Effects of Stress on Our Oral Health
Research shows that stress and anxiety take a toll on our health. In fact, more than 70% of dentists surveyed have seen an increase in the evidence of bruxism among their patients since the onset of the COVID-19 pandemic. In this article, we will focus on the specific ways in which stress can affect oral health.
What are Signs of Stress that can Manifest Orally?
Many adults are under some level of stress. High levels of stress or chronic, ongoing stress can wear on the health of your mouth. The most common manifestation of stress in the oral cavity is heavy clenching or grinding of the teeth. This subconscious habit can occur during sleep or waking hours, especially when concentrating.
The scientific term for clenching and/or grinding of the teeth is bruxism. Bruxism leaves visible signs inside the mouth that your dentist will note during an oral evaluation.
Clenching and grinding can slowly erode the enamel on your teeth, making it difficult to notice the subtle changes in your smile. However there will be visual queues that can alert your dentist to the condition. Signs of bruxism include:
shortening or flattening of the teeth
notches in the teeth near the gums
callous lines on the inside of the cheeks
scalloping of the sides of the tongue
When your dentist sees these signs, he or she will alert you to the potential that you are clenching or grinding your teeth. Your dentist will also ask questions in order to gauge if you may be exhibiting these signs of stress during the day or at night. The natural position of your teeth is a small or slight separation. If your teeth are often touching at times that you aren’t chewing, you could actually be clenching. It is important to know about this habit so you can protect your teeth from serious damage.
What are Stress-Related Dental Conditions, and How Can We Treat Them?
The dental conditions that potentially arise from stress are the result of either bruxism or parafunctional habits. A parafunctional habit is one in which a patient uses the teeth and/or jaws for something aside from chewing. This could include someone biting her fingernails, a pen, pencil or opening packets and other non-food items. It’s important to note that
Stress-related dental conditions include the following:
• TMD - Temporomandibular Disorder occurs when there is a problem with one or both jaw joints (TMJs). TMD can include pain in the joints, limitation of movement of the lower jaw, clicking or popping sounds in the joints, or locking of the joints. TMD can be a serious condition that negatively impacts one’s quality of life. TMD treatment can include splint therapy, physical therapy, chiropractic care, anti-inflammatory injections in the joint, joint surgery, and bite equilibration.
• Cracked Teeth - Under the excessive forces of bruxism, back teeth often crack. Cracked teeth can cause sensitivity to cold and pain on chewing. If the crack enters the nerve it can cause an infection in the tooth or surrounding tissues and eventual loss of the tooth. Treatment for a cracked tooth depends on the extent of the crack. Those extending onto the tooth’s root give the tooth a hopeless prognosis, so it must be extracted and replaced. Others often require coverage of the tooth with a dental crown.
• Chipped Teeth - Many people with bruxism experience chipping of their teeth. This leads to jagged edges that can be sharp to the lips and tongue. It also creates a suboptimal esthetic appearance of the smile when those chips occur in the front teeth. Treatment depends on the extent of the lost tooth structure. Minor chipping may require smoothing only. Your dentist may need to rebuild the lost tooth structure with a tooth-colored filling material or a dental crown.
• Sensitive Teeth - Sensitive teeth often respond to desensitizing agents, such as toothpastes or gels. For some people, relief is only found through removing the heavy forces of bruxism by wearing a protective mouthguard.
• Receding Gums - Gum recession often results from heavy clenching and/or grinding due to the excessive forces applied to the teeth and the surrounding tissues. Gum recession is very difficult to treat. Most treatments aim to stop the recession from progressing. Reversing the recession and providing coverage of the exposed roots is not an easy thing to achieve. Through various gum surgeries, a gum specialist can provide “new” gum tissue coverage over the roots of teeth. It is essential to understand, though, that if you have not treated the underlying cause of the recession, treatments to reverse it are unlikely to succeed.
What are Symptoms of Stress that can Manifest Orally?
The negative impacts of stress that start in your mouth can spread to other areas of your body. Patients who clench or grind their teeth will likely experience some combination of the following symptoms at some point.
• Jaw Muscle Pain - When someone clenches or grinds the teeth, the muscles of the jaws that close the teeth together are hyperactive. Overworking these muscles leads to soreness, tenderness, or pain. The largest muscles are in the cheeks and temples, and these are common sites of pain in patients with bruxism.
• Joint Pain - Heavy clenching or grinding causes compression in the jaw joints (TMJs). Bruxism often causes joint pain similar to arthritis. Due to the location of the jaw joint, this symptom can be misidentified as ear pain. Pain in the joints may occur only when chewing food or upon waking after clenching throughout the night. Some people also experience pain during speaking due to inflammation in the joint(s).
• Ringing in the Ears - The compression in the joint and its proximity to the ears often causes tinnitus, or ringing in the ears. This persistent symptom can be very frustrating to patients, leading them to seek care from a medical doctor or ENT. After ruling out infections or other ear problems, you should investigate the issue with your dentist.
• Chipped or Cracked Teeth - Bruxism applies forces to the teeth that are heavier than the teeth can withstand. This often results in chipped front teeth or cracked back teeth. The risk is greater for teeth that already have existing fillings, which makes them weaker than natural teeth. Many people with bruxism end up with jagged biting edges of the front teeth due to constant microtrauma from clenching or grinding over a sustained period of time.
• Sensitive Teeth - The increased pressure applied to teeth often causes inflammation of the nerves within the hollow center of the teeth. The result is hypersensitivity in otherwise normal, healthy teeth. The sensitivity associated with bruxism usually arises from cold stimuli.
• Headaches - Bruxism can affect muscles in other regions of the head, neck and shoulders. The increase in muscle tension can expand to include muscles outside the jaws, and the elevated muscle tension often leads to headaches.
What Can I Do to Minimize the Effects of Stress on my Oral Health?
Now that you understand the negative effects stress can have on your mouth, you may be wondering how to protect yourself against them. There are countless techniques for stress reduction and management recommended by health professionals. It may take some experimentation to find a technique that helps you deal with your stress levels in a healthy way. Regardless of your stress management technique, you can protect your teeth from the irreversible damage that stress can cause.
The best way to improve your oral health and fight the effects of stress is to prevent the damage associated with bruxism. The best protection against bruxism is a custom-made professional mouthguard. Most people need to wear this appliance while sleeping to protect the teeth from clenching and grinding habits that they cannot control.
Some people also add stretching and physical therapy-type exercises to their bedtime routine to relax jaw muscles and loosen the joint.
During the daytime, it requires a conscious effort to stop clenching, grinding, or parafunctional habits. The only time your teeth are meant to touch is when you are chewing. If you feel it happening more frequently than that, this is considered daytime clenching. Clenching is common during work-outs, commuting in traffic, or concentrating on a particular task. One way to address these habits is to set alerts or alarms throughout the day that cause you to stop and evaluate the status of your jaw. If you find yourself clenching, grinding, or chewing on something that isn’t food, stop and swallow. Then place your tongue between your upper and lower teeth. Performing this throughout the day will help you break the cycle of constant daytime bruxism.
For more specific recommendations unique to you, speak to your dentist about other treatment options that could help protect your teeth from the damage of bruxism.
The Effects of Stress on Oral Health: Your Next Steps
Unfortunately, stress is a normal part of everyday life for most Americans. It is important to manage your stress in a way that allows you to maintain good oral and overall health. In order to protect your teeth from the effects of stress, speak to your dentist about preventive measures you can take to protect your teeth today.