Stress affects oral health

Are you aware that when you get angry, your gums suffer?

happy young smiling womanEveryone knows that stress is harmful and can cause severe health problems. But what we don’t know is that stress-related health problems also include oral health concerns. There is mounting evidence that suggests a strong link between stress and gum disease. 57 per cent of recent studies reviewed showed a positive relationship between gum disease and stress and related psychological symptoms like distress, anxiety, depression, and loneliness. Although it is difficult to pinpoint the negative effects of stress on your gums, studies suggest that elevated levels of the stress hormone, cortisol, may be involved. In addition, stress may make people more lax about their oral health habits.

Individuals with high stress levels tend to increase their bad habits, which can be harmful to periodontal health. They are less attentive to oral hygiene and may increase their use of nicotine, alcohol, or drugs. Such individuals should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep, and maintaining a positive mental attitude.

Stress-related disorders

According to Harvard University research, stress can lead to bruxism, dry mouth, burning mouth syndrome, and lichen planus. If untreated, stress-related gum disease can also cause loss of teeth and loss of bone in the jaw. Symptoms include tender bleeding gums, swollen gums, bad breath, and loose teeth.


Bruxism is characterised by the grinding and clenching of teeth. The condition has been linked to work stress [Journal of Community Dentistry and Epidemiology] and personality type [Journal of Behavioural Medicine]. In the personality type study, it was found that people who were shy, apprehensive and given to worry, tended towards bruxism. When combined with erosion [the effects of acids on teeth from diet or other sources], bruxism can have devastating effects on teeth and may require extensive corrective treatment.

Unconscious clenching or grinding can lead to problems like:

  • Cracked teeth
  • Sensitive teeth due to wear of the teeth
  • Headaches, or tiredness of the jaws on waking
  • Flattened or chipped appearance of the teeth.

Treatment for bruxism includes the use of mouth guards / splints and relaxation techniques such as meditation.

Dry mouth

Dryness of the mouth can be caused by stress. More often, it may be caused by medications taken to treat stress, anxiety or depression. Reduced saliva in the mouth can have consequences such as:

  • Reduced taste and appetite
  • Increased tooth decay because of the lack of protection
  • Difficulty in wearing dentures due to lack of lubrication
  • Increased plaque accumulation and consequent increased gum disease
  • Greater wear of the teeth and subsequent sensitivity.

Burning mouth syndrome

Burning mouth syndrome [BMS] is a painful, frustrating condition often described as a scalding sensation in the tongue, lips, palate, or throughout the mouth. Although BMS can affect anyone, it occurs most commonly in middle-aged or older women.

Moderate to severe burning in the mouth is the main symptom of BMS and can persist for months or years. For many people, the burning sensation begins in late morning, builds to a peak by evening, and often subsides at night. Some feel constant pain; for others, pain comes and goes. Anxiety and depression are common in people with burning mouth syndrome and may result from their chronic pain.

Other symptoms of BMS include:

  • Tingling or numbness on the tip of the tongue or in the mouth
  • Bitter or metallic changes in taste
  • Dry or sore mouth.

With a little awareness and knowledge about oral care, there could be some prettier smiles around the world and less misery from tooth decay.

Prevention tips

man brushing teeth

  • Brush twice a day for at least three minutes each time and floss daily. If you’re not sure whether you’re brushing or flossing properly, your dentist or dental hygienist can show you the right techniques.
  • Always use toothpaste that contains fluoride.
  • Use a toothbrush with soft, polished bristles, as these are less likely to irritate or injure gum tissue. Be sure to replace your toothbrush at least every 3 – 4 months—a worn-out toothbrush can injure your gums. [Some toothbrush brands contain colour indicators on the bristles to remind you to replace them]
  • Eat a healthy diet. Avoid snacks and junk foods packed with sugar that plaque-causing bacteria love to feed on.
  • Don’t smoke. Cigarettes and chewing tobacco cause mouth irritation and are unhealthy for gums and teeth.
  • Visit your dentist regularly for routine check-up—especially cleaning—at least twice a year. Your dentist can remove hardened plaque and any tartar that cannot be removed by brushing or flossing.
  • Rinse thoroughly after every meal.
  • Try healthy snacks that don’t attack your teeth like celery and carrot snacks with hommous [dip made from chickpeas] or avocado dip, vegemite crackers with cheese, plain yogurt, fresh fruit and nuts.
Shantanu Jaradi
Shantanu Jaradi is an aesthetic dentist. He specialises in complex smile makeovers and smile enhancement cases. He is also the Director of the state-of-the-art Dentzz Dental Care Centres in Mumbai.


  1. I would really love to know how you are supposed to be able to eat raw carrots, celery and nuts with TMJ, sensitive, broken, cracked and missing teeth and swollen and sore gums – the result of years of bruxism. I live on soup and scrambled eggs.


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