How Stress Contributes to Dental Damage

When Demi Moore claimed on the June 12th episode of the Tonight Show that stress “sheared off” her teeth, many alarmed viewers and dental professionals wondered what she was talking about. But leaving aside the mystery of what exactly happened to her, there are, in fact, there are two ways in which stress is known to be a factor in tooth damage: periodontal disease and teeth-grinding. To lose an entire crown or more would only happen in the most extreme cases, but weak teeth and enamel erosion are not uncommon among people suffering from chronic stress.

Gingivitis is defined as inflammation of the gums. Whether stress contributes directly to inflammation has been the subject of several recent studies which are not yet conclusive. However, it is known that stress weakens the immune system, which would consequently have a harder time resisting bacterial infections. When bacteria multiply excessively they trigger more severe and widespread inflammation, called periodontitis, which damages the jaw structure. This can cause teeth to come loose as their gum and bone support recedes, and tooth loss is not out of the question. But no matter how bad stress gets, periodontitis requires bacterial infection, so maintaining proper oral hygiene is the best line of defense against it.

The better-evidenced way in which stress contributes directly to tooth damage is teeth-grinding, which is medically referred to as bruxism. This behavior is often done involuntarily during sleep without the patient even being aware of it. One cause of bruxism is sleep apnea, which the body may respond to by pushing the jaw forward in order to keep the airways open. But sleep apnea is believed to be more a cause of stress than a result of it. On the other hand, stress is usually a contributor to temporomandibular joint disorders (TMD or TMJ disorders), which cause a person to clench their jaws together. Pressure and grinding on the teeth will cause the cuspids to wear away and the enamel to rub off, leaving teeth flat and with less material protecting their internal layers. Grinding and clenching can also cause teeth to migrate or become misaligned, which weakens the structure supporting them, and conversely, misaligned teeth are another cause of grinding.

The most serious cases of weak or severely eroded teeth would likely be due to a combination of factors. Dry mouth, for example, which is a common side-effect of anxiety medications, also makes it more difficult for the body to resist oral infections. Teeth that have already been replaced with implants are vulnerable to inflammation and dentists debate the role of bruxism in implant failure. One common way of avoiding the damage of TMJ is with a custom-fitted mouthguard, which keeps a patient’s jaws in place and shields the teeth from being rubbed against. TMJ patients are also commonly prescribed stretching exercises and may need psychological help for dealing with stress. But, as Moore said, modern dentistry has many ingenious ways of repairing and replacing damaged teeth.

Don't Fear the Dental Chair

Most of us look forward to visiting the dentist just as much as we look forward to visiting the car dealership for an oil change. We know it’s a task that needs to be done, but sometimes we just don’t care to do it. For others, however, there is a serious phobia associated with visiting the dentist’s office. In fact, they may be so frightened, that they’ll do just about anything to avoid a dental appointment. Research shows that between 5% and 8% of Americans avoid dentists out of fear, while 20% experience enough anxiety to where they will only visit the dentist when absolutely necessary. People may develop dental anxieties for different reasons, but if you fall into this category, it’s important to understand that you are not alone.

Downfalls of Dental Fear

Those who suffer from dental anxiety and dental fear tend to put off appointments for years. While these traits can result in stress and lack of oral care, it can also have additional consequences. These can range anywhere from developing periodontal disease, tooth decay, tooth infections and potential early tooth loss. Dental fear can also have a serious effect on self-esteem. Some people can become so embarrassed by their poor smile that their personal and professional lives may begin to suffer.

Understanding the Problem

Before you can overcome your fear, you have to understand what causes it in the first place. Some folks may find it helpful to write a list of specific fears. In order to overcome your fear of the dentist, write a list of what is causing your anxiety. Perhaps it’s a cavity filling gone wrong, or maybe you’ve been poked with a dental scaler one too many times. Be sure to take this list to your dentist and discuss your fears with him or her so he or she can offer rational explanations for whatever is causing the problem.

What the Dentist Can Do

No matter how severe dental fear may be, many dentists are specially trained in handling patients with dental phobia and dental anxiety because they are committed to building confidence and trust. Frequently used techniques include psychological approaches such as:

  • Tell-show-do – This involves the dentist explaining to you what they are going to do during the procedure, showing you what is involved, and performing the procedure.
  • Structured time – where the dentist will break up a procedure into manageable chunks, and/or take frequent breaks to assure you aren’t overwhelmed.
  • Positive reinforcement – this one sort of speaks for itself as the dentist will tell you how great you are doing during the dental procedure.

In addition to these psychological approaches, a dentist may suggest sedation dentistry. This involves the dentist administering a sedative such as nitrous oxide or light oral sedation, while the patient is alert and awake to reach a state of relaxation.

*This newsletter/website is not intended to replace the services of a doctor. It does not constitute a doctor-patient relationship. Information in this newsletter/website is for informational purposes only & is not a substitute for professional advice. Please do not use the information contained herein for diagnosing or treating any condition.