How Stress Affects the Mouth

Do you know how emotional stress compromises your oral health? We'll show you 7 ways, according to the experts.

Reviewed and approved by el médico Diego Pereira.

Written by Josberth Johan Benitez Colmenares

Last update: 19 January, 2023

When we talk about stress, it’s often done in relation to its cardiac, metabolic, and mental health consequences. However, stress affects almost every system in the body in the long term, so there are many ways it can affect your health and integrity. Today we’ll look at how stress affects the mouth, according to scientists.

Stress impacts your oral health in many ways, and it always does so progressively. Indeed, at the beginning you won’t notice any symptoms; but if the episodes of emotional stress are postponed, sooner or later you end up developing oral complications. We review 7 of the main ones hand in hand with the evidence found in this regard.

7 ways stress affects the mouth

Experts have identified two mechanisms by which stress affects the mouth and oral health in general. The first is exposure to unhealthy situations as a result of emotional stress. For example, substance use (illicit drugs, alcohol, and tobacco), poor diet, sedentary behavior, and neglect of basic hygiene habits.

The second is that chronic stress contributes to a high allostatic load, which leads to the dysfunction of physiological systems critical for homeostasis.

As a consequence, it may affect the underlying mechanisms of oral disease progression more generally. The connection between stress and oral health has been known for decades, and here are 7 ways it can impact you.

1. Bruxism

As the evidence indicates, stressed people show a higher probability of suffering from bruxism than healthy people. Bruxism is a disorder characterized by grinding of the teeth. It can occur both during the day and at night, but the episodes are more frequent during the last stage of the day.

Whoever does it isn’t aware of it, and it isn’t until someone points out their teeth grinding that they realize. Symptoms can be jaw pain, headaches, dental problems (parts worn by friction, for example), neck and shoulder pain, ear pain, and sleep disturbances.

2. Periodontitis

There’s evidence that psychosocial stress is an indicator of periodontitis risk. Also known as gum disease, it’s characterized by an infection that wears away the soft tissue of the gums and, if not treated, the bone that supports the teeth. Its main symptoms are swollen gums, bleeding when brushing, sensitivity, loose teeth, bad breath, and gaps between the teeth.

3. Bad breath

It has also been suggested that people often develop bad breath as a result of stress and anxiety. Halitosis, as it is also known, can cause people to isolate themselves out of shame about the symptom, which in turn creates more stress.

It’s a process that feeds itself, and one that affects the quality of the person’s interpersonal relationships.

There are many ways in which stress can cause bad breath. First, it can compromise your immune system; there will then be an increase in the bacterial and viral population inside the mouth.

The metabolic processes that these create can result in changes in a person’s breath. Similarly, stress can cause dry mouth, which also affects the control of pathogens on the tongue, cheeks, gums, and teeth.

4. Canker sores

According to these researchers, psychological stress can both trigger canker sores and make them worse once they develop.

Canker sores, also known as aphthous stomatitis, are characterized by the manifestation of small ulcers on the lips, cheeks, and, less frequently, on the gums and tongue. They’re very common in children and young people, although in adults they’re less common.

Although they’re benign, they’re very painful and can affect the act of eating, drinking, and speaking. If your stress levels are very high they can develop as a consequence, and there are practically no limits to them. Their diameter varies and they take an average of 7 days to disappear.

5. Cold sores

Experts have also suggested a connection between psychosocial stress, anguish, anxiety, and other emotional disturbances with the reactivation of the herpes virus in the body. As you well know, after infection with the herpes virus, it remains in a latent state. It can be reactivated again in the presence of certain factors, such as stress.

When it happens due to this last trigger, it appears more frequently in the oral area than in the genital area. It’s characterized by small blisters that develop on or near the lips.

They don’t leave scars when they disappear, although they usually do so only up to 2 or 3 weeks later. There aren’t any drugs that can speed up this process, so people just have to wait for it to go away on its own.

6. Temporomandibular joint syndrome

Another way that stress affects the mouth is through temporomandibular joint syndrome. The association has been described by experts, especially after episodes of prolonged stress.

Temporomandibular joint syndrome is characterized by pain in the jaw joint, and also in the muscles that control its movement.

Although most of the episodes are temporary, they produce great discomfort in the person. They can prevent you from eating, drinking water, speaking, and concentrating, and it affects your general well-being. It can also occur as a consequence of bruxism, so it’s another indirect way through which stress can lead to this complication.

7. Tooth decay

Finally, there’s evidence that stress increases the chances of developing dental caries. Stress isn’t only a catalyst for their development, but can also make episodes worse.

Caries are the main cause of the loss of teeth, and this is a latent risk in people who live out their day-to-day lives with permanent stress.

Stress and oral health are closely related, so much so that reducing levels of emotional tension must be your priority to keep these complications at bay. Include relaxing habits throughout the day, so you can control its manifestation a little. Yoga, meditation, and breathing sessions can also be of great help.