When we talk about the health of elite athletes, the mouth is one of the last places most people look. Yet oral health sits surprisingly close to the things we care about in high-performance sport: pain and infection that disrupt sleep and training, systemic inflammation, nutritional habits, and simple day-to-day quality of life. The evidence base in elite football, and in Asian football in particular, has been thin. So together with the Sports Dentistry department at Aspetar we set out to add some hard numbers.
Our study, just published in Research in Sports Medicine, screened the oral health of professional players competing at the AFC Asian Cup held in Qatar in January and February 2023. It is, as far as we are aware, one of the first structured looks at the dental status of elite footballers in this region.
What we did
This was a cross-sectional clinical study. Three dentists carried out standardized examinations on 70 randomly selected players (mean age 26.8 years), using established indices — DMFT for dental caries, BPE for periodontal health, and BEWE for erosive tooth wear — alongside assessment of wisdom-teeth status, dental trauma, and temporomandibular joint (TMJ) function. Using calibrated examiners and validated indices matters here: it means the numbers can be compared against other populations and tracked over time, rather than being one clinician’s impression.
The main results
SPORTS DENTISTRY · ASPETAR
Oral health of elite footballers
70 players screened at the AFC Asian Cup, Qatar 2023 · cross-sectional study using the DMFT, BPE and BEWE indices · mean age 26.8 years
85.7%
had dental caries — mean DMFT 5.6; 77.1% had restorations
88.6%
showed tooth erosion — 10% classified as high risk
82.9%
had gingivitis — 12.9% with signs of periodontitis
30%
sports-related dental trauma — history of injury to teeth or mouth
38.6%
partially erupted wisdom teeth — pericoronitis in 7.1%
A substantial, largely silent oral-disease burden — the case for routine dental screening within athlete health programmes.
Alsaey, Almasri, Tabben, Cardinale et al., Research in Sports Medicine 2025 · DOI 10.1080/15438627.2025.2599859
What the numbers tell us
The headline is the sheer prevalence. Dental caries were present in 85.7% of players, with a mean DMFT of 5.6, and more than three-quarters already carried restorations. Erosive tooth wear was even more common at 88.6%, with one in ten players in the high-risk category — a finding that inevitably raises questions about the acidic sports drinks and gels that are so routine in this population. Gingival inflammation affected 82.9%, and while frank periodontitis was less common at 12.9%, that is still a meaningful proportion in otherwise fit young men.
Beyond decay and gum disease, the structural and functional findings stood out: partially erupted wisdom teeth in 38.6% (with pericoronitis in 7.1%), a history of sports-related dental trauma in 30%, and TMJ disorders in 21.4%. Individually each is manageable; collectively they describe a group of elite athletes carrying a considerable, and largely unmanaged, load of oral pathology.
Why it matters
What strikes me about these numbers is how quiet the problem is. Most of these conditions do not stop a player training or competing — until they do, in the form of acute pain, infection, disturbed sleep, or an emergency the week of a match. Oral health is exactly the kind of modifiable, low-cost factor that high-performance systems are well placed to manage, and yet it is routinely left off the medical screening checklist.
This was a preliminary, single-tournament study with a modest sample, and it describes association and prevalence rather than a direct effect on performance — caveats we are careful to state. But the direction is clear and consistent with what has been reported in other elite cohorts. The practical conclusion is straightforward: dental assessment and preventive care deserve a place in the routine health programmes we build around athletes, not an afterthought once something hurts. Screening is cheap, the interventions are well understood, and the upside — in comfort, sleep, systemic health and availability to train — is real.
My thanks go to our Sports Dentistry colleagues at Aspetar, who led this work, and to the AFC medical team for making the screening possible. It is a small but useful step toward treating the mouth as part of the athlete, rather than a separate specialty that only gets involved in a crisis.
Reference
Alsaey M, Almasri D, Tabben M, Cardinale M, Alkuwari A, Singh GSA, Hashem A. Dental health status of professional football players during the Qatar 2023 AFC Asian Cup: a preliminary study. Research in Sports Medicine, 2025;34(4):451-463. DOI: 10.1080/15438627.2025.2599859 (via PubMed).
For most of my career, the richest data in elite football sat behind closed doors. Tracking systems, multi-camera optical feeds, possession context, off-the-ball movement — the kind of information that actually explains why a match unfolds the way it does — was the private property of a handful of federations and clubs wealthy enough to own it. Everyone else worked with shots, corners, fouls and possession percentage, and squinted to fill in the rest.
That is changing, and the FIFA World Cup has become the most visible stage for the shift. Over the last two tournaments FIFA has done something I think is genuinely important for our field: it has taken some of the most modern performance data ever produced in football and made a meaningful slice of it public. As someone who has spent years arguing that data only becomes knowledge when people are allowed to interrogate it, I find this exciting — so I wanted to write down where this data lives, who is doing interesting things with it, and why the act of sharing matters as much as the numbers themselves.
FIFA’s initiative: Enhanced Football Intelligence
The centrepiece is Enhanced Football Intelligence (EFI) — the set of metrics that first appeared as those small graphics in the corner of the screen during the 2022 World Cup. EFI was built by FIFA’s Football Performance Analysis & Insights team to move us beyond traditional counting stats and toward metrics that describe how a team plays.
What makes EFI different is its source. Rather than relying only on on-the-ball event data, it combines event data with live tracking data from every player on the pitch, captured by a multi-camera optical system. When something happens, you know where all twenty-two players were in relation to it. That positional context is what unlocks metrics you simply cannot derive from a traditional stats sheet, including:
Line breaks — how often a pass cuts through an entire defensive unit, and whether it went through, around or over. FIFA’s own analysis shows that the more line breaks a team concedes in midfield, the more games it tends to lose.
Ball recovery time — how long, on average, it takes a team to win the ball back after losing it.
“In contest” possession — the honest third category that sits between “our ball” and “their ball,” capturing the messy phases when nobody is truly in control.
Receptions behind the midfield and defensive lines — where and how players make themselves available between the opponent’s units.
Pressure on the ball and forced turnovers — whether a side is genuinely disrupting the opponent or merely looking busy.
Crucially, FIFA makes this available to the public. The metrics are explained — with video and multilingual PDFs — on the FIFA Training Centre, and snippets of match data are published after games. For the 2026 tournament FIFA has gone further still, layering on two new initiatives: the FIFA Power Rankings, an objective player-rating system scoring every outfield player 0–10 for attacking, creativity and defending using EFI algorithms; and FIFA AI Pro, which gives all 48 teams the same generative-AI tools to explore match data and rebuild moments in 3D — explicitly framed as democratising analytics that used to belong only to the biggest budgets.
Where to find the data and the people working with it
Here are the sites I’d point any coach, analyst or curious fan toward. I’ve grouped them deliberately, because one distinction matters a great deal and is easy to miss: some of these work directly from data officially published by FIFA, while others produce excellent World Cup analysis using third-party providers such as StatsBomb. All are worth your time — but knowing which is which keeps you honest about where a number actually came from.
This is the well from which everything else is drawn. Free, open, and aimed at coaches of every level, it hosts the EFI metric explainers, the “Football Language” glossary, video breakdowns, the FIFA Insight interviews with the people who built EFI, and — the part I’d flag for 2026 — the Match Report Hub, a live index of post-match summary reports for every World Cup match, organised by group and added as the tournament unfolds. If you only bookmark one link from this article, make it this one.
The sharpest example I’ve seen of someone treating FIFA’s openness as a system rather than a curiosity. Tactics Journal points out that FIFA is publishing a roughly 52-page post-match summary for every group-stage game — formations, pressing phases, line-break tables player-by-player, defensive pressure maps, sprint-zone physical data — all in a consistent structure. Their argument is that because every report follows the same layout, you can parse all of them into a structured, auditable evidence layer for scouting and tournament-wide tactical questions. They call it “tactical infrastructure,” and I think that’s exactly the right way to think about it: the PDF is content; the structured layer you build from it is infrastructure.
An independent blog that does something quietly useful: it organises and explains the EFI metrics as a reference, pulling together the definitions of phases of play, line heights, team lengths, receptions and the rest into one navigable place. A patient companion to the official material that helps a newcomer go from “what is a line break?” to actually reading a match through that lens.
My favourite example of why open methods matter as much as open data. Parlak built an open-source implementation of FIFA’s EFI metrics — data, concept and visualisation layers — with the explicit goal of reproducing FIFA’s match reports and testing whether the published concepts are specified well enough to be rebuilt by an outsider. That is science in the best sense: take the published method, try to recreate it, and flag the ambiguities. For analysts and students it doubles as a practical toolkit for generating EFI-style visualisations. You can read his Master’s thesis on this project here.
The wider analytics and data-journalism ecosystem
These don’t all run on FIFA’s own feed, but they show what a culture of shared football data makes possible — and they’re some of the most engaging World Cup analysis being published right now.
A blog “powered by data science and written by journalists,” produced by Northeastern’s Network Science Institute (the NetSI Sport group led by Brennan Klein). It’s a masterclass in turning event data into narrative: passing networks and passing-cluster maps that fingerprint a team’s style, xG shot maps, dribble-and-carry graphics, and genuinely novel angles like whether the 2026 hydration breaks are changing scoring patterns. Worth knowing that their underlying data comes from Hudl StatsBomb(over 3,400 events per match), not FIFA’s EFI feed — a good illustration of how the official and commercial data worlds sit side by side.
Not a football site at all, but a weekly roundup of the best data visualisations from newsrooms around the world, and during the tournament it’s been a reliable showcase of World Cup charts — qualification journeys, the evolution of the match ball, player and game analyses from the likes of Reuters, The New York Times and El País. The best place to see how professional data journalists choose to present this kind of information. Some details are also here.
A reminder that you don’t need a newsroom to do this. This is a community-built interactive Power BI dashboard — one example aimed at World Cup Fantasy players, with a “Stat View” toggle to compare a player’s club versus international form before making transfer decisions — sitting within Fabric’s wider Data Stories Gallery of user-made World Cup dashboards. A nice window into the grassroots, build-it-yourself end of the spectrum.
(Two more worth a look in the same spirit: Tactical Football Analysis for written post-match tactical breakdowns, and Flourish, whose football chart templates are a quick way to build your own tournament visualisations.Also, have a look at this substack on how to build team-shape visualisations.)
What the analysis actually looks like
The reason this data is worth sharing is that it produces visuals that change how you see a match. A few of the workhorse formats:
Pass networks map who connects to whom and where, turning a team’s structure into a readable shape — you can see at a glance whether a side is building through its full-backs, overloading one flank, or bypassing midfield entirely.
Tracking heatmaps show where players and teams actually spend their time, exposing the difference between nominal position and real behaviour, and revealing how compact or stretched a side is in and out of possession.
xG (expected goals) shot maps put a probability on every chance so you can judge whether a team created genuine danger or simply accumulated low-value shots — useful, as long as you remember it’s a guide, not a verdict.
The principle underneath all of them is the same one I keep coming back to: the best statistics don’t make football more complicated, they make it easier to understand. A line-break count, a compactness number or a clean sprint map isn’t there to replace the coach’s eye — it’s there to sharpen the question the coach is already asking as well as providing additional information for support staff to improve how players are prepared.
The other half of the story: injuries and player health
It would be a strange omission, for me especially, to write about World Cup data and talk only about what happens when players are on the pitch. The same tournament that generates all this performance data also generates a great deal of information about the cost of playing it — and FIFA itself frames its data mission broadly, as unlocking the potential of video and data to drive technical development and education, not just tactical analysis.
This World Cup has put player load firmly in the spotlight. The expansion to 48 teams and 104 matches, layered on top of an already congested club calendar, has prompted warnings from sports-medicine specialists that fatigue and tight scheduling are pushing injury rates up — with the knee particularly exposed to the constant cutting, pivoting and rapid changes of direction the modern game demands. FIFA’s own venue medical staff have pointed to the injuries they see most often in elite players: ankle sprains, and hamstring and calf strains. None of that is new in kind, but the volume and the schedule are. At the end of each tournament there is always a published paper on the injury surveillance activities conducted by the FIFA medical team. If you want to read more about our experience at the FIFA 2022 World Cup you can read the following papers:
For the public, the most visible “injury data” is the running tracker — outlets such as ESPN, The Independent and others maintain live lists of who is ruled out or racing to be fit, and this tournament has tested several squads hard, with sides like Brazil and the Netherlands losing first-choice players before a ball was kicked. These are journalism rather than open datasets, but they perform a real function: a structured, continuously updated public record of availability.
FIFA has a long history of medical research around its tournaments, and the combination of tracking data (sprint loads, high-intensity distances, accelerations) with injury records is exactly the kind of linkage that could move us from counting injuries to understanding and preventing them. The performance data and the medical data are two halves of the same picture; sharing both is how we protect the players who generate it.
Why sharing the data matters
I want to close on the part I care about most, because it’s easy to treat “FIFA released some metrics” as a minor technical footnote. It isn’t.
It democratises insight. When tracking-derived data was private, the gap between the richest and poorest programmes was partly a data gap. Publishing EFI, and giving every World Cup team the same AI tools, narrows that gap. Insight stops being a function of budget alone.
It creates a shared language. When a coach in one country and an analyst in another can both point to the same definition of a line break or “in contest” possession, conversations get more precise and more productive. Common metrics are the grammar of a common discussion.
It invites scrutiny and reproducibility. The moment a method is public, people like Doğan Parlak can try to rebuild it, stress-test it, and improve it. That is exactly how a field matures — not by guarding methods, but by exposing them to challenge.
It stimulates new ways of analysing the game. This is the part that excites me as a scientist. Hand the same dataset to a hundred curious people and you will get analyses no single organisation would ever have commissioned. Open data is generative: it produces questions, tools and visualisations that wouldn’t otherwise exist, and the elite game gets smarter as a result.
Football has always been understood through stories and through the eye. What FIFA’s data initiative does is add a third lens — a transparent, shareable, contestable one — and then, remarkably, hand it to everyone. The numbers are interesting. But the decision to share them is what will change how we understand the game at the very highest level. So, well done to my FIFA colleagues for this initiative.
At Aspetar we have produced a special issue of our Journal dedicated to Football and the World Cup. You can access it by clicking on the cover page.
1Center of Excellence for Sport Science and Coach Education, Department of Kinesiology, Leisure, and Sport Science, East Tennessee State University, Johnson City, TN, USA – harahara10@hotmail.com.
Abstract
AIM:
The aim of the study was to investigate the applicability of a repeated change-of-direction (RCoD) test for NCAA Division-I male soccer players.
METHODS:
The RCoD test consisted of 5 diagonal direction changes per repetition with a soccer ball to be struck at the end. Each player performed 15 repetitions with approximately 10 seconds to jog back between repetitions. Data were collected in two sessions. In the first session, 13 players were examined for heart rate responses and blood lactate concentrations. In the second session, 22 players were examined for the test’s ability to discriminate the primary from secondary players (78.0 ± 16.1 and 10.4 ± 13.3 minutes per match, respectively).
RESULTS:
Heart rate data were available only from 9 players due to artifacts. The peak heart rate (200.2 ± 6.6 beats∙min1: 99.9 ± 3.0% maximum) and blood lactate concentration (14.8 ± 2.4 mmol∙L1 immediately after) resulted in approximately 3.5 and 6.4fold increases from the resting values, respectively. These values appear comparable to those during intense periods of soccer matches. In addition, the average repetition time of the test was found to discriminate the primary (4.85 ± 0.23 s) from the secondary players (5.10 ± 0.24 s) (p = 0.02).
CONCLUSION:
The RCoD test appears to induce physiological responses similar to intense periods of soccer matches with respect to heart rate and blood lactate concentration. Players with better average repetition times tend to be those who play major minutes.
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