Growing health concerns, economic pressures and uncertainties stemming from the COVID-19 pandemic may be causing you to feel more stress than usual. In addition to affecting your mental health, stress can also affect your teeth. Paying attention to oral symptoms of stress can provide clues to how it’s affecting the rest of your body.
1. Teeth grinding and clenching
Grinding or clenching your teeth, known as bruxism, can be a sign of stress or anxiety.1 You may not be aware that you’re grinding your teeth. The most significant activity usually takes place in your sleep. But check several times each day to ensure your teeth aren’t clenched together. If you notice chips, flattened tips, or sharp edges, you may be suffering from bruxism. Teeth may also become more sensitive to temperature if they’re subject to excess forces.
When this crisis passes, your dentist can help determine if bruxism is putting you at risk for future problems. During COVID-19, elective dental care is difficult to find. But you don’t want bruxism to cause fractures or cracks that become an emergency. If your dentist offers teledentistry consultations, you may want to consider consulting them. If your dentist is not available, you may want to consider a store-bought nightguard to wear for now. If you continue clenching and grinding after COVID-19, and your dentist begins to see patients again, you should consider making an appointment in order to get the care you need.
2. Gum disease
Stress produces complex, detrimental effects on the body’s immune system. For example, our body’s ability to resist infections can lead to cycles of gum disease in susceptible patients. Over 50% of the adult U.S. population has periodontitis, the most severe form of gum disease.2
Stress is one factor behind the progression of this condition. In addition, oral infections further weaken immunity and allow harmful bacteria to spread into the body by entering the bloodstream through inflamed gums. Taking extra care when you can’t visit a dentist for regular cleanings during COVID-19 can help keep bacterial plaque levels down in your mouth.
3. TMD and TMJ
Temporomandibular disorders (TMD) describe conditions that affect the muscles and joints in your jaw. For example, pain in the temporomandibular joints (TMJ) in front of the ears isn’t normal. Sore jaw muscles or popping and clicking in your jaw indicate you may have TMD. Sometimes it even hurts to chew or open wide. Many headaches are related to muscle tension in the neck, jaw, and back.3
Clenching or grinding of your teeth can contribute to TMD through muscle tension. Jaw muscles under abnormal function tend to become sore and inflamed. According to the American Psychiatric Association, nearly half of Americans are anxious about the possibility of getting the coronavirus.4 The increased stress associated with COVID-19 can also lead to tight muscles in the neck and that further aggravates discomfort.
Most store-bought nightguards don’t eliminate muscle pain. But during COVID-19, you could try using one. If it worsens your pain, stop immediately. Your pain may diminish as life returns to normal but see your dentist when elective care resumes.
4. Dry mouth
Dry mouth, known as xerostomia, occurs when your saliva glands fail to produce enough saliva. Your mouth may feel parched and scratchy, and it may be worse at night when output drops further.
Xerostomia may result in response to certain medications, cancer treatment, or general medical conditions. Stress, anxiety, and depression have been shown to decrease the production of saliva, too.5 If you’re anxious and breathe through your mouth, the airflow may further dry out the oral tissues.
Drinking plenty of water helps increase saliva, and non-alcoholic mouthwash may help relieve your dry mouth. It’s important to identify the underlying cause of xerostomia. If you deal with dry mouth beyond stressful periods, be sure to talk to your dentist about causes, solutions, and preventive measures against tooth decay. Xerostomia can significantly increase the risk of cavities.6
5. Canker sores
Canker sores, also known as aphthous ulcers, are painful sores on the tissues of your mouth. An injury to the delicate oral mucosa can lead to ulcerations that take 10-14 days to heal. If you bite your cheek or tongue, for example, you may end up with a sore that takes time to heal.
Research also shows that stress can increase the risk of developing canker sores.7 The tissue breaks down when the immune system attacks the mouth lining, but the mechanism isn’t fully understood.
Most canker sores don’t require treatment, and there isn’t an easy cure once they develop. To reduce discomfort, you can apply a numbing agent, like Orajel, or other over-the-counter medications. Home remedies, such as a saltwater rinse, may also be helpful. During COVID-19 and other periods of stress, you may experience mouth ulcers and find they’re correlated to stress and anxiety.
Stress has complex, detrimental effects on your immune system, and that may increase your risk for oral infections. If you have a festering, low-grade infection, stress may cause a sudden increase in bacterial growth. On the other hand, if you have diabetes and gum disease, stress may cause both conditions to amplify. These conditions work against each other, and a cycle of aggravated disease activity can occur.8
Limit stress and look forward
Stress never really goes away, but COVID-19 has brought new levels of anxiety to many of us.9 Every step you take to reduce stress helps your system from head to toe. Make sure you get adequate sleep, include daily physical activity, deep breathing or meditation, and spend time connecting with family.
The limited availability of dental care during COVID-19 can add another form of stress. But your awareness and self-care can help limit the negative long-term effects of this experience. If your dentist offers teledentistry consultations, you may want to contact them. When the time is right, follow-up with your dentist regarding any concerns. A good dental insurance plan covers preventive care and check-up, and that helps you maintain your oral health for a lifetime.
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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice. This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.