Research suggests that 1 in 14 adults in the UK feel stressed every day. The most common cause, at 79%, is work related.[i] With so many people feeling the pressure on a daily basis, it is important to understand the impact that this can have on the body, and the ways in which your patients may be coping.
Stress is one of the leading causes of temporomandibular disorder (TMD).[ii] TMD is very common, with many people across the UK experiencing symptoms. Some are more minor, but if left untreated, or allowed to worsen, they can lead to additional problems. This includes trismus which can prevent patients from opening their jaws properly, impacting their ability to eat and talk. Trismus can seriously affect patients’ quality of life, so professionals should start treatment early to minimise the impact on their health.
Many patients will have developed coping mechanisms to deal with day-to-day stress, with some being healthier than others. Some can have an effect on patients’ oral health, so it is important to look out for the signs, and advise patients on how to reduce the impact on their mouths as appropriate.
74% of people reported feeling so stressed that they were unable to cope, with 46% admitting to eating too much or more unhealthily when stressed. This is along with 29% of people turning to alcohol, and 16% using cigarettes to ease the tension. These high levels of stress can also have a detrimental effect on mental health, with 51% feeling depressed due to stress, and 61% experiencing anxiety as a result.[iii]
One of the ways people cope, unhealthy eating, can impact oral health directly. Particularly if patients are consuming a large amount of food which is high in sugars, this will have a negative impact on patients’ oral health. It can make them more susceptible to gum disease and tooth decay, as the sugar attacks the teeth and gums.[iv]
Alcohol and tobacco use are shown to have a negative effect on oral health. They can both lead to tooth discolouration, tooth decay, gum disease, and oral cancer.[v],[vi] It is important that you provide patients with cessation advice where appropriate as patients are four times more likely to quit smoking with the support of a professional.[vii]
Those who suffer with stress and anxiety are also more likely to grind their teeth. Not only can this chip or wear away the tooth enamel, making the teeth more vulnerable to infection, but it can also cause TMD.[viii]
High levels of stress can cause patients to clench and grind their teeth (bruxism). Bruxism puts pressure on the jaw joint, causing patients pain and leading to TMD. This can make it painful for patients to open their jaw, make an uncomfortable clicking/popping/grinding sound, and in severe cases, can prevent patients from opening their jaw at all.
It is vital to intervene as quickly as possible. TMD can have a big impact on patients’ quality of life, so it is important to help them manage their condition effectively, and help them to regain their range of motion.
There are several exercises patients should try to relax the muscles and regain jaw opening. Particularly when TMD is caused by tension, focussing on relaxing the muscles is crucial. Advise patients to massage the affected area regularly, and particularly when painful, to help relieve the tension. Then move on to strengthening exercises, designed to stretch the jaw and facial muscles and strengthen the joint. Passive motion is particularly useful here, with its aim being to expand the jaw joint range of motion, allowing the patient to open their mouth wider.[ix] The OraStretch Press Rehab System, available from Total TMJ, is a handheld device which uses passive motion to help patients to extend the range of motion in the jaw.
When patients are experiencing high levels of stress, their oral health can be very difficult to manage. Make sure to highlight the importance of relieving tension in the muscles to help reduce the impact on the jaw.
[i] https://championhealth.co.uk/insights/stress-statistics/
[ii] https://www.asianscientist.com/2022/11/topnews/stress-might-be-making-your-jaw-pop/
[iii] https://championhealth.co.uk/insights/stress-statistics/
[iv] https://www.who.int/news-room/fact-sheets/detail/sugars-and-dental-caries#:~:text=Free%20sugars%20are%20the%20essential,teeth%20(enamel%20and%20dentine).
[v] https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/alcohol-and-teeth/
[vi] https://www.cdc.gov/oralhealth/fast-facts/tobacco-use/index.html
[vii] https://www.ncsct.co.uk/usr/pub/NCSCT%20dental%20VBA.pdf
[viii] https://www.asianscientist.com/2022/11/topnews/stress-might-be-making-your-jaw-pop/