Stress, Anxiety? Tell Your Dentist!

You can do it all. You manage your career, family and friends, your budget and your health. You’re even on top of all the newest apps for your smartphone. So what’s the big deal if all of that takes a toll on your stress and anxiety levels? The reality is, your busy lifestyle may not only wreak havoc on your nerves, but also on your pearly whites. With all you do to stay happy, be sure to protect your smile so you can show it off! 

If you think you can’t develop oral health problems from average, everyday stress levels and anxiety, think again! While anxiety disorders — like phobias, panic attacks and post-traumatic stress disorders (PTSD) — are a few of the more serious conditions with oral health implications, even “normal” stress levels can be harmful.

There are a number of oral health problems associated with stress and anxiety that read like the long list of symptoms in a T.V. commercial for a prescription medicine: canker sores, dry mouth, burning mouth syndrome, temporomandibular joint (TMJ) disorders and even Lichen Planus (lacy white lines, red areas or ulcers that form in your mouth). 

Not surprisingly, signs of stress and anxiety often first show up in the dentist's office. Dentists can detect oral symptoms of stress — including mouth pain, bruxism, TMJ disorders, mouth sores and gum disease. And to add to the physical manifestations of stress, some anti-anxiety medications can cause dry mouth, acid reflux or vomiting — all of which can also increase the risk of developing tooth decay.

So if you’re feeling tense or anxious, take a deep breath or two, and keep a watchful eye for signs of the following stress-related disorders:


Bruxism is the technical term for grinding teeth and/or clenching jaws. It can be caused by sleep disorders, an abnormal bite or teeth that are missing or crooked, or it could be caused by stress and anxiety. Have you ever caught yourself clenching your teeth when concentrating on a dramatic part of a movie or when you are in a rush and waiting in a really long line? Nervous tension, anger, frustration — all of these can cause people to start showing the signs of bruxism. 

It's important to know the signs and to seek treatment if you suspect you may have bruxism, which is challenging for those who are not aware that they are grinding their teeth in their sleep! How can you find out? Pull out your pocket mirror and look for these signs:

  • The tips of your teeth appear flat 
  • Your tooth enamel is rubbed off and your tooth feels extremely sensitive 
  • You have indentations in your tongue

During your next appointment, ask your dentist to examine your teeth for signs of bruxism and to suggest appropriate treatment if needed. 

TMJ Disorders

TMJ refers to how the muscles you use to move your jaw and neck affect your temporomandibular joint in your jaw. Stress can aggravate TMJ by causing overuse of jaw muscles when clenching or grinding teeth (like bruxism). But even if you aren’t seeing signs of bruxism, you may still notice other symptoms of TMJ — such as jaw joint pain, popping and clicking of your jaw or inability to open and close your mouth easily. If you experience any of these, check with your dentist to see if TMJ may be the cause.

Gum Disease

Do results of clinical studies get your attention? Well, studies found that emotional factors played a significant role in the development of adult gum disease1. Researchers discovered that the severity of gum disease increased with amount of stress experienced in a patient's previous 12 months. Factors included typical life stress involving spouses and children, finances or work. The study showed that even the stress resulting from a lack of companionship made an impact.

The researchers found those at greatest risk for gum disease were the ones most likely to lose their cool dealing with financial problems. But patients who faced stressful situations more calmly and had a more positive attitude tended to have a lower risk of severe gum disease.  

Canker Sores

Canker sores (also called mouth ulcers) generally occur inside the mouth. No worries, they aren’t contagious, but you can give them to yourself. These sores are often triggered by biting your cheek or jabbing your gums during overly-aggressive brushings. 

Canker sores may also be triggered by stress alone. According to a report2 in the Academy of General Dentistry's clinical, peer-reviewed journal, studies have shown students have a high prevalence of canker sores, yet the sores appear less frequently during breaks and after graduation, when students are less stressed.

Maintain Your Oral Health When Stressed

One of the best ways to fight the negative effects of stress is to remove the source. Not likely in your case? Well then try exercise, relaxation or meditation. Massage and physical therapy may also help reduce your tension. Seeking counseling may be an effective option for you. 

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 TMJ, your dentist may suggest some adjustment, including orthodontic treatment, to correct teeth alignment that may be magnifying orofacial pain. It’s best to first check your benefits to see what treatments are covered under your dental benefits plan.

Make it a habit to brush twice a day, floss every day and have your gums and teeth regularly evaluated by your dentist.


1 A Systematic Review of Stress and Psychological Factors as Possible Risk Factors for Periodontal Disease. Daiane C. Peruzzo, Bruno B. Benatti, Glaucia M.B. Ambrosano, Getúlio R. Nogueira-Filho, Enilson A. Sallum, Márcio Z. Casati, and Francisco H. Nociti Jr. Journal of Periodontology 

2 Academy of General Dentistry. Mouth Sores: Caused by Student Stress. Retrieved October 26, 2012 from:

The oral health information on this website 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.