Stress is a common and often underestimated factor influencing systemic and oral health.
📌 Recommended Article :
Dental Article 🔽 How does hypertension affect oral health? ... Although our understanding of the pathophysiology of elevated arterial pressure has increased, in 90 to 95% of cases the etiology is still largely unknown.Chronic psychological stress has been strongly associated with multiple oral conditions, affecting both hard and soft tissues. Through neuroendocrine, immunological, and behavioral pathways, stress can significantly compromise oral health outcomes and dental treatment success.
Advertisement
✅ Biological Mechanisms Linking Stress and Oral Health
Stress activates the hypothalamic–pituitary–adrenal (HPA) axis, increasing cortisol levels. Elevated cortisol:
▪️ Suppresses immune response
▪️ Alters inflammatory regulation
▪️ Reduces salivary flow
These changes create a favorable environment for oral disease progression.
📌 Recommended Article :
Dental Article 🔽 Lingual Coating: Causes, Characteristics, Bacterial Profile, Consequences, and Treatment ... Lingual coating, also known as tongue biofilm or tongue plaque, is a common condition in the oral cavity characterized by a whitish, yellowish, or brownish layer on the dorsal surface of the tongue.✅ Stress-Related Oral Conditions
1. Bruxism and Temporomandibular Disorders
Psychological stress is a major risk factor for bruxism, leading to:
▪️ Tooth wear
▪️ Dental fractures
▪️ Muscular pain
▪️ Temporomandibular joint disorders (TMD)
2. Periodontal Disease
Stress is associated with increased periodontal inflammation and attachment loss. Behavioral factors such as poor oral hygiene and smoking often coexist, compounding disease severity.
3. Xerostomia
Stress-induced autonomic dysfunction can reduce salivary secretion. Xerostomia increases the risk of caries, oral infections, and discomfort, negatively affecting quality of life.
4. Oral Mucosal Conditions
Stress has been linked to:
▪️ Recurrent aphthous stomatitis
▪️ Lichen planus exacerbations
▪️ Burning mouth syndrome
📌 Recommended Article :
Dental Article 🔽 Can Malocclusion and Stress Cause Headaches and Dizziness? ... Recent studies suggest that dental malocclusion and psychological stress act as risk factors that can lead to temporomandibular disorders (TMD), which in turn may result in craniofacial pain and vestibular symptoms.✅ Behavioral Pathways
Stress often leads to:
▪️ Neglect of oral hygiene
▪️ Increased consumption of sugary foods
▪️ Tobacco and alcohol use
▪️ Missed dental appointments
These behaviors amplify the biological effects of stress on oral health.
📊 Comparative Table: Stress-Related Oral Conditions
| Aspect | Advantages | Limitations |
|---|---|---|
| Bruxism Awareness | Early detection prevents tooth damage | Requires patient compliance and stress control |
| Periodontal Monitoring | Improves long-term periodontal outcomes | Stress-related inflammation may persist |
| Xerostomia Management | Reduces caries and discomfort | Does not address underlying stress |
Current evidence highlights that stress acts as both a direct and indirect risk factor for oral disease. While biological mechanisms such as immune suppression play a role, behavioral changes significantly contribute to disease progression. Dentists are uniquely positioned to identify early oral signs of chronic stress and initiate preventive or interdisciplinary interventions.
📌 Recommended Article :
Dental Article 🔽 How Do Sodas Affect Your Teeth? Understanding the Hidden Dental Risks ... Sodas are among the most consumed beverages worldwide, but their high acidity and sugar content make them harmful to dental health.🎯 Clinical Recommendations
▪️ Screen patients for signs of stress-related oral conditions
▪️ Educate patients on the oral–systemic link between stress and disease
▪️ Consider occlusal splints for stress-related bruxism
▪️ Encourage stress management strategies alongside dental treatment
▪️ Promote regular dental visits during periods of high psychological stress
✍️ Conclusion
Stress has a profound and multifactorial impact on oral health, influencing inflammatory responses, salivary function, and patient behavior. Recognizing stress as a modifiable risk factor allows dental professionals to adopt a more comprehensive and preventive approach to care, ultimately improving oral and overall health outcomes.
📚 References
✔ Genco, R. J., Ho, A. W., Grossi, S. G., Dunford, R. G., & Tedesco, L. A. (1999). Relationship of stress, distress, and inadequate coping behaviors to periodontal disease. Journal of Periodontology, 70(7), 711–723. https://doi.org/10.1902/jop.1999.70.7.711
✔ Peruzzo, D. C., Benatti, B. B., Antunes, I. B., Andersen, M. L., Sallum, E. A., & Casati, M. Z. (2007). Chronic stress may modulate periodontal disease. Journal of Periodontology, 78(8), 1491–1499. https://doi.org/10.1902/jop.2007.060477
✔ Manfredini, D., Lobbezoo, F., et al. (2017). Stress, sleep, and bruxism. Journal of Oral Rehabilitation, 44(9), 722–736. https://doi.org/10.1111/joor.12527
✔ Turner, M. D., & Ship, J. A. (2007). Dry mouth and its effects on the oral health of elderly people. Journal of the American Dental Association, 138(Suppl), 15S–20S. https://doi.org/10.14219/jada.archive.2007.0358
📌 More Recommended Items
► Dental Considerations in Pregnant Patients: Updated Clinical Guidelines
► Best Toothpaste for Sensitive Teeth: What Science Says
► Clindamycin in Pediatric Dentistry: Indications, Dosage, and Clinical Considerations
