Sunday, November 17, 2019

Over the past two decades, I have tracked a pattern throughout my patient population that I feel has directly impacted their oral health. This has been noted by comprehensive examination of patients of all ages, from toddlers to the elderly. It is nature for some, and nurture for others. It can be harnessed and controlled by few, but is destructive for most.

That pattern is called «stress.”

Why have I asked my patients about this through the years? What are the signs and symptoms that manifest themselves in the mouth that tip us off? Yes, we know coming to the dentist is stressful enough for some, but that’s episodic and can be handled by comforts that we have discussed in our past articles. However, the stress that physically reveals itself in the mouth is what I will outline in this article.

According to Merriam-Webster: “Stress is a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation.”

So who falls into this category? I’d say pretty much all of us. Professionals, parents, students, children, the elderly...all of us have something to stress about, and we all handle it in different ways. So, let’s discuss what we see when we say «Ahh...»

Recession, worn and chipped teeth, bleeding gums, jaw (TMJ) pain, mouth (canker) sores and overall fatigued facial muscles. Can this all happen from stress? The answer is yes! It’s finals week, wedding plans, career changes, our kids, our parents and  personal challenges that tell all in our mouths.

The most common symptom is bruxism. This is the technical term for grinding teeth and clenching jaws. Although it can be caused by 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. I have many parents telling me that they are concerned because they hear their children grinding their teeth outside their bedroom door when they are asleep. And, lo and behold, I see short worn teeth in their children’s mouths. It is 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; crowns and fillings appear worn or cracked; tooth enamel is rubbed off primarily by the roots or ‘necks’ of the teeth, causing extreme sensitivity and more susceptibility to infection and decay and tongue indentations and/or cheek biting. For some, TMJ pain and soreness is reported in the the facial muscles as well as directing over the joint by the ear; for others, waking up with headaches or soreness by your temple area are signs that you are suffering. Most of the time it’s very difficult to prevent this phenomenon; however, it is wise to protect from it. If you experience aching teeth and other symptoms of bruxism, see your dentist as soon as possible. If bruxism is due to misaligned teeth, straightening your bite with Invisalign or braces could help solve the problem. But if bruxism is due to chronic stress, stress management techniques may be needed to help relieve your aching teeth.

A mouthguard worn day or night, whenever appropriate, is recommended. This will save your teeth, limit recession, protect your jaw from wear and tear and serve as a shock-absorber for your joint. Discuss the options with your dentist as to what is the best appliance for you.

As for your kids, don’t worry, most grow out of it, and others will deal with it as they enter adulthood.

Gingivitis, mouth sores and acid reflux are also signs of stress. So brush and floss, stay away from spicy foods and watch your acidity intake while you are suffering from these symptoms. This will greatly improve your oral health and comfort.

Now that the weather is nice, go for a run, play a round of golf or a match of tennis, take a long bike ride, read a good book or do whatever relaxes you. You never know, maybe this will keep you smiling for many more years!a

With Dr. Brian M. Kalb

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