April is National Stress Awareness Month. Everyone has stress in their lives and that stress takes its toll on nearly every part of our bodies. The stress response is part of our body’s sympathetic (fight or flight) response controlled by our autonomic nervous system. During a stress response (such as a lion coming at us), the adrenal cortex releases cortisol, a steroid hormone that, in short bursts, is good for the body. It controls inflammation, regulates blood pressure, and maintains homeostasis, which is why corticosteroid drugs are administered for certain health conditions. However, an excess of cortisol due to chronic stress can be detrimental to the body. Too much cortisol can lead to problems, including a loss of sleep, immune system suppression, and weight gain.
Studies have also shown consistent links between heart disease and self-reported psychological stress, social isolation, and other stress-related factors. Chronic stress leads to an increased risk of coronary heart disease, while short-term stresses can trigger a cardiac event in patients with existing atherosclerosis.
Oral health is an area of the body particularly affected by increased cortisol levels. Here are a few of the most common ways stress affects oral health.
Bruxism — Also known as the clenching and grinding of teeth, bruxism is a parafunctional activity (or, a bad habit) that can wear down your teeth, increase your likelihood of tooth decay, and make your teeth lose their precision. The front teeth can also shorten, causing the lips to sag inward due to lack of support, which makes you look years older. The front teeth are also critical for function as they separate the back teeth when we chew. Most people do clench and grind their teeth at night, and aren’t even aware they do it. This can cause long-term joint pain and significant damage to your teeth. If you suffer from bruxism, consider jaw alignment or wearing a night guard to protect the teeth from wear due to grinding before there is tooth loss. During three meals’ worth of chewing, our teeth experience only 12 minutes of tooth-to-tooth contact. In comparison, bruxism causes hours of tooth-to-tooth contact and results in rapid wear.
TMJ — Temporomandibular joint disorder is a condition that affects the hinge joint connecting the upper and lower jaw. Stress can play a major role in the development of TMJ since high levels of stress can cause some people to unconsciously clench and overuse their jaws, which can lead to painful joint pain.
Gum Disease — When we are stressed, we often lose sleep, revert to unhealthy habits, and may feel inclined to skip brushing or flossing. If we are not flossing as much we should, or are rushing through our oral care regimen, the combination of inflammation in the mouth and the wear of grinding or clenching accelerates the effects of gum disease.
Canker Sores — Canker sores are non-contagious mouth ulcers that occur on the inside of the mouth. They can be brought on by minor trauma to the mouth, like bites or cuts on the inside of your cheek. Stress is believed to be a contributing factor to canker sore development since it can slow the healing process and dampen the body’s immune response. To minimize discomfort, it’s a good idea to avoid spicy foods when you have a canker sore.
Cold Sores — Not to be confused with canker sores, cold sores are contagious lesions of the mouth or lip area caused by the herpes simplex virus (HSV-1). Once you’re infected with the virus, you have it for life, but flare-ups are usually triggered by stress. Cold sores tend clear up on their own in about a week, but some people can have more painful and serious symptoms. If cold sores are causing you serious issues, talk to your doctor about options for medications that may help.
Dry Mouth — Saliva is crucial for a clean, healthy mouth. It contains bicarbonate, calcium, and phosphate, which help to neutralize the acid from plaque, repair early tooth damage and prevent decay. Under stressful conditions, the mouth may produce less saliva than normal, resulting in xerostomia, or dry mouth syndrome. This shortage of saliva can increase the likelihood of dental decay.
Unfortunately, stress takes a toll on children too. As well as the problems listed above, stressors in children’s lives such as death, divorce, or economic troubles can lead to poor dental hygiene habits and unhealthy diets full of sugary foods, both of which lead to tooth decay. Stress can also cause children to revert back to habits like thumb-sucking or bruxism, which are both harmful to the mouth and teeth.
Being aware of the stresses in your life and learning how to cope with them effectively can be hugely beneficial for your oral health as well as your overall health, since the same things that cause the body to break down have a similar impact on the impact of our mouths. Remember, a healthy mouth is a healthy body.