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Stressed out? Your dentist can tell

Stressed out

More and more signs of stress are showing up in the dentist's office. During routine dental examinations and cleanings, dentists are able to detect oral symptoms of stress, including orofacial pain, bruxism, temporomandibular disorders (TMD), mouth sores and gum disease.

"It's hard for most people to identify how much stress they're experiencing and to what degree it's affecting their body until they get sick," said Kevin Sheu, DDS, director of professional services for Delta Dental. "Regular six-month dental checkups can be the first line of defense for detecting stress-related disorders early."

If you’re feeling tense or anxious, you should keep a watchful eye for signs of the following stress-related disorders.


Bruxism is the technical term for grinding teeth and clenching jaws. Although it can be caused by sleep disorders, an abnormal bite or teeth that are missing or crooked, it can also be caused by stress and anxiety. Nervous tension, anger and frustration can cause people to start showing the signs of bruxism without even knowing it.

Because people are often not aware that they grind their teeth, it's important to know the signs and to seek treatment if you suspect you may have bruxism. Some signs of bruxism include:

  • Tips of the teeth appear flat
  • Tooth enamel is rubbed off, causing extreme sensitivity
  • Tongue indentations

Your dentist can examine your teeth to determine whether you may have bruxism and, if so, can suggest the best method of treatment.

Temporomandibular disorders

TMD refers to a group of conditions that affects the jaw joint (temporomandibular joint) and the associated muscles used in moving the jaw and neck. Stress is thought to be a factor in TMD. Stressful situations can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth, as with bruxism. But even if you aren’t seeing signs of bruxism, such as flat tips of teeth or decreasing tooth enamel, you may still experience other symptoms of TMD, such as jaw joint pain or popping and clicking of the jaw. If you experience any of these, you should check with your dentist to see if TMD may be the cause.

Gum disease

Studies at State University of New York at Buffalo, the University of North Carolina and the University of Michigan found that emotional factors played a significant role in the development of adult gum (periodontal) disease. Researchers also discovered that the severity of gum disease increased with amount of stress (from spouse, children, lack of companionship, finances or work) experienced in a patient's previous 12 months.

In addition, the researchers found that those at greatest risk for gum disease were those who were highly emotional in dealing with financial problems. But there's good news: Patients who dealt with their financial strain in an active and positive manner had no more risk of severe gum disease than those without money problems.

Canker sores

Canker sores (or mouth ulcers) generally occur inside the mouth and are not contagious. They often are triggered by trauma such as biting your cheek, jabbing your gum with your toothbrush or even overzealous tooth cleaning.

Canker sores may also be triggered by stress. According to a report in General Dentistry, the Academy of General Dentistry's clinical, peer-reviewed journal, studies have shown that students have a high prevalence of canker sores, yet the sores appear less frequently during breaks and after graduation, when stress levels are lower.

Maintaining your oral health when stressed

One of the best ways to fight the negative effects of stress is to remove the source of stress. If it's not possible, counseling, exercise such as yoga or jogging, relaxation or meditation or even massage and physical therapy may help reduce your tension.

Depending on your symptoms, your dentist can also recommend specific treatments. For example, if you have bruxism, your dentist can fit you with a mouth guard to protect your teeth during sleep. For TMD, your dentist may suggest some adjustment, including orthodontic treatment, to correct teeth alignment that may be magnifying orofacial pain. Check your benefits to see what treatments are covered under your plan.

It's also important to continue to practice good oral hygiene.

"People who are going through stressful events tend to compromise their oral care," Sheu said. "To prevent stress from affecting your oral health, you should continue to brush twice a day, floss every day and have your gums and teeth regularly evaluated by your dentist."

Related reading

Last updated: June 2016

The oral health information on this web site is intended for educational purposes only. You should always consult a licensed dentist or other qualified health care professional for any questions concerning your oral health.