Stress and Your Smile: How to Protect Your Oral Health

Stress is something we all deal with in our day-to-day lives and stems from a number of sources covering everything from work and finances to our interpersonal relationships and health. While a little stress is normal, the stress many Americans are facing right now is unprecedented. According to the American Psychological Association (APA). In fact, in their “Stress in America 2020: Stress in the Time of COVID-19; Volume Two” report released in June, 8/10 Americans report, “the future of our nation is a significant source of stress.” So, what does all of this stress have to do with your mouth? More than you might think.
We’ve all heard that oral health affects our overall health, and it’s true. Because it can be difficult to gauge just how intensely your stress is affecting your body, twice-yearly visits to your dentist are essential for early detection of new or worsening oral health problems. The good news is that most of the following conditions have easy fixes you can do at home or with a dentists’ supervision.
The most common stress-related oral health concerns include:

  • Bruxism (teeth grinding)
  • Temporomandibular Joints (TMJ)
  • Gum Disease
  • Cold Sores
  • Dry Mouth
  • Canker Sores
  • Poor Oral Hygiene


Grinding your teeth, called bruxism, is common in adults experiencing stress and anxiety (and can be a side effect of some sleep disorders). While only about 10% of American adults grind frequently, most people have experienced this at least once or twice. Often, patients are unaware that they are grinding their teeth as it occurs most often during sleep. The worst bruxers among us can grind their teeth for 40 minutes out of each hour of sleep. During your waking hours, you might also find that you’re clenching your jaw when you’re stressed or concentrating.
When patients grind their teeth, they can exert 10x the normal amount of pressure it takes to chew your food. The most common signs that you might be a bruxer include:

  • The ends of the teeth appear flat, cracked or chipped
  • Tooth enamel is worn down, potentially exposing the sensitive dentin within
  • Indentations on the tongue
  • Waking up with a dull headache or unspecific pain the jaw

If you suspect you may be grinding your teeth, there are a few ways you can alleviate your discomfort and prevent further damage. Reducing your stress overall can go a long way towards keeping you from grinding at night, and being mindful of your stress levels during the day can help you to stop clenching. Often, this mindfulness alone can help you lessen or stop grinding altogether. Self-massages along the jaw, warm compresses, and reminders throughout the day to unclench your jaw can also provide relief.
Your dentist may also recommend a night guard to serve as a protective barrier between your teeth while you’re sleeping. Night guards are available both over-the-counter in most pharmacies and online, or your dentist can custom-fit a night guard for your teeth. If you’ve only recently started grinding, your dentist may recommend trying an over-the-counter night guard for a few weeks to see how efficient it is for you before committing to a custom night guard.


Nearly 10 million Americans suffer from pain in the temporomandibular joint, a horseshoe-shaped joint that hinges to allow you to open and close your mouth, as well as to slide the lower jaw down and forward, allowing you eat, yawn, and speak. Similar to bruxism, stress from clenching can contribute to TMJ discomfort.
TMJ can be difficult to diagnose because there isn’t a standardized form of testing. Everything from sinus problems to toothaches can mimic this generic discomfort in the jaw. Some symptoms are more telling though, these include:

  • Pain in or around the ear
  • Headaches and neck aches
  • Tenderness of the jaw or jaw muscles
  • Jaw pain or soreness that is more prevalent in the morning or late afternoon
  • Jaw pain when chewing, biting or yawning
  • Aching facial pain
  • Locking of the joint, making it difficult to open or close your mouth
  • Clicking or popping noises when opening the mouth
  • Sensitive teeth with no other dental problems found

It is important to note that sounds your jaw makes, such as clicking or grinding, may be present without pain or discomfort.
Luckily, the best treatment for soothing TMJ pain is to keep things simple: eat softer foods, alternate heat and ice packs, and avoid extreme jaw movements like big yawns. Oral splints and night guards can also help provide relief for some patients. If your pain persists or worsens, talk to your dentist.

Gum Disease

Gum disease, also known as periodontal disease, is a bacterial infection in the gums and bone around your teeth that affects about 50% of adults 30 years and older. As we age, our risk of periodontal disease only rises. If left untreated, gum disease can cause a myriad of oral health problems, up to and including tooth loss. Luckily, gum disease is not only treatable – it’s preventable.
When we experience long episodes of stress, it can affect our immune systems, and our ability to resist gum disease (and other infections) lowers. Studies conducted by State University of New York at Buffalo, the University of North Carolina, and the University of Michigan found emotional factors played a significant role in the development of gum disease.
Common symptoms associated with gum disease include:

  • Persistent bad breath
  • Red, tender, swollen, or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or teeth that appear longer

In order to keep gum disease at bay, patients need a combination of routine dental cleanings and exams and good at-home dental care. If your gum disease does progress, the good news is that it is treatable with deep cleanings from your dental hygienist.
If left untreated, the infection from gum disease can spread into the rest of your body, creating complications for patients with heart disease or diabetes.

Dry Mouth

Dry mouth, also known as xerostomia, happens when your saliva glands fail to produce enough saliva to keep your mouth hydrated. Most of us have experienced dry mouth at some point or another, whether as a side effect to a medication, a lack of hydration, or from – you guessed it – stress.
When we are stressed, anxious, or depressed saliva output drops, leaving you with a dry, parched mouth. If you catch yourself breathing through your mouth from anxiety, you may notice the airflow further dries out the oral tissue.
Staying hydrated helps more than just your mouth; it helps support your whole body. Avoid alcohol and tobacco products, as well as mouthwashes with alcohol in them, as these will dry your mouth out further. If your dry mouth problems persist, talk to your dentist about it.
While dry mouth is a common side effect of many medications, medical conditions, and even cancer treatments – there are solutions and preventative measures you can take to protect yourself against cavities and tooth decay. Simple solutions, like chewing sugar-free gum or savoring some hard candy can help promote saliva. Artificial saliva and oral rinses are also easy over-the-counter options to help combat dry mouth.

Canker Sores

Canker sores, also known as aphthous ulcers, are uncomfortable and sometimes painful sores on the inside of your mouth, most commonly on the cheeks or tongue. The lining of your mouth, called the oral mucosa, is very delicate and when you accidentally bite your cheek or tongue, you can create a canker sore that needs about one to two weeks to heal.
Research from both the National Center for Biotechnology Information (NCBI) and the Academy of General Dentistry shows that stress substantially increases the risk of developing canker sores.
Common triggers for canker sores (outside of accidentally biting yourself) include:

  • Extreme stress
  • Vitamin B deficiency
  • Hormonal imbalances
  • Sensitivity to sodium lauryl sulfate (a common foaming ingredient found in some toothpaste)
  • Allergic reactions to mouth bacteria

As annoying and painful as canker sores can be, most don’t need treatment. To make them more bearable, apply a numbing agent like Orajel. Other home remedies include warm salt-water rinse a few times a day.

Cold Sores

Cold sores are painful red blisters that appear on and around the lips and are caused by the herpes simplex virus (HSV) types 1 and 2. Almost half of all adults have been infected with HSV and it spreads easily from one person to another. For most people, the virus lays dormant until a trigger causes it to flare up, creating a cold sore. Because the virus that creates cold sores lives in the same nerves where it settled, flare-ups tend to happen in the same spot every time.
Common triggers that activate cold sores include:

  • Stress
  • Anxiety
  • Sunburn
  • Hormonal changes
  • Physical exhaustion

Fevers are also known to trigger cold sores, which is why they are sometimes referred to as “fever blisters.”
When a cold sore is about to erupt, patients report a slight tingling or tenderness at the edges of their lips. From there, it develops into a swollen red lump. In the next couple of days, the bump blisters, bursts, and crusts over. Once the yellow crust peels away, the cold sore secretes a clear liquid. All in all, cold sores take about two weeks to fully heal.
Treating cold sores can mostly be done from home, with over-the-counter antiviral ointments, which can help shorten the duration of the cold sore. Again, over-the-counter anesthetics like Orajel can help numb the discomfort. Applying ice to the area at the first signs of tingling can also help shorten the lifespan and sometimes even prevent it from erupting. If you experience frequent, painful cold sores, talk to your doctor about prescription antiviral medicines.

Poor Oral Hygiene

When we’re stressed, it’s easy to put aside things that we think we can wait – we brush our teeth too quickly or forget to brush before bedtime, we skip flossing in favor of a toothpick or skip it altogether. But putting your oral health on the backburner because of stress can end up putting you in an even more stressful situation – needing an emergency appointment.
Sticking to a consistent routine – brushing your teeth for two minutes, twice a day, and flossing once a day – help keep your mouth on track. Preventative care, including twice-yearly dental cleanings, will also go a long way to protect and preserve your smile for years to come.
If you develop a concern with your oral health, reach out to your dentist with your questions. Preventative treatment is always the best option when it comes to your smile. So, slow down and make sure that you aren’t rushing through your oral health habits.

Reduce Overall Stress

We all deal with stress from a variety of sources and to different extents. It’s a normal part of our lives, but it’s important to acknowledge that we are living in very stressful times. It’s okay to feel stressed, but it’s important to actively make efforts to lower your stress levels for both your physical and mental wellbeing.
There are many ways to go about reducing your stress, such as eating healthy foods, getting exercise, good sleep habits, and staying connected with your loved ones. Some people look to different physical activities like yoga or hiking, while others reduce their stress by working on arts and crafts. Whatever way you choose to decompress, do so knowing that you’re protecting your health.
If you do experience concerns with the stress-related dental concerns listed above, we’re here to help. Our offices are committed to keeping our patients safe and healthy. And now we’ve made getting an appointment even easier. You can reach us by phone once you select a location, through our webchat, or via text (Text APPT to 405-389-4544). We’re here for you and your family, and we are looking forward to meeting your dental needs for years to come.

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