The Link Between Stress and Dental Health (Podcast)

John Maher: Hi, I am John Maher. I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental, health and whole body health. And author of the best-selling books, Age with Style: Guide to a Youthful Smile and Healthy Living, and Total Wellness: Understanding the Link Between Your Teeth and Your Health.

Today, our topic is the link between stress and dental health. Welcome, Dr. Nammy.

Dr. Nammy Patel: Thank you for having me, John.

Oral Health Problems Exacerbated by Stress

John: Sure. Dr. Nammy, how does stress impact dental health and what are some of the most common oral health problems that can be caused or maybe exacerbated by stress?

Dr. Nammy: So stress is very, very, very detrimental to us. It is detrimental to our body because it produces cortisol, which is the stress hormone and makes our entire body be on hyperdrive. And just as it puts our body on hyperdrive, the same thing happens to our teeth.

We tend to clench and grind our teeth when we’re stressed out. Have you ever noticed sometimes when you’re really stressed out, you’ll clench or if you’re really scared, you’ll clench? And that actually happens unconsciously, which is really interesting. And when we’re stressed like that, what it does, we clench down on our teeth and we tend to chip our teeth, which is no fun because it means that you need more dental treatment.

Now, the other thing I also mentioned to you earlier is that stress actually increases the amount of cortisol in your body. When you have a lot of cortisol in your body and in your blood, you’re actually not able to fight off like gum disease. And so people who are stressed out a lot tend to have more bleeding gums and have signs of gingivitis or even periodontitis if they haven’t been to a dentist in a long time. So the common things we really see in the mouth is really clenching, grinding, and a lot of gum disease for sure. And sometimes if people are super stressed out and they’re drinking a ton of coffee or drinking a lot of sodas and things like that, we’ll see cavities as well.

How to Recognize Stress-Related Dental Issues

John: Okay. And how can patients recognize the signs of stress related dental issues and what steps can they take to prevent or treat those problems?

Dr. Nammy: The most common one, especially when it comes to clenching and grinding, is stress related. You’ll notice yourself waking up and your jaw will hurt. You’ll realize that you’ve been clenching all night, and you’ll also know what’s going on in your life. You’ll notice that, hey, there’s a lot on my mind. There’s a lot all happening all at once, and I’m unable…

You’re trying to process that information and you’re trying to process how to deal with that, the struggles or the troubles that you may be having, even if it means overwhelm, your body’s trying to process that and unconsciously it tends to clench and grind the teeth.

Stress Management Techniques

John: And what are some effective stress management techniques that can improve both your mental health and your dental health, and how can patients incorporate those techniques into their daily routine?

Dr. Nammy: The best things I recommend for stress management for patients is that, number one, have a nightly routine. Before you go to sleep, take a shower, floss, brush your teeth, and then before going to bed, take five minutes, write down everything you need to get done and everything that has occurred, maybe like a checklist and where the struggles are, what the problems are, what are some potential concerns may be for you.

And then I recommend that you actually meditate. So take 20 minutes and just breathe in through the nose and out through the nose for 20 minutes. What will happen is that all that mind chatter will stop. You’ll get the solutions that you’re really looking for, for all the concerns that you have. You’ll be able to be more alert, and your mind will actually find the answers, so the problems you’re seeking, and you’ll sleep better and also clench less, which is going to be really awesome for you.

How List Making Can Help Reduce Stress

John: Does that act of writing down your list of what you have to get done the next day and problems that you’re facing, does that just mentally help to unload all of those things from your brain so that then you can kind of put it aside until the next day?

Dr. Nammy: What it does is it creates space. I’m a big believer in space. We are amazing human beings. We put people on Mars, we’re detecting new galaxies. We are smart individuals. Our brains are wonderful, evolving, an organ that can do so much, and we push its limits and as we should, which is great. Now, it’s also an organ that we know how it works. So if we can write down all the things that are just not working, and then you can prioritize, I need to do A, B, and C, and then you can ask your actually unconscious brain to actually find you solutions, which is pretty amazing. And it’ll be working smarter versus working harder. And that’s the reason I recommend writing these things down and creating space for the solutions to come in.

John: So it’s not so much trying to put those thoughts aside as much as trying to embed those thoughts into your mind so that then your mind can come up with the solutions?

Dr. Nammy: Absolutely. And doing it one at a time, because if we try to solve 10 problems all at once, it becomes really overwhelming. But if you kind of chunk your goals down to three, what are my top three things I need to get done? It’s really easy for your body to do that. And then the second thing that’ll happen is your brain will be like, okay, I did the things I said I was going to do. I feel accomplished, I feel really good. And it creates a positive momentum versus a negative one one, which is what comes from overwhelm.

The Link Between Your Immune System and Oral Health

John: Okay. So how does stress impact the immune system and what role does healthy immune systems play in maintaining your good oral health?

Dr. Nammy: So stress is horrific in our entire body. What stress does, it puts us in a fight or flight response, and when it does that, it puts our body into hyperdrive. For example, if there was a snake in front of you, your heart will be thumping, you are going to be frozen probably in space. You will be so scared, your blood is pumping, your blood pressure’s high, and your body is strictly focusing on survival.

It is not focusing on thriving at all. It is strictly how do I keep you alive? How do I keep you alive while that snake is there, or how do I keep you alive and get out of this situation, your fight or your flight? Those are the two things that it’s going to occur. And during that process, when our bodies are really in that stressful situation for a long time, we create this hormone called cortisol.

And that cortisol, when it’s in short periods, it’s actually really good for you, but when it’s there for you over a long period of time, what it does, it does a detrimental effect on our entire body and it actually gets our hormones to dysfunction. For example, for women, it’s most actually men and women. What we typically find is that when they have a thyroid concern, what usually happens is that they’ve had a stressful event for over 18 months that their body’s been coping with unconsciously or consciously.

Something has occurred like a death, a divorce, maybe a mold issue, something along those lines that their body is chronically dealing with for about 18 months before the thyroid levels actually deplete and they become hypothyroid because that organ is fighting too much. It’s firing, firing, firing, firing, firing, firing. And we can’t have that because as you can imagine, if you’re riding a bike for 24 hours, you’re going to get tired, right?

You’re going to need some time to relax, and our body needs that time to rest and digest. And that’s really key because that’s when our body self regulates. That’s when our immune system is going in and taking away cancerous cells. That is how we age it. That is when we get rid of toxins from our body so that rest is really important, and we can’t be in that rest and digest mode if we are firing cortisol all the time or firing all those stress hormones all the time.

And so typically in the mouth, what we really find is that the immune system is hyperactive, and if the immune system is hyperactive a lot of other hormones are going to be very important. Like I said, that thyroid hormone is one of the ones I just talked about a couple seconds ago, and that influences your metabolism.

So it influences everything else that’s going on in the body. So over a period of time, that person’s going to be more predisposed to diabetes, which means gum disease isn’t going to heal very well. Also, people who are stressed out tend to clench and grind their teeth, like I was saying earlier. Also it makes certain bacteria overgrow in the mouth because if our immune system isn’t active like the way it needs to be or hyperactive, we actually get more bacteria in the mouth that isn’t supposed to be there, and it’s firing everything off versus just the bad ones.

And that’s really key because our oral microbiome is a balance, and we needed to have good bacteria and bad bacteria. We just don’t want it so that the good bacteria are eaten away and the bad bacteria survive or the other way around. It’s a nice ecosystem that needs to be balanced.

And when our stress levels are in balance, we’re able to balance that really well in our oral microbiome as well. And we now know that our oral microbiome is actually related to heart attacks, diabetes, cancers, arthritis, atopic pregnancy, so just a lot of different things, obviously our gut health and our ability to be able to absorb food. So that’s really key because when we’re swallowing, we’re swallowing five gallons of bacteria that go into our belly, and our entire immune system is really bacteria as well, because we do need some of these bacteria to be able to break down certain vitamins, certain things that we eat. For example, vitamin K, vitamin D, they’re very important in good oral health and oral systemic health as well.

Will your Dentist Help You Reduce Stress Levels?

John: Okay. And how can dental professionals help patients to manage their stress and improve their oral health? Are there resources that are available also to patients who are struggling with stress related issues?

Dr. Nammy: It depends, actually. It depends on what kind of a practice you go to. If you’re going to a practice that’s highly customized, highly personalized, you will get stress management ideas and resources. I know when I have patients come into my practice, we know we have meditations that we can give them. We have different ways of helping them sleep better. Also giving them nightly routines, giving them certain supplements that may be helpful as well.

And certain practices, they don’t. They give you a night guard and that’s it. So it just depends on where you’re going. In a holistic practice like mine, we definitely make an effort to highly customize and personalize the treatment for you and give you tools for success as far as stress related lifestyles, really, because one of the things that we know, and this is what I tell my patients, is stress is not going away.

As you get older in life, stress is going to increase. Now my goal is to help you deal with the stress, so that way your capacity to deal with it becomes better. And so it’s not having detrimental effects on you because we do have to live life, and life can be a challenge many of the times. And especially, we see stuff, we read our newspaper and we see what’s wrong in the world every day, and we have to function in this society. We have to live in this society, and it’s important that we are aware and we’re good citizens, and we also are taking care of ourselves. And so giving you good tools and techniques is really important.

Contact Green Dentistry to Talk About Stress and Oral Health Today

John: All right. Well, that’s really great advice. Dr. Nammy, thanks again for speaking with me today.

Dr. Nammy: My pleasure, John.

John: And for more information about Green Dentistry, visit the website at sfgreendentist.com or call (415) 433-0119.