Feb. 23--At one time or another, we've all dealt with the effects of chronic stress -- from migraines and backaches to anxiety and depression.
But stress -- and our response to it -- also can do a number on the mouth, teeth, jaws and gums.
"We all know that stress can impact the immune system," said Dr. Douglas Smail, an oral and maxillofacial surgeon affiliated with Samaritan Hospital in Troy, N.Y. "You can't necessarily point to a particular dental problem and say it's caused by stress. But like the rest of the body, the mouth can be affected."
The potential fallout from stress and anxiety on oral health is jaw-dropping. Conditions include the clenching or grinding of teeth, or bruxism; mouth sores, including canker and cold sores; and poor oral hygiene. The Centers for Disease Control identified stress as one of the top risk factors for periodontal disease.
Smail, who practices at East Hudson Oral and Maxillofacial Surgery in Troy, sees at least one patient for bruxism every day. The effects can be extremely damaging to the jaws and teeth.
"These patients may have a cracked tooth that needs to be removed. They might not be able to chew correctly. There may even be a loss of teeth to the point where dentures are required," he said.
The worst aspect of bruxism is that it most commonly occurs at night, "so it's not something you can consciously control," Smail added. Grinding your teeth at night might lead to serious jaw pain in the morning.
But the effects of stress on dental health don't end there. Stress can also cause irritating canker sores -- little white bumps, or ulcers -- that appear inside the mouth.
Doctors aren't positive how the sores surface, but "stressful episodes can bring them out," said Dr. Paul Rockoff, an oral and maxillofacial surgeon affiliated with Bridgeport Hospital.
"Stress can lead to recurrent cold sores," he added. "And they can make existing ones worse."
While stress can have a direct impact on oral health, the way in which we respond to that stress also comes into play. Smoking is a major example, as is an unhealthy diet and poor oral hygiene. The effects can be crippling -- dry mouth, tooth decay, gum disease and in the case of smoking, mouth cancer.
In some instances, people may be so bogged down by stress -- and related ailments, such as anxiety and depression -- that they simply neglect oral hygiene. In a 2009 study in the Journal of Periodontology, 56 percent of test subjects reported that stress led them to disregard regular brushing and flossing.
"People may be suffering from fluctuations in mood, so they don't have the desire or motivation to take care of dental health," said Justin Schechter, attending physician in psychiatry at Stamford Hospital and assistant clinical professor of psychiatry at the Yale School of Medicine in New Haven. "Some patients with depression can barely get out of bed, let alone floss or brush their teeth."
However, there are several ways of mitigating the backlash of stress on oral health. By wearing a night guard at bedtime, people can reduce damage to teeth and jaw muscles from the grinding or clenching of teeth. A twice-annual visit to the dentist is the best way of pinpointing stress-related dental problems before they flare up.
However, doctors agree the most effective approach is to address the root of the problem -- the stress itself. Meditation, exercise, yoga or even a change of jobs might do the trick, they said. In more extreme cases, psychiatric help could become necessary.
In any case, it's important to be aware of your stress level -- not just as it relates to the mind and body, but to your smile.
"We need to be open to this discussion and recognize the stress in ourselves," Smail said. "It's important to realize this is not good for me, and seek help."
Stress can impact your smile:
Bruxism -- Stress can cause grinding or clenching of teeth, which can lead to cracked teeth and problems with the temporomandibular (jaw) joint. Doctors may prescribe a night guard to protect against nighttime grinding and clenching.
Poor oral hygiene -- Stress can affect your mood and cause you to skip brushing and flossing. This can lead to gingivitis, cavities and gum disease. It's important to schedule twice-annual visits with a dentist and remain diligent when it comes to dental hygiene.
Unhealthy habits -- Stress can drive you to bad habits, such as smoking and consumption of sugary foods. Recognize and remedy your bad habits, as it can impact oral health and in the case of smoking, cause cancer.
Mouth sores -- Stress can cause or inflame existing canker sores and cold sores. Sores may last for up to 10 days, but over-the-counter topical anesthetics can soothe the pain.
-----
To see more of The Stamford Advocate, or to subscribe to the newspaper, go to http://www.stamfordadvocate.com.
Copyright (c) 2011, The Stamford Advocate, Conn.
Distributed by McClatchy-Tribune Information Services.
For more information about the content services offered by McClatchy-Tribune Information Services (MCT), visit www.mctinfoservices.com.