Stress Related Dental Problems


Statistics show that in the past 30 years, Dentists have successfully achieved a 70% reduction in tooth decay, as well as improved the treatment and prevention of gingivitis and periodontitis through the use of fluoride and patient education for better oral hygiene. Through Cosmetic Dentistry and Dental Implants, Dentistry has advanced beyond the basic Dental care.

Despite Dentists success in managing and treating Bacteria related Dental problems a new challenge has arise.

Doctors consider stress, (a common phenomenon in this society) a cause or a contributing factor to many health problems including Cardiovascular, Autoimmune and Mental Diseases. Stress related Dental problems were known to ancient societies thousands of years ago. Teeth, gums and other oral structures may be affected by stress in many ways:

1. Stress can reduce the body immunity by increasing the secretion of the endogenous steroids from the suprarenal glands which produce the macrophages (the 1st line of body defense among the white blood cells) lazy and incapable of opsonizing or fixing foreign bodies like bacteria when it invades the human body. Gingivitis and periodontitis are more likely to develop in a stressed individual without showing the same signs of bleeding and swelling that would normally appear in a stress-free individual. Generalized and sever forms of tooth decay (rampant decay) were reported in very stressed patients especially women.


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2. Stress is a major factor in teeth grinding and clinching. A large percentage of the grinders and clinchers do not even realize that they grind or clinch because most of them do it during their sleep; in some cases it could occur during the day too. It has been reported that the clinchers and grinders have 10 to 20 folds increase in the amount of masticatory forces. Grinding and clinching will increase the frequency of the upper and lower teeth contact (normally the upper and lower teeth are in contact 20-30 minutes a day, clinchers and grinders may have their teeth in contact several hours a day). This may cause one ore more of the following: 1. Tenderness, spasm and fatigue of the muscles of mastication, the muscles of the face and neck leading to frequent headaches especially in the morning. 2. Damage to the temporomandipular joint (TMJ), the joint in front of the ala of the ear. The damage may be minor presented with a clicking sound when opening or closing the mouth or may be as severe as to prevent the lower jaw from functioning properly. 3. If the problem becomes chronic, the cheek muscles may enlarge causing some distortion to the face. 4. Excessive grinding and clinching wears-off the occlusal surfaces and incisal edges, which leads to flat shorter teeth. When the lateral forces exceeds the physiologic level, smooth V-shaped cavities will develop followed by gum recession and subsequent tooth sensitivity (figures 1&2). 5. Gum and periodontal damage causes tooth mobility and tooth fracture. 6. Fracture of Dental restorations such as Porcelain crowns, Bridges, Inlays, Fillings and Dentures.


Treatment varies depending on the cause and severity of the case.

Suggested treatment may include muscle relaxants (i.e. Valium), occlusal night guards, occlusal adjustments, physical therapy, full mouth rehabilitation, TMJ surgery and psychological treatment.

For further information contact Dr. Khalifeh at

Museum Dental Center

5757 Wilshire Blvd, Promenade #5

Los Angeles, CA 90036

Tel. (323)933-3855

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