From gum disease to bad breath, is stress sabotaging your oral health?
Medically reviewed by Dr Louise Wiseman MBBS, BSc (Hons), DRCOG, MRCGP and words by Jenny L. Cook
From work to relationships to general health, stress can have a huge impact on all aspects of life, but most people don’t realise just how much tension and anxiety can affect your oral health too.
We speak to dentist Dr Richard Marques about the different ways your teeth, mouth and general health can suffer at the hands of stress, and what you can do to look after your wellbeing and your oral hygiene:
Translucent or shortened teeth and stress
Normal, healthy teeth should be opaque, but sometimes the edge of the teeth appears somewhat translucent. This can be there from your early years in conditions like coeliac disease that can affect enamel development, or later from acid erosion from certain foods or repeated exposure to stomach acid such as in acid reflux conditions or bulimia.
If you have never noticed it before and the teeth seem to be becoming somewhat more translucent along the edge or even shortening over time discuss with your dentist. Could this be stress related or even part of ageing?
Book a massage, take a holiday or try mindfulness meditation to keep your stress in check.
‘Translucent teeth may be due to Bruxism, otherwise known as grinding of the teeth,’ says Dr Marques. According to The Bruxism Association, up to 70 per cent of bruxism can be attributed to stress, so prioritise addressing your anxiety levels. Book a massage, take a holiday or try mindfulness meditation to keep your stress in check.
Once you’ve addressed the root cause, you may need a bite guard to protect your teeth from wearing further says Dr Marques. ‘Most of the time, people who grind their teeth or clench their jaw aren’t aware they are doing it, or do it while they are asleep, which is why a mouth guard may be the most successful treatment method.’
Aching or clicking jaw and stress
It is estimated that up to 30 per cent of adults will experience an aching or clicking jaw at some point in their lives. This is sometimes referred to as temporomandibular disorder (TMD) or myofascial pain disorder.
Sometimes people develop TMD without any obvious causes but if in doubt, it might be time to explore relaxation techniques to address your stress levels.
‘A clicking or uncomfortable jaw is a common sign of stress,’ says Dr Marques. ‘You may need a treatment for the jaw, such as a special splint or even Botox to relax the muscle.’
Bleeding gums and stress
A small amount of blood in the sink when you spit out toothpaste might not seem like a big deal, but consistently bleeding gums should not be ignored.
Visit your dentist to check that your brushing and flossing routine is correct and don’t forget to work on your stress levels too.
Bleeding gums are a symptom of gum disease such as gingivitis or periodontitis, which can be caused by stress.
‘Bleeding gums are a symptom of gum disease such as gingivitis or periodontitis, which can be caused or exacerbated by stress,’ says Dr Marques. ‘You might need a gum treatment in some cases, such as a deep clean root planing.’
Dental abscesses and stress
A dental abscess is a collection of pus – caused by a bacterial infection – that can form inside the teeth, gums, or bone around the mouth. Although dental abscesses rarely cause long-term problems, they can be painful and need attention – as they do not go away on their own. Always see your dentist.
‘An abscess can sometimes occur during times of stress, as your body’s ability to fight off infections can become compromised,’ says Dr Marques. ‘Antibiotics or further treatment will be required for this.’
Root canal problems and stress
Damaged tissue or infections within the root canal can be extremely painful – as can the treatment for it and stress can exacerbate this, so try to keep your anxiety levels down.
‘Issues with root canals – the area inside the tooth – can be caused by stress if the grinding becomes so severe that the nerves of the teeth are exposed,’ says Dr Marques. ‘Root canal treatment may then be needed to remove the nerve from the teeth.’
Bad breath and stress
Bad breath, otherwise known as halitosis, is thought to affect as many as one in four people in the UK and stress definitely won’t help the condition.
Stomach acids can build up in times of stress, potentially leading to acid reflux that causes bad breath.
‘Stomach acids can build up in times of stress, potentially leading to acid reflux and other compounds that cause bad breath,’ says Dr Marques. ‘If this becomes a concern, you will need to see your GP and may need treatment with antacids or other medication. If it persists, further investigation into the stomach lining may be required.’
Cheek biting and stress
The self-injurious habit of cheek biting is a repetitive action that is linked almost entirely to stress and anxiety.
‘Biting the inside of your cheeks is a definite sign of stress, or – more accurately – it is a habit people develop to cope with stress,’ explains Dr Marques. ‘In serious cases, acupuncture or hypnosis are treatment options that can be used to relax and prevent cheek biting.’
If your cheek biting habit is stress-related or an obsessive-compulsive issue, then you might benefit from cognitive behavioural therapy (CBT).
Stress busting tips
If you find yourself persistently injuring the inside of your mouth – whether that be through teeth grinding, cheek biting or otherwise, there are a few simple steps you can take to reduce stress and promote good oral health:
- Identify your triggers
Once you know what sets you off and triggers your stress levels, you can then address these and put preventative measures in place to stop it from happening.
- Exercise regularly
Something as simple as a short walk can provide immediate relief in stressful situations, so make the most of this useful tool to combat anxiety and tension and try to get outside for at least 30 minutes a day.
- Give yourself time to relax before bed
Not only will a bedtime routine improve sleep quality, but getting enough shut-eye also means you’re less likely to grind your teeth, so prioritise a good night’s sleep by switching off gadgets and hour before bed.
- Avoid unhealthy habits
Smoking, drinking and unhealthy eating are all proven to make stress worse and they can also cause various oral health issues such as tooth decay, halitosis and gum disease, so take care of your entire body to get the best from your oral health.
- Be kind to yourself
Stress can be self-perpetuating so give yourself a break, accept the things you cannot change and try to be positive. In the words of Buddha, ‘you, yourself, as much as anybody in the entire universe, deserve your love and affection.’