Can your dentist tell you’re stressed?
Short answer. Yes, stress can affect all areas of your health, including your oral health. Clinical oral manifestations of stress can appear different for everyone, but common signs are pain, tooth wear, mouth sores, and gum problems.
Orofacial pain is very common and typically comes and goes as stress levels change. Stress can cause clenching, producing fatigue in the muscles used to open and close your mouth, and also fatigue in the periodontal ligament which helps anchor the teeth into bone. Pain can also be found in the temporo-mandibular joint (TMJ) and could be signs of stress induced temporo-mandibular disorders, or TMD. Symptoms of TMD can be jaw clicking or popping, pain upon opening and closing, and difficulties chewing.
Stress can also cause bruxism, or the technical term for tooth clenching or grinding. Often times, this stress related bruxism happens while you sleep therefore most people are not aware of their clenching or grinding habits. Symptoms to be aware of include flattening tips of your teeth, increased tooth sensitivity, and indentations on your tongue. The tooth wear caused by bruxism is one of the ways dentists and other oral healthcare providers can observe changes in your stress level.
Other clinical manifestations include canker sores and gum issues. Canker sores are not contagious and can arise from cheek biting or overly aggressive brushing, both habits that can be related to stress. Additionally, a study conducted by the Academy of General Dentistry indicated that increased levels of stress, specifically in students, correlated with increased appearances of canker sores. Stress can also aggravate gum issues from reduced immune function that provides destructive bacteria the opportunity to produce gum inflammation and discomfort, or gingivitis. Signs of stress related gingivitis can be red, tender, painful gums that bleed when brushing or flossing.
Efforts to relieve stress can greatly reduce oral manifestations with the exception of tooth wear, once tooth structure is gone it cannot be replaced unless restored by a dental professional. Stress relief can be accomplished many ways, but frequently looks different for every individual. WebMD recommends exercise, guided deep breathing, making time for hobbies, and avoiding triggers as ways to reduce stress.
Sources:
1. “Stressed out? Your Dentist Can Tell.” Stressed out? Your Dentist Can Tell - Delta Dental, Delta Dental , June 2016, www.deltadentalins.com/oral_health/stressed_out.html.
2. Muzalev, K., et al. “Long‐Term Variability of Sleep Bruxism and Psychological Stress in Patients with Jaw‐Muscle Pain: Report of Two Longitudinal Clinical Cases.” Wiley Online Library, John Wiley & Sons, Ltd, 18 Dec. 2017, onlinelibrary.wiley.com/doi/full/10.1111/joor.12594?casa_token=a2psY5SYNkwAAAAA%3A90ZYtf3MiaxcKvEUK5wBqPX1MTcXd4eZPpdoW5yavg33smwYpDXG9zSZ1AWv6oS_bFgtzmFkv4ogvPCY2g.
3. Kaur, Sapanpuneet, and Jaskiran Nain. "Effect of Stress on the Oral Health." Journal of Advanced Medical and Dental Sciences Research 7.3 (2019): 118-122.
4. Breivik, Torbjørn, et al. “Emotional Stress Effects on Immunity, Gingivitis and Periodontitis.” Wiley Online Library, John Wiley & Sons, Ltd, 1 Oct. 2007, onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0722.1996.tb00087.x?casa_token=FZRPVu9HgGkAAAAA%3AycXmDRXkX4fMe0oAI7us6td6ij7U08tRfqX3EFs5cd44qdQEDW4T7xN7G1fV0sT3d02BCD_030vYNipVZw.
5. Ratini, Melinda. “Stress: Ways to Manage and Reduce It.” WebMD, WebMD, www.webmd.com/balance/guide/tips-to-control-stress.
