Side Effects of Stress on Oral Health

Stress can cause tooth-grinding and/or clenching of the jaw, leading to tooth damage. A common stress response is to grind the jaw during sleep. Often done unconsciously, this can be occurring during waking hours as well, it’s a kind of Para functional habit which gets worse on stress. This habit can lead to the wearing down of the teeth (attrition), as well as cracking or fracturing of your teeth…….
By Dr Deepti Sharma

We all encounter stress in our lives, you are probably aware of what stress does to our bodies — it can cause anxiety disorders and panic attacks, insomnia which can lead to grogginess and irritability. But stress and oral health is an entirely new ballgame for most people. Unfortunately, our mouths have just as much of a chance of being affected by stressful situations as our bodies and minds do.

Affect of Stress on Dental Health
Clenching/Grinding (Bruxism): Stress can cause tooth-grinding and/or clenching of the jaw, leading to tooth damage. A common stress response is to grind the jaw during sleep. Often done unconsciously, this can be occurring during waking hours as well, it’s a kind of Para functional habit which gets worse on stress. This habit can lead to the wearing down of the teeth (attrition), as well as cracking or fracturing of your teeth. It can lead to a syndrome called TMD (temporomandibular joint disorder). Excessive clenching or tooth grinding can lead to myalgia (muscle pain) in your jaw, face, ear and head as well as arthritic changes in the joint.
Canker Sores (apthous ulcers): stress initiates a breakdown in host protective factors which can lead to the development of canker sores. Canker sores are small ulcers or lesions located on the mucosal membranes in the mouth. Canker sores usually appear as a red lesion with a white or yellow center on the inside of the cheeks or lips, the tongue, the upper surface of the mouth or the base of the gums. Symptoms can include a burning sensation, pain, inflammation, fever and swollen lymph nodes. Canker sores are not contagious and usually go away on their own within 1-2 weeks.
Dry Mouth (xerostomia): When the mouth doesn’t produce enough saliva, it can experience chronic dryness. Not only does dry mouth result from conditions caused by stress, but it is also a common side effect of allopathic drugs used to treat depression.
Burning Mouth Syndrome: Psychological problems are just one of the many factors known to cause burning mouth, which is identified by a burning sensation on the tongue, lips, gums or palate.
Lichen Planus: Lichen planus of the mouth is characterized by white lines, sores and ulcers in the oral cavity. Some experts believe lichen planus is a reaction to viral infections caused by stress ,it’s a chronic inflammatory condition that affects mucous membranes inside the mouth. Oral lichen planus may appear as white, lacy patches; red, swollen tissues; or open sores. These lesions may cause burning, pain or other discomfort. .
TMJ/TMD: Stress contributes to temporomandibular joint disorders in many fashions. Trauma and tooth grinding are common causes of TMD, while emotional factors such as anxiety and depression can also trigger symptoms of TMJ. It refers to a variety of conditions that affect jaw joints, jaw muscles and facial nerves. TMD may occur when the jaw twists during opening, closing or side-motion movements. People with TMD may experience pain in or around the ear, headaches and neck aches, tenderness of the jaw or jaw muscles, jaw pain or soreness that is more prevalent in the morning or late afternoon, jaw pain when chewing, biting or yawning, difficulty opening and closing the mouth, clicking or popping noises when opening the mouth, and sensitive teeth.When the body is stressed, muscles tense up. Muscle tension is a reflex reaction to stress — it is the body’s way of guarding against injury and pain. With sudden onset stress, the muscles tense up all at once, and then release their tension when the stress passes. Chronic stress causes the muscles in the body to be in a more or less constant state of guardedness. When muscles are taut and tense for long periods of time, this may trigger other reactions of the body and even promote stress-related disorders..
Gum Disease: Studies have shown that long-term stress affects our immune systems, increasing our susceptibility to infections such as periodontal disease. Long-term stress can lead to chronically elevated levels of the stress hormone called cortisol, which can weaken the immune system. When the immune system is weak, conditions are ripe for bacteria from plaque to invade the gums. More and more research is revealing a strong link between stress and gum disease (periodontal disease). Symptoms of gum disease include bleeding gums, swollen gums, loose teeth, and bad breath. Left untreated, gum disease can lead to tooth loss.
Tooth decay (cavities): Natural bacteria live in the mouth and form plaque. The plaque produces acids by interacting with deposits on your teeth from sugary and starchy foods. These acids damage tooth enamel over time which weakens the teeth and leads to tooth decay. Stress can lead to oral hygiene neglect and other detrimental behaviors such as poor diet, smoking, and alcohol abuse. Individuals who are stressed tend to consume more sugary and starchy foods, which can lead to higher incidence of tooth decay.

How Do You Protect Your Teeth From Stress?
If you’re feeling stressed, don’t forget about your dental health. Take the time to focus on your oral hygiene regimen, and don’t use smoking or alcohol to relieve stress. These habits are highly addictive, and they have damaging effects on your oral cavity. Instead, take proper measures to reduce stress in your life, such as eating well, exercising and getting plenty of sleep. If you suffer from extreme anxiety or depression, seek professional help. Stress and control are risk factors for periodontal disease and cardiovascular diseases. When an individual feels stressed, adrenaline and stress hormones (e.g., cortisol) are released to prepare the body for the “fight-or-flight” response.While stress is a normal part of life, excessive stress can lead to health problems and lifestyle behavioural changes (e.g., taking up or increasing smoking, increasing alcohol intake, changing dietary habits, becoming physically inactive, neglecting oral and personal hygiene) which further increase health risks.
Chronic stress speeds up the process of atherosclerosis in the coronary arteries and that the stress hormone cortisol plays a role in increased periodontal destruction. Cortisol also acts to suppress the immune system, allowing bacteria to flourish in the mouth.Exercise and stress management techniques provide individuals with tools to cope with the anxieties in their lives. The most effective way to deal with stress is by correcting or modifying its underlying causes.

Suggestions for Stress Reduction:
Exercise: Exercise promotes production of neurohormones like norepinephrine that are associated with improved cognitive function, elevated mood and learning. Exercise forces the body’s physiological systems –all of hich are involved in the stress response—to communicate more closely than usual. The cardiovascular system communicates with the renal system, which communicates with the muscular system. All of these systems are controlled by the central and sympathetic nervous systems which must also communicate with each other. The workout of the body’s communication system may be the true value of exercise. The more sedentary a person is, the less efficient the body is in stress response.
Be Grateful &Volunteer: Volunteering provides many benefits to both mental and physical health. It can increase self-confidence, provide a sense of purpose, combat depression, improve mood, reduce stress, reduce anxiety and promote feelings of gratitude.
Have Fun and be Silly: Fun activities in life may be one of the best stress relief solutions. While many responsible adults have adult-sized responsibilities that make it easy to put fun on the low end of the priorities list, letting your inner child come out to play can keep you feeling vital and happy. There are many benefits of having good old fun, so get inspired to play and relax today (even if just for a short time) and see how you feel.
Eat well: The more plant-based foods the better. They help to keep your body chemistry alkaline. Meats and other heavy protein foods, refined sugars, trans fats, fast foods and processed foods all set up an acid condition in the body, and an acid system produces inflammation, and inflammation causes stress.
Magnesium supplementation: To reduce stress my first and foremost recommendation is to take magnesium. But it has to be in the right form and you have to take enough of it. Magnesium is responsible for the activity of 700-800 enzyme systems that make energy, digest food, support the adrenal glands, detoxify heavy metals, relax your muscles and nerves and help you sleep well at night.
Be Present in Each Moment: When you’re basing yourself firmly in the present moment (rather than ruminating on past or anticipated stressors), you’re more open to happiness, laughter and having fun.
Meditate: Meditation can give you a sense of calm, peace and balance that benefits both your emotional well-being and your overall health. These benefits don’t end when your meditation session ends. Meditation can help carry you more calmly through your day and may improve certain medical conditions. When you meditate, you clear away the information overload that builds up every day and contributes to your stress. The emotional benefits of meditation can include, gaining a new perspective on stressful situations, building skills to manage your stress, increasing self-awareness, focusing on the present, and reducing negative emotions.
Positive affirmations: Positive affirmations are a great tool to reprogram your unconscious and subconscious minds from negative thinking to positive. The idea is to take positive statements and repeat them enough so that they’re part of your way of thinking and seeing the world; this operates in the same way that negative self-talk does, but in a way that benefits you. By repeating calming, soothing positive affirmations to ourselves we can feed the body nourishing mental energy.

(The author is owner at Dr, Sharma’s Dental Care, CMPDI Road, Shobhalok Building and Chairwomen of SSD Seva Mission and SNA Social Welfare Foundation Medical Branch, Nagpur)