Effective oral hygiene for the stressed patient
UncategorisedPosted by: Dental Design 11th November 2023
We all experience stress at various points in our lives, with some periods being harder to manage than others. The source could be work or school, family or a relationship, maybe large changes like moving house or having a child; it’s normal to feel life’s pressures build up.
It’s no different for your patients. They have complex lives that extend far outside of the dental chair. When feelings of stress bubble over, though, they could seriously impact a patient’s general and oral health.
Manifestations of stress
Stress can make itself known in a number of ways. A faster heartbeat or simply sweating are easily identifiable physical symptoms of feeling under pressure, but if this feeling becomes consistently overwhelming, it could create further issues.[i] This includes an increased risk of heart attacks and high blood pressure.[ii]
Mentally, sustained periods of stress could lead to individuals developing depression or anxiety disorders.[iii] It could also affect the quality of sleep, with some studies suggesting a more pronounced effect for women compared to men.[iv]
These changes are likely well known amongst most people, but patients may not have considered how their stress management affects their oral health.
Stress and saliva
In periods of stress, the body’s autonomic nervous system increases sympathetic activities.[v] These could be considered the signs of a fight or flight response: the aforementioned increased heart rate, sweating, goose bumps. Importantly for oral care, sympathetic activities also decrease salivary flow.[vi] Prolonged stress could see these responses continue for an extensive period, decreasing salivary flow for a considerable time.[vii] This may result in the feeling of xerostomia. [viii]
Saliva plays a crucial role in the maintenance of the oral cavity and its protection against harmful bacteria. It develops dental pellicle, a film that prevents mineral loss on a tooth’s surface; it can physically remove food from the tooth surface and within any gaps in the dentition; and saliva provides antibacterial and buffering activity, which keeps the oral pH neutral.[ix]
Without the clearance of dangerous bacteria, dental plaque can develop and thrive, in turn increasing the risk of dental caries.[x] The pH of plaque is also incredibly important to manage. It presides over the delicate balance between acid demineralisation of the teeth, and the remineralisation of an initial caries lesion.[xi]Without the removal of food debris and bacteria, which can lower the pH,[xii] or the presence of enough saliva to neutralise it, patients can expect enamel to dissolve – bringing about decay, which could result in infection or eventual tooth loss.[xiii]
A lower level of salivary production can also be a result of bruxism.[xiv] A stressful lifestyle is a significant psychosocial risk factor,[xv] and without appropriate care it could contribute to further damage in the oral cavity, with worn down or broken teeth prevailing alongside caries development as a result of the reduced salivary flow.[xvi]
Managing the oral impact
Fantastic oral health shouldn’t be another thing patients have to worry about. Whilst patients can’t solve all of their problems in the dental chair, the support of the dental team could be important to help them get through a stressful period.
The dental team should reiterate to patients the importance of a consistent and effective oral hygiene routine. By looking after a dentition with comprehensive care, brushing twice a day and using effective accessories, the possibility of decreased salivary flow may not have such a damaging impact. Ensure that patients display adequate brushing technique whilst in the practice to be sure that care can continue at home. The dental team should also consider recommending high-quality products that could aid their patient’s care.
To efficiently fight against plaque build-up, these products could be a specific toothbrush or fluoridated toothpaste, or the Waterpik® Water Flosser. The Waterpik® Cordless Slide is clinically proven to remove up to 99.9% of plaque,[xvii] and be more effective than string floss.[xviii] The all-new compact design can slide to 50% of its size for simple storage in the bathroom, or in a wash bag when travelling. This way, patients can protect their oral hygiene wherever they are.
Stress isn’t always something patients can control in life, but their oral health might be, with diligent and comprehensive care. By providing essential support to everyone in the chair, the dental team can offer patients the greatest chance at healthy teeth for a happier life.
For more information on the Waterpik® Water Flosser Cordless Slide visit www.waterpik.co.uk/shop-products/cordless-slide.
The Waterpik® Water Flosser Cordless Slide is currently available from Boots in select stores and online, and will be available soon online at Superdrug and in Argos, as well as select stores across the UK and Ireland.
Join the 3,000+ dental teams who have already benefitted from a professional Waterpik Lunch & Learn. Book your free session for 1 hour of verifiable CPD and a free Waterpik Water Flosser – available either face to face or as a webinar – at
www.waterpik.co.uk/professional/lunch-learn/
Charleane McInally is a professional educator for Waterpik, and dental hygienist
[i] NHS, (2022). Stress, (Online) Available at: https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/ [Accessed August 2023]
[ii] Pietrangelo, A., (2023). The Effects of Stress on Your Body, healthline. (Online) Available at: https://www.healthline.com/health/stress/effects-on-body [Accessed August 2023]
[iii] Mariotti, A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future science OA, 1(3).
[iv] Dolsen, M. R., Crosswell, A. D., & Prather, A. A. (2019). Links between stress, sleep, and inflammation: are there sex differences?. Current psychiatry reports, 21, 1-6.
[v] Won, E., & Kim, Y. K. (2016). Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Current neuropharmacology, 14(7), 665-673.
[vi] Govindaraj, S., Daniel, M. J., Vasudevan, S. S., & Kumaran, J. V. (2019). Changes in salivary flow rate, pH, and viscosity among working men and women. Dentistry and Medical research, 7(2), 56-59.
[vii] Won, E., & Kim, Y. K. (2016). Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Current neuropharmacology, 14(7), 665-673.
[viii] Bulthuis, M. S., Jan Jager, D. H., & Brand, H. S. (2018). Relationship among perceived stress, xerostomia, and salivary flow rate in patients visiting a saliva clinic. Clinical oral investigations, 22, 3121-3127.
[ix] Su, N., Marek, C. L., Ching, V., & Grushka, M. (2011). Caries prevention for patients with dry mouth. J Can Dent Assoc, 77(b85), 1-8.
[x] Su, N., Marek, C. L., Ching, V., & Grushka, M. (2011). Caries prevention for patients with dry mouth. J Can Dent Assoc, 77(b85), 1-8.
[xi] Dodds, M., Roland, S., Edgar, M., & Thornhill, M. (2015). Saliva A review of its role in maintaining oral health and preventing dental disease. Bdj Team, 2, 15123.
[xii] Dodds, M., Roland, S., Edgar, M., & Thornhill, M. (2015). Saliva A review of its role in maintaining oral health and preventing dental disease. Bdj Team, 2, 15123.
[xiii] National Institute of Dental and Craniofacial Research, (2023). Tooth decay. (Online) Available at: https://www.nidcr.nih.gov/health-info/tooth-decay [Accessed August 2023]
[xiv] Vasundhara, V. (2021). Sleep bruxism. International Journal of Medical and Oral Research, 6(2), 43-45.
[xv] Murali, R. V., Rangarajan, P., & Mounissamy, A. (2015). Bruxism: Conceptual discussion and review. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S265.
[xvi] Vasundhara, V. (2021). Sleep bruxism. International Journal of Medical and Oral Research, 6(2), 43-45.
[xvii] Gorur, A., Lyle, D. M., Schaudinn, C., & Costerton, J. W. (2009). Biofilm removal with a dental water jet. Compendium, 30(1), 1.
[xviii] Goyal, C. R., Lyle, D. M., Qaqish, J. G., & Schuller, R. (2013). Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. The Journal of clinical dentistry, 24(2), 37-42.
No Comments
No comments yet.
Sorry, the comment form is closed at this time.
