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9438136/v1/c2b5e3dd-4965-4832-a39b-42f50a8cc180.pdf"},{"id":109193104,"identity":"dc59550f-043b-41db-986a-04313c8f667a","added_by":"auto","created_at":"2026-05-13 12:29:48","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":143126,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-9438136/v1/e7e7cc74cdd354199acecceb.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Impact of Sports on Oral Health in Adolescents: A Cross-Sectional Study of 2025 Participants","fulltext":[{"header":"Background","content":"\u003cp\u003eOral and dental health is an integral component of overall health and represents a major public health domain that directly influences individuals\u0026rsquo; nutrition, speech, social interaction, and quality of life [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Global burden of disease analyses reveal that oral diseases demonstrate high prevalence from childhood and adolescence onward and are distributed unequally both between and within societies, highlighting that they constitute a significant public health problem, particularly among adolescents [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdolescence is a critical period in which health behaviors established in childhood are consolidated and carried into adulthood [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Hormonal changes, irregular diets, increased intake of free sugars and acidic beverages, and poor oral hygiene increase adolescents\u0026rsquo; susceptibility to dental caries [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Thus, this stage offers a key opportunity for preventive and risk-based caries interventions.\u003c/p\u003e \u003cp\u003eRecently, the oral health of individuals engaged in sports has also gained attention. Current studies provide that oral diseases are common among athletes and may negatively affect both performance and quality of life. School-aged adolescents who participate in sports may be more vulnerable to these risks due to their ongoing growth and development [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo better clarify the contribution of dietary habits, oral hygiene behaviors, and lifestyle factors emerging during adolescence to caries development, comprehensive studies integrating clinical findings with behavioral variables are needed.\u003c/p\u003e \u003cp\u003eAnother important contribution of this study is that it extended beyond generating epidemiological data by integrating clinical oral examinations and adolescent interviews with oral health education and, when necessary, referral for treatment. In this respect, the study also functioned as a preventive and educational public health intervention. The literature indicates that comprehensive, behavior-oriented interventions delivered during adolescence may yield positive long-term oral health outcomes. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe aim of this study was to evaluate the association between dental caries experience and sports participation status and intensity among adolescents aged 14\u0026ndash;16 years and to examine how this relationship is shaped by oral hygiene behaviors and the consumption of between-meal sugars and energy products. By addressing clinical caries indicators alongside lifestyle and behavioral factors in a mid-adolescent sample, the study seeks to contribute to the existing literature. The findings are expected to support the development of risk-based preventive oral health strategies for adolescents and to inform public health policies.\u003c/p\u003e \u003cp\u003eTwo null hypotheses were tested in this study.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eH₀₁: There is no statistically significant difference in DMFT scores between adolescents who participate in sports and those who do not.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eH₀₂: Among adolescent athletes, there is no statistically significant association between duration of sports participation or weekly training intensity and DMFT scores or oral health behaviors.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis cross-sectional study was approved by the Non-Interventional Clinical Research Ethics Committee of Ordu University (No. 65 / 28.06.2024).\u003c/p\u003e \u003cp\u003ePermission to conduct the study in schools was obtained from the Ordu Provincial Directorate of National Education (Application No: MEB.TT.2025.020210.01).\u003c/p\u003e \u003cp\u003eThis study was conducted between March 17 and November 28, 2025, in 10 high schools located in Ordu Province, which ranks 28th in population size in T\u0026uuml;rkiye. To ensure adequate representation of high school students in Ordu, 10 schools were selected using a stratified cluster sampling method. The sampling unit was defined as the school, while the unit of analysis was the student. The study was carried out in accordance with the principles of the Declaration of Helsinki.\u003c/p\u003e \u003cp\u003e Prior to the clinical examination, informed consent forms and parental permission documents were distributed to both students and their parents. Students who returned signed consent forms, personally agreed to participate in the study, and had no systemic disease or pathological condition that could affect growth and development were included. Students who were unable to cooperate during the examination or who submitted incomplete or incorrectly completed questionnaires were excluded from the study.\u003c/p\u003e \u003cp\u003eExaminations were conducted under standardized conditions, ensuring confidentiality and anonymity. Students requiring treatment were referred to public dental clinics. No identifiable personal data were collected, and all records were kept anonymous. Oral examinations were performed by a single calibrated dentist in accordance with the American Dental Association (ADA) Type III examination criteria, using disposable sterile mouth mirrors, gloves, and a portable light source. Third molars were excluded from the evaluation. Dental caries were diagnosed based on the epidemiological diagnostic criteria recommended by the World Health Organization (WHO). Oral health status was assessed using the DMFT (Decayed, Missing, and Filled Teeth) index. The DMFT score was calculated as the sum of decayed (D), missing due to caries (M), and filled (F) permanent teeth (DMFT\u0026thinsp;=\u0026thinsp;D + M\u0026thinsp;+\u0026thinsp;F). Examiner calibration was performed through a pilot study involving 50 students who were not included in the main study (κ\u0026thinsp;=\u0026thinsp;0.82).\u003c/p\u003e \u003cp\u003eHeight and weight were measured under standardized conditions, and BMI was calculated as kg/m\u0026sup2;. After the measurements, students completed a structured questionnaire form.\u003c/p\u003e \u003cp\u003eThe questionnaire included items on demographic and anthropometric characteristics, oral hygiene habits, sports participation status, and the consumption of energy drinks and between-meal sugary snacks. Content validity was evaluated by a six-member expert panel consisting of a dietitian, a public health specialist, a dentist, a school counselor, a sports coach, and a biostatistician.\u003c/p\u003e \u003cp\u003eDMFT and its components (D, M, and F) were analyzed separately as dependent variables. Gender, BMI classification, oral hygiene behaviors, sports participation status, duration of sports licensure, weekly duration of sports activity, frequency of energy drink consumption, and frequency of between-meal sugary snack consumption were included in the model as independent variables.\u003c/p\u003e \u003cp\u003eIn this study, a \u0026ldquo;licensed athlete\u0026rdquo; was defined as an individual who reported holding a valid sports license for at least one year and regularly participating in training within the framework of a competition or league system organized by the Ministry of Youth and Sports or relevant sports federations. Licensed athlete status was assessed based on self-report. The specific sport branch and level of competition were not included within the scope of the study. Duration of licensure was recorded in years, and weekly sports activity duration was recorded in hours, both based on self-report.\u003c/p\u003e \u003cp\u003eEnergy-boosting products (energy drinks, sports drinks, and energy bars) were grouped as a single variable and classified by consumption frequency. These products were classified according to frequency of consumption. Due to concurrent use, product types were analyzed as a single variable.\u003c/p\u003e \u003cp\u003eIn this study, \u0026ldquo;between-meal sugary snack consumption\u0026rdquo; was defined as the intake of high free-sugar snack products and sugar-sweetened beverages consumed outside the main meals (breakfast, lunch, and dinner). The frequency of consumption of energy-boosting products and between-meal sugary snacks was assessed using a questionnaire adapted from the NHANES Food Frequency Questionnaire (FFQ), modified to include products commonly consumed in T\u0026uuml;rkiye.\u003c/p\u003e \u003cp\u003eInternal consistency was assessed using Cronbach\u0026rsquo;s alpha, with α values ranging between 0.69 and 0.83 across subscales. Since the items represented different thematic domains, reliability analyses were conducted separately for each subscale. Values between 0.70 and 0.90 are generally considered indicative of good internal consistency [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, test\u0026ndash;retest reliability was evaluated in a pilot group of 100 participants by re-administering the questionnaire after a two-week interval. The Pearson correlation coefficient for the total questionnaire score was r\u0026thinsp;=\u0026thinsp;0.863. A correlation coefficient between 0.70 and 0.90 is considered to reflect good test\u0026ndash;retest reliability [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The questionnaire used in this study is provided as \u003cb\u003eAppendix A\u003c/b\u003e in the online supplementary materials.\u003c/p\u003e \u003cp\u003e Reporting followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guideline.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePower Analysis\u003c/h2\u003e \u003cp\u003eAn a priori power analysis was performed using G*Power software (version 3.1.9.7). Assuming a medium effect size (Cohen\u0026rsquo;s f\u0026thinsp;=\u0026thinsp;0.25), a significance level of α\u0026thinsp;=\u0026thinsp;0.05, and a statistical power of 0.90 (1\u0026thinsp;\u0026minus;\u0026thinsp;β), the minimum required sample size for a two-way ANOVA (fixed effects, main effects, and interaction) was calculated as 247 participants [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analyses were performed using IBM SPSS Statistics v26.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation for continuous variables and as frequency (n) and percentage (%) for categorical variables.\u003c/p\u003e \u003cp\u003eThe distribution of continuous variables was assessed using the Kolmogorov\u0026ndash;Smirnov test. Since DMFT and related numerical variables did not demonstrate normal distribution, nonparametric tests were preferred. Comparisons between two independent groups were conducted using the Mann\u0026ndash;Whitney U test (effect size: r). For comparisons involving three or more groups, the Kruskal\u0026ndash;Wallis test was applied; the test statistic (H) and effect size (η\u0026sup2;) were reported. When statistically significant differences were identified, Dunn\u0026ndash;Bonferroni-adjusted post hoc analyses were performed. Associations between categorical variables were evaluated using the chi-square (χ\u0026sup2;) test, and effect size was reported using Cram\u0026eacute;r\u0026rsquo;s V coefficient. To assess the independent relationships between oral health indicators in adolescents (DMFT and its components: D, M, and F) and sociodemographic characteristics as well as behavioral factors, multiple regression analysis was performed. The level of statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 for all analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eA total of 2,025 adolescents aged between 14 and 16 years were included in the study. Of the participants, 48.35% were female (n\u0026thinsp;=\u0026thinsp;977) and 51.65% were male (n\u0026thinsp;=\u0026thinsp;1,048). The mean age was 15.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71 years (95% CI: 15.00\u0026ndash;15.06).\u003c/p\u003e \u003cp\u003eThe primary criteria evaluated in the study were sports-related characteristics of the students. The distribution of licensed athlete status, duration of licensure, and weekly time allocated to sports according to gender is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSports participation characteristics of adolescents according to sex\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLicensed athlete status (n\u0026thinsp;=\u0026thinsp;2025)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGirls n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBoys n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.845\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1207 (59.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e585 (59.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e622 (59.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e818 (40.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e392 (40.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e426 (40.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of sports\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (1.64)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e175 (21.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112 (28.57)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63 (14.79)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e239 (29.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 (30.61)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e119 (27.93)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e397 (48.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e160 (40.82)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e237 (55.63)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWeekly time spent on sports (n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 hour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (0.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (2.04)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e160 (19.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96 (24.49)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71 (16.67)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e215 (26.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (20.41)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e135 (31.69)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e245 (29.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 (30.61)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e125 (29.34)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e183 (22.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88 (22.45)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95 (22.30)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Data are presented as counts and percentages [n (%)]. The total sample size was 2025. Duration of sports license and weekly time spent on sports were reported only for licensed athletes (n\u0026thinsp;=\u0026thinsp;818). Percentages were calculated based on the total number of individuals within each relevant subgroup. Values indicated with different superscript letters within the same row represent statistically significant differences between girls and boys, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ\u0026sup2;) test. Statistical significance was accepted at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003eNo statistically significant difference was observed between female and male students regarding licensed athlete status (χ\u0026sup2;(1)\u0026thinsp;=\u0026thinsp;0.038, p\u0026thinsp;=\u0026thinsp;0.845; V\u0026thinsp;=\u0026thinsp;0.004).\u003c/p\u003e \u003cp\u003eHowever, when evaluated according to duration of licensure, a statistically highly significant difference was identified between genders (χ\u0026sup2;(3)\u0026thinsp;=\u0026thinsp;52.61, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.253). Although overall sports participation rates were similar, male students demonstrated longer continuity in sports participation.\u003c/p\u003e \u003cp\u003eA statistically significant difference was also found between genders in terms of weekly time allocated to sports (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;36.84, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.212). Female students were more concentrated in the low and moderate weekly sports duration categories, whereas male students were more frequently represented in the 3\u0026ndash;5 hours and higher weekly sports duration groups. The proportion of very intensive sports participation (more than 10 hours per week) was similar between female and male students.\u003c/p\u003e \u003cp\u003eAnother main criterion evaluated in the study was students\u0026rsquo; oral hygiene behaviors, which are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eOral health behaviors according to sports participation characteristics among adolescents\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eTooth Brushing Frequency n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eDental Floss Use n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eRegular Dental Visit n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNever\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eOnce Daily\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eTwice Daily\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026ge;\u0026thinsp;3 Times Daily\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLicensed athlete status (n\u0026thinsp;=\u0026thinsp;2025)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (1.99)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146 (12.10)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e922 (76.39)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e115 (9.52)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68 (5.63)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1139 (94.37)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e99 (8.20)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e1108 (91.80)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (0.98)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e292 (35.70)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e470 (57.46)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48 (5.87)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55 (6.72)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e763 (93.28)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e120 (14.67)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e698 (85.33)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of sports\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (38.86)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95 (54.29)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (6.86)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e168 (100.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e55 (100.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (3.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52 (21.85)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e167 (70.17)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (4.62)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (6.30)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e119 (93.70)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e35 (14.71)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e203 (85.29)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (20.29)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90 (65.22)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (12.32)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20 (6.52)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e287 (93.48)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e41 (11.14)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e327 (88.86)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e144 (53.33)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118 (43.70)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (2.96)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27 (12.50)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e189 (87.50)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e44 (28.03)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e113 (71.97)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWeekly time spent on sports (n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 hour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e8 (100.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (40.72)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (47.90)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (11.38)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (5.00)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e152 (95.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25 (15.53)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e136 (84.47)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92 (41.26)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118 (52.91)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (5.83)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (3.72)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e207 (96.28)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e40 (18.60)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e175 (81.40)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (31.80)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e149 (62.34)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14 (5.86)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23 (9.39)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e222 (90.61)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e31 (12.70)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e213 (87.30)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (4.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (30.94)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115 (63.54)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (1.10)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (8.74)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e167 (91.26)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e24 (12.63)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003e166 (87.37)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Data are presented as counts and percentages [n (%)], with a total sample size of 2025. Analyses related to duration of sports license and weekly time spent on sports were performed only among licensed athletes (n\u0026thinsp;=\u0026thinsp;818). Percentages were calculated base d on the total number of individuals within each relevant subgroup. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ\u0026sup2;) test. The p values presented in the table correspond to comparisons of the distributions of dental floss use according to sports-related variables. Statistical significance was accepted at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003eAccording to licensed athlete status, tooth brushing frequency differed significantly between groups (χ\u0026sup2;(3)\u0026thinsp;=\u0026thinsp;164.72, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.285). Brushing once daily was more common among licensed athletes. Brushing frequency was also significantly associated with duration of licensure (χ\u0026sup2;(9)\u0026thinsp;=\u0026thinsp;78.41, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.309) and weekly duration of sports participation (χ\u0026sup2;(12)\u0026thinsp;=\u0026thinsp;92.66, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.336).\u003c/p\u003e \u003cp\u003eIn terms of dental floss use, licensed athletes demonstrated a lower rate of flossing compared to non-licensed students (χ\u0026sup2;(1)\u0026thinsp;=\u0026thinsp;10.94, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.074).\u003c/p\u003e \u003cp\u003eThe proportion of regular dental check-ups was higher among licensed athletes (χ\u0026sup2;(1)\u0026thinsp;=\u0026thinsp;27.83, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.117). Regular dental attendance was higher among licensed athletes and remained significantly associated with licensure duration and weekly sports time (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The highest rate of regular dental visits was observed in the group engaging in 3\u0026ndash;5 hours of sports per week.\u003c/p\u003e \u003cp\u003eOther criteria evaluated in the study included the frequency of energy-boosting product consumption and the frequency of between-meal sugary snack consumption. Their distribution according to licensed athlete status, duration of licensure, and weekly sports participation is presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of energy-boosting product and snack consumption according to sports participation characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eEnergy-Boosting Product Consumption Frequency n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003eSnack Consumption Between Meals n (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA Few Times per Month\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eA Few Times per Week\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDaily/Multiple Times per Day\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eA Few Times per Month\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eA Few Times per Week\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDaily/Multiple Times per Day\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLicensed athlete status (n\u0026thinsp;=\u0026thinsp;2025)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e966 (80.03)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e163 (13.50)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (6.46)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e208 (17.23)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e443 (36.70)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e197 (16.32)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e359 (29.74)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e495 (60.51)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (9.29)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e159 (19.44)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88 (10.76)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (0.98)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 (1.47)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e224 (27.38)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e574 (70.17)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of sports\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 (62.69)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (11.94)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (25.37)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7 (14.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e43 (86.00)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106 (63.47)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (6.59)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37 (22.16)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (7.78)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (0.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e31 (16.67)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e154 (82.80)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e260 (58.43)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (10.56)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74 (16.63)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64 (14.38)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (1.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e154 (33.85)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e286 (62.86)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87 (62.59)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (7.19)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (22.30)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (7.91)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (3.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e32 (25.20)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e91 (71.65)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWeekly time spent on sports (n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 hour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8 (100.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e144 (90.57)ᵈ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (4.40)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (5.03)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (1.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e56 (35.44)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100 (63.29)ᵃ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152 (70.70)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (11.16)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (6.98)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (11.16)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (1.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (0.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e52 (24.19)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e159 (73.95)ᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127 (50.40)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (11.51)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56 (22.22)ᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (15.87)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (2.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (0.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e73 (30.04)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e164 (67.49)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (39.13)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (8.70)ᵃᵇ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72 (39.13)ᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (13.04)ᵇᶜ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e35 (18.42)ᵃ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e151 (79.47)ᶜ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Data are presented as counts and percentages [n (%)], with a total sample size of 2025. Analyses related to duration of sports license and weekly time spent on sports were conducted only among licensed athletes. Percentages were calculated based on the t he total number of individuals within each relevant subgroup. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Comparisons between categorical variables were performed using the chi-square (χ\u0026sup2;) test. The p values presented in the table correspond to comparisons of the distributions of energy-boosting product consumption frequency according to sports-related variables. Statistical significance was accepted at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003eEnergy-boosting product consumption differed significantly by licensed athlete status (χ\u0026sup2;(3)\u0026thinsp;=\u0026thinsp;233.07, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.339). Energy-boosting product consumption differed significantly by licensed athlete status, licensure duration, and weekly sports time (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eSugary snack consumption also differed by licensed athlete status (χ\u0026sup2;(3)\u0026thinsp;=\u0026thinsp;16.02, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; V\u0026thinsp;=\u0026thinsp;0.089). Licensed athletes more frequently reported weekly or daily consumption, whereas non-licensed students reported lower or no consumption more often. Sugary snack consumption showed similar significant associations with sports-related variables (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eThe distribution of DMFT and its components (D, M, F) according to licensed athlete status, licensure duration, and weekly sports participation is presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDMFT and its components according to sports participation characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLicensed athlete status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDMFT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53ᵇ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.06\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68ᵇ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17ᵇ\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e8.02\u0026thinsp;\u0026plusmn;\u0026thinsp;4.95ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.87ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.95\u0026thinsp;\u0026plusmn;\u0026thinsp;2.98ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.214\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of sports\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;1 year\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e8.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.69ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e4.83\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;5.10ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u0026ndash;3 years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e9.02\u0026thinsp;\u0026plusmn;\u0026thinsp;3.20ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.31ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u0026ndash;5 years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e8.11\u0026thinsp;\u0026plusmn;\u0026thinsp;5.03ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.72\u0026thinsp;\u0026plusmn;\u0026thinsp;4.01ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.23\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;5 years\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e6.90\u0026thinsp;\u0026plusmn;\u0026thinsp;4.31ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.20\u0026thinsp;\u0026plusmn;\u0026thinsp;3.92ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.50\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07ᶜ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.087\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWeekly time spent on sports (n\u0026thinsp;=\u0026thinsp;818)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;1 hour\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e7.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.93ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00ᶜ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u0026ndash;3 hours\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e7.67\u0026thinsp;\u0026plusmn;\u0026thinsp;5.26ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.42\u0026thinsp;\u0026plusmn;\u0026thinsp;4.09ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.11\u0026thinsp;\u0026plusmn;\u0026thinsp;3.31ᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u0026ndash;5 hours\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e8.41\u0026thinsp;\u0026plusmn;\u0026thinsp;4.94ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.40\u0026thinsp;\u0026plusmn;\u0026thinsp;4.22ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e5\u0026ndash;10 hours\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e8.65\u0026thinsp;\u0026plusmn;\u0026thinsp;4.60ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.95\u0026thinsp;\u0026plusmn;\u0026thinsp;3.16ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00ᵃ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;10 hours\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e7.39\u0026thinsp;\u0026plusmn;\u0026thinsp;5.02ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.77\u0026thinsp;\u0026plusmn;\u0026thinsp;4.06ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.57\u0026thinsp;\u0026plusmn;\u0026thinsp;2.90ᵃᵇ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.062\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Data are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD) (n\u0026thinsp;=\u0026thinsp;2025). Because the continuous variables did not meet the assumption of normal distribution, the Mann\u0026ndash;Whitney U test (ᵃ) was used to compare two independent groups, and the Kruskal\u0026ndash;Wallis te t (ᵇ) was used to compare three or more groups. Within each variable group (column-wise), values with different superscript letters indicate statistically significant differences, whereas values sharing the same letter do not differ significantly. Each p value corresponds to the separate comparison of the relevant variable (DMFT, D, M, or F) across groups. Statistical significance was accepted at p\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003eIn analyses by licensed athlete status, DMFT scores were significantly higher in licensed athletes compared with non-licensed students (Mann\u0026ndash;Whitney U, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, r\u0026thinsp;=\u0026thinsp;0.24). This difference was mainly driven by the D (decayed) and F (filled) components, whereas no significant difference was observed for the M (missing) component (p\u0026thinsp;=\u0026thinsp;0.214).\u003c/p\u003e \u003cp\u003eAccording to licensure duration, DMFT, D, and F values differed significantly (Kruskal\u0026ndash;Wallis; DMFT: H(3)\u0026thinsp;=\u0026thinsp;149.34, η\u0026sup2; = 0.071; D: H(3)\u0026thinsp;=\u0026thinsp;118.04, η\u0026sup2; = 0.056; F: H(3)\u0026thinsp;=\u0026thinsp;134.73, η\u0026sup2; = 0.064; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No significant difference was found for M (p\u0026thinsp;=\u0026thinsp;0.087). Similarly, weekly sports duration was significantly associated with DMFT, D, and F (DMFT: H(4)\u0026thinsp;=\u0026thinsp;139.29, η\u0026sup2; = 0.067; D: H(4)\u0026thinsp;=\u0026thinsp;114.45, η\u0026sup2; = 0.054; F: H(4)\u0026thinsp;=\u0026thinsp;100.50, η\u0026sup2; = 0.047; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), but not with M (p\u0026thinsp;=\u0026thinsp;0.062). DMFT, D, and F differed significantly across licensure duration (DMFT: H(3)\u0026thinsp;=\u0026thinsp;149.34; D: H(3)\u0026thinsp;=\u0026thinsp;118.04; F: H(3)\u0026thinsp;=\u0026thinsp;134.73; all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and weekly sports time (DMFT: H(4)\u0026thinsp;=\u0026thinsp;139.29; D: H(4)\u0026thinsp;=\u0026thinsp;114.45; F: H(4)\u0026thinsp;=\u0026thinsp;100.50; all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), whereas M did not differ (p\u0026thinsp;=\u0026thinsp;0.087 and p\u0026thinsp;=\u0026thinsp;0.062, respectively).\u003c/p\u003e \u003cp\u003eAnalyses showed that students licensed for 1\u0026ndash;3 and 3\u0026ndash;5 years had significantly higher DMFT and D values than those licensed for \u0026ge;\u0026thinsp;5 years (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Regarding weekly sports duration, students exercising 3\u0026ndash;5 and 5\u0026ndash;10 hours per week had significantly higher DMFT scores than those exercising 1\u0026ndash;3 hours (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). For the F component, students exercising 5\u0026ndash;10 hours per week had more filled teeth than those exercising 1\u0026ndash;3 hours (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eMultivariable regression analysis was conducted to examine the associations between oral health indicators (DMFT and its components: D, M, F) and sociodemographic as well as behavioral factors. Regression coefficients and corresponding p-values are presented in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation of demographic, behavioral, and sports-related factors with DMFT and its components\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDMFT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56)\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.59\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.24\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.085\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTooth brushing frequency\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.82\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.89\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.41\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.76\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDental floss use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1.34\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.21\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.91\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.796\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.80\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegular dental visit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.90\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.83\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.01\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.935\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.05\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.632\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLicensed athlete\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1.59\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.58\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.54\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.66\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of sports license\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.94\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.083\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.95\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.270\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.88\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.445\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.91\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.399\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWeekly time spent on sports\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1.03\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.379\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.02\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.655\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.74\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.091\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.07\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.575\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnergy-boosting product consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.99\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.789\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.02\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.728\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.03\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.822\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.93\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.421\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of energy-boosting product consumption\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2.06\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.05\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.2\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.179\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.24\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of energy-boosting product\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1.25\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.040\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.19\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.192\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.33\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.036\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.49\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.098\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of snack consumption between meals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2.31\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.40\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e1.28\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.313\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.70\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. Results are presented as IRR (Incidence Rate Ratio) with 95% confidence intervals (CI). An IRR of 1 indicates no effect, an IRR\u0026thinsp;\u0026gt;\u0026thinsp;1 indicates that the variable is associated with an increased level of caries indicators, and an IRR\u0026thinsp;\u0026lt;\u0026thinsp;1 indicates a decreasing (protective) effect. Each estimate presented in the table is adjusted for all other variables included in the model and represents the independent effect of the corresponding variable.\u003c/p\u003e \u003cp\u003eIn multivariable regression \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e, gender and BMI were independently associated with higher DMFT. Tooth brushing showed a protective effect, whereas energy-boosting products and sugary snack consumption were positively associated with DMFT, particularly the D component. Licensed athlete status remained significant after adjustment.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, oral health in adolescents was evaluated using the DMFT index and its components (D, M, F), and their potential associations with sports participation and behavioral factors were examined.\u003c/p\u003e \u003cp\u003eAdolescents were selected as the study population because the literature reports that health-related behaviors established during this period influence health outcomes later in life [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Moreover, oral health behaviors are shaped by socioeconomic and environmental factors, and adolescents are therefore emphasized as an important age group for epidemiological studies [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe mean DMFT value identified in this study was higher than those reported in some studies conducted in similar age groups across different countries [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, comparable or even higher DMFT levels have also been reported in adolescent populations [\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. These differences may be explained by contextual factors such as sample characteristics, access to preventive oral health services, fluoride exposure, socioeconomic conditions, and behavioral patterns.\u003c/p\u003e \u003cp\u003eDMFT values were higher in licensed adolescent athletes compared with non-athletes. The low M component in both groups indicates that tooth loss is limited in this age range. The higher D and F components among athletes suggest a greater active caries burden and increased restorative treatment need. Overall, the first null hypothesis was partially rejected.\u003c/p\u003e \u003cp\u003eThe association between licensure duration and DMFT was not linear. Adolescents licensed for 1\u0026ndash;3 years exhibited higher caries experience, whereas those licensed for longer periods showed relatively lower values. This finding suggests that sports participation alone may not be protective; rather, sports-related consumption habits and increasing health awareness over time may jointly influence outcomes.\u003c/p\u003e \u003cp\u003eSimilarly, weekly sports duration showed a non-linear pattern. DMFT values increased in the 1\u0026ndash;3 hour group but declined in those exercising more than 10 hours per week, indicating that the relationship between physical activity and caries experience may not be linear.\u003c/p\u003e \u003cp\u003eSeveral studies report that physical activity may have a protective role in oral health [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Associations between physical inactivity and dental caries in adolescents have also been documented [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Moreover, higher levels of physical activity have been linked to better oral health indicators in this age group [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. While some of these findings partially align with the present results, other studies have found no consistent or direct association between physical activity and DMFT, which is also partly consistent with our findings [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne possible explanation is the higher frequency of energy-boosting product and sugary snack consumption among athletes, which may partly account for their higher DMFT values and active caries burden. Carbohydrate-rich dietary patterns in sports settings may lower plaque pH and increase enamel demineralization, thereby elevating caries risk [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Sugar intake is a major determinant of dental caries, and physical activity alone may not counteract this effect [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The association between high soft drink consumption and increased DMFT further supports this mechanism [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the multivariable regression analysis, the frequency of between-meal sugary snack and energy-boosting product consumption showed strong positive associations, particularly with the D component. This finding supports the role of consumption frequency in active caries development and is consistent with previous research emphasizing its importance in caries risk [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough some studies report no increase or only weak associations between high sugar intake and caries experience in athletes, these studies emphasize that timing of consumption and accompanying oral hygiene practices may be decisive factors [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The multivariable regression findings in the present study, showing no significant associations between licensure duration, weekly sports time, or mere presence of energy-boosting products and DMFT components, are partly consistent with this perspective and highlight the importance of qualitative rather than purely quantitative preventive strategies.\u003c/p\u003e \u003cp\u003e Current evidence also suggests that the non-linear relationship observed between licensure duration and DMFT in this study may be shaped by oral hygiene behaviors. Community-based studies in adolescent populations indicate that oral health outcomes tend to cluster with dietary and hygiene patterns [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, previous research has reported that intensive training schedules in adolescent athletes may reduce the time allocated to oral hygiene, potentially contributing to increased DMFT levels [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e Comparison of oral hygiene behaviors showed no consistent overall advantage for either group. Non-athletes reported higher brushing and flossing rates, whereas athletes had more regular dental visits. Thus, sports participation does not define a uniformly better or worse oral hygiene profile. Low floss use across all groups and modest differences in dental visits suggest generally limited preventive behaviors. Cariogenic dietary patterns related to training may indicate insufficient nutrition and oral hygiene education for athletes.\u003c/p\u003e \u003cp\u003eGiven the cross-sectional design, reverse causality must be considered; adolescents with caries experience may attend dental visits more frequently [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Therefore, differences in DMFT\u0026mdash;mainly in D and F\u0026mdash;should be interpreted cautiously, as dental attendance may reflect treatment need rather than preventive care.\u003c/p\u003e \u003cp\u003eSome studies report better hygiene behaviors among physically active adolescents, yet without a significant reflection on DMFT [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Higher physical activity has also been associated with twice-daily brushing, although such relationships vary by population and are shaped by sociodemographic clustering [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOverall, the impact of sports on adolescent oral health appears multifactorial and inconclusive in the literature. In our data, higher DMFT values in the 3\u0026ndash;10 hour activity range may be better explained by accompanying dietary and care behaviors rather than sports itself. Thus, the second null hypothesis was partially rejected.\u003c/p\u003e \u003cp\u003eMultivariable regression showed a clear hierarchy of factors influencing DMFT and its components. Behavioral variables demonstrated stronger and more direct effects, whereas sociodemographic factors acted more as structural determinants.\u003c/p\u003e \u003cp\u003eBMI showed a significant positive association with DMFT. Although BMI is not a direct oral health behavior, it may be indirectly linked to caries risk through sugar intake, snacking frequency, and lifestyle patterns. However, inconsistent findings in the literature regarding the BMI\u0026ndash;caries relationship indicate its multifactorial nature [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGender also independently influenced DMFT. As a non-modifiable factor, it is mainly relevant for identifying risk groups. Mixed or non-significant associations reported in previous studies suggest that caries experience is shaped more by behavioral and sociocultural factors than by biological differences alone [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese findings should be interpreted considering methodological limitations. The cross-sectional design precludes causal inference. Self-reported behavioral data may introduce measurement bias. The absence of radiographic assessment may have led to underdetection of proximal or early lesions. Sports participation was not analyzed in detailed subcomponents, and factors such as dehydration, fluoride exposure, and detailed socioeconomic indicators were not evaluated, leaving potential residual confounding.\u003c/p\u003e \u003cp\u003eWithin these limitations, licensed athletes had higher DMFT values than non-athletes, yet the relationship between sports duration and caries experience was non-linear. Frequent consumption of energy-boosting products and between-meal sugary snacks emerged as key behavioral factors associated with increased caries burden. Sports participation itself did not demonstrate a consistent protective effect through oral hygiene behaviors.\u003c/p\u003e \u003cp\u003eOverall, the effect of sports on adolescent oral health should be evaluated together with accompanying dietary and hygiene habits. Preventive strategies should target nutrition and oral hygiene practices in both school and sports settings.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eThis cross-sectional study was approved by the Non-Interventional Clinical Research Ethics Committee of Ordu University (No. 65 / 28.06.2024)\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eConsent for publication\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eHA and SB contributed equally to this work. Both authors made substantial contributions to the conception and design of the study; methodology, investigation, data curation, formal analysis, and validation. HA and SB were equally involved in drafting the original manuscript and substantively revising it, as well as in funding acquisition and project administration. Both authors have read and approved the final submitted version of the manuscript and have agreed to be personally accountable for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBotelho-Filho CR, Bordin GM, Paula ICSF, et al. Impact of dental caries on the quality of life of adolescents: a systematic review and meta-analysis. 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Dental caries prevalence and oral health status among 15-year-old adolescents in Kosovo. Acta Stomatol Croat. 2022;56:42\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.15644/asc56/1/5\u003c/span\u003e\u003cspan address=\"10.15644/asc56/1/5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Adolescent Oral Health, DMFT, Youth Sports, Energy Drink, Oral Hygiene, DMFT","lastPublishedDoi":"10.21203/rs.3.rs-9438136/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9438136/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study aimed to evaluate oral health among adolescents aged 14\u0026ndash;16 years using the DMFT index in relation to sports-related lifestyle factors, oral hygiene practices, and dietary behaviors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was conducted in 14\u0026ndash;16-year-old high school students. Oral examinations were performed by a single calibrated examiner, and dental caries were recorded using WHO standards. Oral health status was assessed with the DMFT index. Height and weight were measured to calculate BMI. Students completed a validated questionnaire evaluating oral hygiene behaviors, sports participation, and consumption of energy-boosting products and between-meal sugary snacks. Statistical analyses were performed using SPSS v26.0 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eLicensed athletes had significantly higher DMFT scores than non-licensed students (8.02\u0026thinsp;\u0026plusmn;\u0026thinsp;4.95 vs. 5.55\u0026thinsp;\u0026plusmn;\u0026thinsp;4.53; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), mainly due to higher D (5.87\u0026thinsp;\u0026plusmn;\u0026thinsp;3.87 vs. 4.06\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68) and F (1.95\u0026thinsp;\u0026plusmn;\u0026thinsp;2.98 vs. 1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17) components. DMFT values differed significantly according to licensure duration and weekly sports participation; however, the relationship between them was not linear. Frequent consumption of energy-boosting products and sugary snacks was significantly associated with higher DMFT (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eHigher DMFT values among licensed athletes, primarily driven by the D component, suggest that sports participation alone may not be protective. The non-linear relationship between sports duration and caries experience, together with multivariable analyses, indicates that behavioral factors may be more influential than sociodemographic variables.\u003c/p\u003e\u003ch2\u003eTrial registration:\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e","manuscriptTitle":"The Impact of Sports on Oral Health in Adolescents: A Cross-Sectional Study of 2025 Participants","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-13 12:29:06","doi":"10.21203/rs.3.rs-9438136/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-05-05T06:45:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-17T11:42:59+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-16T23:31:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-16T23:31:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2026-04-16T12:07:52+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"aec480b2-0de2-426b-b7bd-93470636f7c7","owner":[],"postedDate":"May 13th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewersInvited","content":"3","date":"2026-05-05T06:45:43+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-13T12:29:07+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-13 12:29:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9438136","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9438136","identity":"rs-9438136","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}