Take It Easy: How Stress Increases the Risk of Gum Disease

Published by The Advanced Institute for Oral Health

Are you stressed out? Most of us are. And while the news has been full of studies linking the effects of chronic stress on your general health – weakening your immune system, increasing the risks of colds and flus, and potentially contributing to more serious medical issues like high blood pressure, diabetes and even some types of cancer – what you might not know is that experiencing stress on a regular, or chronic, basis can also wreak havoc on your gums. That’s the conclusion of several recent studies that evaluated the impact of chronic stress on periodontal disease and the factors that contribute to it.

In fact, one meta-analysis found 57 percent of the studies they reviewed showed a positive relationship between periodontal disease and stress, depression, anxiety and loneliness. The results were so startling, the former president of the American Academy of Periodontology Preston Miller, DDS, advised patients to lower their risk of gum disease by looking for “healthy ways to relieve stress through exercise, balanced eating, plenty of sleep, and maintaining a positive mental attitude.”

How are they related?

Researchers aren’t sure exactly how stress contributes to the development and progression of gum disease, but they have identified some “likely suspects.” First, multiple studies have demonstrated a link between chronic stress and vascular disorders and diseases, including coronary artery disease and angina. There’s no doubt chronic stress can affect the body’s ability to circulate the oxygen- and nutrient-rich blood necessary to keep organs and tissues healthy. And there’s also no doubt having healthy circulation plays a major role in maintaining healthy gums. So it may not be a surprise that when stress affects circulation, it can also have an effect on gum health.

But that’s just one way stress can play a role in gum disease. Researchers have found the way the immune system reacts in response to stress also plays a role in gum disease. Why? Many studies have shown that when we experience chronic stress, we’re also much more likely to experience inflammation of the tissues inside our bodies. Inflammation of blood vessels and tissues can cause damage all on its own; but what researchers are now beginning to understand is that the inflammatory response causes additional changes that can result in an ongoing cycle of damage. That cycle begins with the body’s natural release of cortisol, a “stress hormone” that is released in huge quantities in response to stress. When stress is temporary and acute, the body is able to handle and respond appropriately to the influx of cortisol. But when we’re under chronic stress, the immune system kicks into overdrive and cortisol levels soar, overwhelming the body’s ability to balance itself and increasing inflammation – which in turn causes more cortisol to be released, and the cycle continues. The continual increased production of cortisol eventually causes the immune system to malfunction, and it begins to attack even healthy tissue, including gums.

It’s easy to see how the impact of chronic stress – both vascular and immune system issues – can combine with harmful bacteria to create a “perfect storm” for gum disease; but there’s still more. Studies have also shown people who are under stress on a regular basis tend to adopt and maintain bad habits, like chewing on objects, indulging in sugary or sticky snacks, grinding their teeth, smoking, and abusing alcohol or drugs, all habits that can take a toll on the health of gums and tooth roots. Plus, people who feel overwhelmed by stress may be less attentive to personal hygiene habits like regular brushing and flossing.

What you can do

Reducing stress isn’t always easy, but there are some things you can start doing today to help relieve chronic stress and avoid tooth loss that can occur as a result of gum disease:

  • Maintain a regular sleep schedule; getting your body into a regular wake-rest routine can help ensure it’s able to manage stress without overwhelming the immune system.
  • Eat a healthy diet.
  • Get some exercise – not only is it good for circulation, but it can also be a big help in reducing stress.
  • See your periodontist for regular exams so gum disease can be battled at its earliest and most treatable stages.

If you have chronic stress and anxiety, it’s also a good idea to talk to your family doctor about strategies and even medications that may help you cope. Managing stress is one of the most important things you can do – not just to avoid gum disease, but also to maintain optimal physical and emotional health as well.