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Gum Disease (Periodontal Disease) and Stress

September 23, 2022 / DENTISTRY

Stress is ever present in our world today. Like many chronic illnesses (heart disease, diabetes etc.) gum disease intensity does not follow a linear path but fluxuates in severity over time. It is thought that more stressful periods correspond to increased disease progression, likely due to activation of the immune response and the associated increase in inflammation. A direct link causal link between gum disease and stress in unproven due to the difficult nature of such studies (animal models?, the many factors influencing the incidence and severity) however, studies do show stress in a risk factor for periodontal disease. Learning to accept, cope and minimizes stress is important.

Gum disease, both gingivitis (inflamed gums) and periodontitis (bone loss), causation is proposed to be multifactorial and includes stress, oral hygiene, diet (related to psychological factors), genetics, immune system health, smoking, saliva flow and tooth grinding. As a chronic disease, gum disease results from the long term interaction between host and the oral environment.

Stress can down regulate the cellular immune response through a complex maze of bidirectional signals linking the nervous, immune and endocrine system. Stress also causes the release of adrenal corticosteriod hormones which stimulate the peripheral mast cells (immune cells) to produce more proteins increasing inflammation and leading to more gum disease. Host resistance to a bacterial insult may be reduced by the nervous system releasing hormones causing reduced gingival microcirculation. Studies show, people who cope poorly with challenges have poorer wound healing as the immune system poorly protects the wound site, poorly prepares it for healing and poorly regulates its repair.

It has long been known that emotions affect periodontal disease. Stress disrupts the body's natural rhythms affecting immune system function. Meditation, mindfulness, adequate sleep, proper nutrition, exercise, and examining one's values are all worthwhile goals to decrease stress and likely contribute to healthier gums.

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