Chronic Stress, Chronic Inflammatory Disease

by | Dec 9, 2020 | Oral Health, Periodontal Health

For lots of us, the holidays are a time of amped up stress – although this year, it might be hard to tell the difference between holiday stress and what we’ve all grappled with throughout this wildly challenging year. The American Psychological Association reports that 76% of folks say they’re stressed by the pandemic. Thirty-seven percent of them say their stress about it has gone up in the past month.

But with the recommendation that we scale back on holiday gatherings and other activities comes a hidden blessing. Where light stimulates us into activity, the increased darkness of winter prompts us to slow down, like bears hibernating for winter. As one writer has described it,

Our ancestors didn’t have central heat and electric light, so they lived differently in summer and winter of necessity. In summer, they were outdoors and active much of the time. In winter, they retreated indoors and hunkered down around a central fire, repairing tools and telling the tales that wove their culture. They packed themselves close together; piled on skins, quilts, and dogs; and slept long and deep.

But we modern folks not only have light and heat, we have alarm clocks to wake us up at the same time every day, no matter where the sun is. A client of mine, who likes to arise at 5:00am for yoga and meditation, was beating herself up for having trouble waking up in winter. “Stop thinking there’s something wrong with you,” I suggested, “and listen to your body’s wisdom.”

Embracing this natural phenomenon as an opportunity to practice rejuvenating self-care can do wonders for reducing stress – and that’s something that can pay dividends when it comes to your oral health.

While there’s been a lot of online chatter about how dentists are seeing more dental damage these days due to more people clenching and grinding their teeth, that’s hardly the only way stress can show up in your mouth, as a pair of recent studies reminds.

A Dutch paper published this past summer highlights how chronic stress affects immune fitness. Like smoking, chronic stress affects the body in ways that make it more vulnerable to disease, including gum disease.

There are indications that neurons are able to secrete pro-inflammatory cytokines and chemokines [proteins involved in cell signaling] that worsen chronic inflammatory reactions in the periodontium and compromise immune fitness. In vitro studies show high cortisol levels may contribute to the increased growth of P. gingivalis.

More harmful microbes like P. gingivalis – one of the main players when it comes to gum disease – more infection, inflammation, and destruction of gum and bone tissue in your mouth.

Another review, published last month in Clinical Oral Investigations, looked into stress, depression, and inflammation as a collective risk factor for periodontitis, or severe gum disease. Like gum disease, depression is also an inflammatory condition and is considered a stress-related disorder.

The 26 studies included by the researchers focused on potential links between stress-related disorders and biomarkers such as cortisol, pro-inflammatory cytokines, and DHEA (a hormone produced in the adrenal gland and helps make other hormones).

While pro-inflammatory cytokines alone didn’t appear to tell much about the severity of gum disease, no matter a person’s stress level, the researchers did see an overall relationship between stress-related biomarkers and gum disease severity.

“Stress-related disorders should be included in the list of globally screened diseases,” they concluded,

because it can change the biochemistry of both the local periodontal microenvironment as well as the global systemic inflammatory burden.

There are lots of tools and strategies available for managing stress more effectively, which you can learn more about here. Any bit of reduction you can manage, the better – for mouth and body alike.

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