Dr. Michael Handler

Beating the Blues – How Stress Can Affect Oral Health

By Dr. Michael Handler

How Stress Can Affect Oral Health

When you’re stressed out, your dentist can tell! No, there’s no magic or mind-reading involved—simply clear evidence of how stress affects your oral health. While stress can cause minor dental issues such as dry mouth, canker sores and burning mouth syndrome, it can also cause more serious conditions that affect your overall wellbeing. Whether you think you’re handling your stressful life well or not, these signs and symptoms can alert you to how your body is really reacting to the situation.

#1: Bruxism or Tooth Grinding

Many reasons exist for grinding your teeth during sleep, or clenching your jaws together at any time. An abnormal bite or missing teeth are the most common physical reasons, but the condition can also be caused by stress factors such as frustration, anger, or nervous tension. Usually, patients don’t even realize at first that they are grinding their teeth, until a family member comments on the sound. These signs may be evidence you’re suffering from bruxism:

  • The tips of your teeth appear to be level and flat
  • The tooth enamel looks thin or worn down in places, and the teeth are especially sensitive in those areas
  • You have indentations in your tongue that you have no explanation for.

Treating bruxism requires addressing both the cause and the symptoms, and your dentist can help you determine whether it’s caused by dental issues or not. He can also recommend methods of treating the symptoms, but in the absence of a physical cause may suggest consulting your family doctor to see if you’re experiencing emotional stress.

#2: Periodontal Disease

A study published in the Industrial Psychology Journal shows stress can cause a disruption in the communication between your central nervous system and your immune system, which can change the way the immune system works. This creates a perfect environment for the development of periodontal or gum disease. Signs and symptoms of gum disease include bad breath, redness and swelling of areas of gum, sensitivity and pain, especially when eating, loose teeth and receding gum tissue.

Although periodontal disease is not a direct result of stress, other research has found the condition is worse in patients who experienced a higher level of stress in the previous 12-month period. Financial stress, in particular, causes patients to develop gum disease, but it often clears up when the financial problems are resolved. Your dentist can recommend the right form of periodontal therapy to treat gum disease and prevent it getting worse.

#3: Temporomandibular Disorders (TMD)

Your temporomandibular or jaw joint connects your upper and lower jaws, and any disorders of this joint can have a significant effect on your oral and overall health. Stress is a factor in TMD because tension and clenching of jaw can result in overuse of the muscles, pain in the joint, or the jaw making “popping and clicking” sounds and movements. This can affect your ability to speak, eat, swallow, and sometimes even your breathing. TMD affects around 12 percent of the population at any given point, and while both genders experience it, the majority of patients are adult women under 35 years.

TMD also plays a role in causing other medical conditions, with many patients also experiencing the following:

  • Chronic Fatigue Syndrome
  • Chronic Headache
  • Endometriosis
  • Fibromyalgia
  • Interstitial Cystitis
  • Irritable Bowel Syndrome
  • Low Back Pain
  • Sleep Disorders
  • Vulvodynia

Research also shows TMD is a complex condition similar to hypertension and diabetes, which involves genetic, environmental and behavioral factors, according to the TMJ Association.

#4: Oral Lichen Planus

This is the inflammation of the mucous membranes of the mouth, which shows up as white patches on the gum, red and swollen gum tissue or open mouth sores that are burning and painful. It’s an autoimmune disorder caused by the immune system attacking the mucous membranes, according to the Mayo Clinic. Although it isn’t contagious patients need careful monitoring to reduce the risk of developing oral cancer. Stress is known to be one of the primary factors in immune system irregularities, and it could manifest as a condition like oral lichen planus.

Maintaining Your Oral Health During Stress

Treating the cause of the stress is an important factor in recovering from any of these dental issues. If that’s not possible, find ways to manage your stress levels through exercise, counseling, relaxation or massage therapy. At the same time, treat your oral health symptoms to avoid them becoming worse. A mouth guard can help prevent tooth grinding during sleep.

Treating the cause of the stress is an important factor in recovering from any of these dental issues. If that’s not possible, find ways to manage your stress levels through exercise, counseling, relaxation or massage therapy. At the same time, treat your oral health symptoms to avoid them becoming worse. A mouth guard can help prevent tooth grinding during sleep.

If it’s painful to brush and floss daily, rinsing your mouth with warm salt water can reduce the discomfort. Your dentist can also prescribe various products to help you combat mouth sores and prevent the development of gum disease.


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