PTSD and Oral Health: Key Dental Challenges for Vets

Veterans day isn’t just a time to honor military service; it’s an opportunity to understand the unique health challenges veterans face along with the often hidden impacts of post traumatic stress disorder, better known as PTSD. Other than mental well-being, PTSD can affect physical health by weakening the immune system and increasing chronic pain. Of note, PTSD and oral health have a link.

Many veterans struggle with issues like teeth grinding, gum disease, or neglected dental care which is linked to PTSD-related anxiety and stress. Recognizing these effects allows us to support veterans holistically, promoting health in every sense, from mind to body, this Veterans Day and beyond.

In this article, we explore PTSD , its effects on physical and mental health, and the connection between PTSD and oral health. We will provide effective strategies for managing various challenges and tips on how to prevent them.

What is PTSD?

Post-traumatic stress disorder, or PTSD, is a psychiatric condition triggered by exposure or, in some cases, as a witness to aversive or extremely stressful events that can be life-threatening. This may include situations such as combat, natural disasters, serious accidents, or even prolonged human stress such as abuse or neglect.

Symptoms of PTSD may include flashbacks, nightmares, severe anxiety, and intrusive thoughts about the traumatic event, which can impact interpersonal relationships, quality of life, and overall functioning. Therefore, early recognition and treatment are essential for effective recovery.

The Impact of PTSD on Physical and Mental Health

Post-Traumatic Stress Disorder affects both the mind and body, often triggering chronic stress responses that interfere with daily life. Combat veterans face a particularly high risk; for example, according to a study, 15.7% of Iraq and Afghanistan veterans reported PTSD, with some estimates reaching 20-30%. PTSD symptoms extend beyond emotional distress, often manifesting physically due to the body’s prolonged “fight or flight” mode.

Physical symptoms can include pain in the face and jaw area, muscle pain around the mouth, difficulty moving the jaw, and extra sensitivity during dental check-ups. People with PTSD may also have clicking or popping sounds in the jaw while opening and other movement limitations.

Here’s a breakdown of the physical and mental symptoms associated with PTSD:

Physical symptoms PTSD

● Skin issues: Dryness, eczema, acne, rosacea due to stress-related moisture loss.

● Sleep disturbances: Insomnia, fatigue, muscle tension.

● Tinnitus: Stress-induced ear ringing, often tied to trauma recollections.

● Weight changes: Increased cortisol boosts cravings, leading to weight gain.

● Digestive problems: High cortisol causes acid reflux and bloating.

● Chronic pain: Cortisol depletion heightens pain sensitivity and muscle aches.

● Muscle loss: High cortisol hinders muscle growth and recovery.

● Poor circulation: Reduced blood flow causes cold hands and feet.

● Yawning & sweating: Nervous sweating and yawning from anxiety.

Psychological Symptoms

● Flashbacks/nightmares: Vivid re-experiences of trauma with physical responses.

● Avoidance: Avoiding trauma reminders (places, sounds, smells).

● Hyperarousal: Constant alertness, leading to exhaustion.

● Mood swings: Depression, anger, guilt, isolation.

● Self-destructive behavior: Substance abuse, impulsivity.

● Panic attacks: Dizziness, vomiting, rapid heartbeat linked to trauma.

● Memory and concentration issues: difficulty remembering and concentrating.

PTSD and Oral Health

PTSD can lead to various oral health issues due to both the psychological impact of the condition and the side effects of treatment. Veterans and others dealing with the condition may neglect oral hygiene, increasing the risk of inflammation, gum disease, and other dental problems.

Why Does PTSD Cause Oral Health Issues?

This disorder often disrupts daily self-care routines, including oral hygiene. PTSD and oral health are interrelated as high-stress levels lead to an increase in cortisol production, which can further cause inflammation and negatively impact gum health. In many cases, individuals may skip regular brushing and flossing, worsening their oral health over time.

Common Problems Linked to PTSD and Oral Health

● Gum disease: Increased cortisol levels and inflammation can contribute to periodontal disease.

● Tooth decay: Neglecting oral hygiene routines can lead to plaque buildup and cavities.

● Teeth grinding (bruxism): Stress-related bruxism can wear down tooth enamel and cause temporomandibular joint pain.

● Dry mouth: High cortisol and stress can reduce saliva production, leading to dry mouth and a higher risk of tooth decay. Along with this, changes in taste, glossitis, gingivitis, and periodontitis have also been found in 15–25% of PTSD patients.

Medications prescribed for PTSD, such as antidepressants (fluoxetine, escitalopram, etc) and anti-anxiety drugs, can cause dry mouth due to reduced saliva production. Saliva is crucial for protecting teeth against decay; thus, reduced saliva can increase the risk of tooth decay.

PTSD and oral health: How can veterans manage?

For veterans managing PTSD, self-care, including oral health, can often be neglected. However, simple daily habits can help prevent issues like dry mouth, tooth decay, and gum disease, which stress can worsen. Here are a few practical tips:

● Set daily reminders: Phone alarms or apps can be useful for keeping up with brushing and flossing, even on difficult days.

● Stay hydrated: Drinking water throughout the day promotes saliva flow, which helps protect teeth.

● Practice relaxation: Managing stress through deep breathing, meditation, or mindfulness can improve overall well-being and benefit oral health.

● Build a support network: Building a strong support network, including a mental health professional and a dentist, can help manage PTSD’s impact on oral health through a holistic approach.

● Use a night guard if necessary: Teeth grinding (bruxism) is common with PTSD. A night guard can protect teeth and ease jaw discomfort.

● Routine check-ups: Problems often arise when issues are identified too late, leading to complications and unwanted stress from additional dental work that could have been avoided because of which regular dental visits are important.

● Selecting the right products: A soft-bristled toothbrush, fluoridated mouthwash and toothpaste can contribute to making oral care on their own easier and even more comfortable.

Nutrition for Optimal Dental Health in PTSD Management

Diet plays a critical role in both mental well-being and oral health. Veterans with PTSD can benefit from nutrition choices that support their unique health needs, such as:

● High-fiber, calcium-rich, and omega-3 foods: Incorporate foods like leafy greens, nuts, fish, and dairy. These are not only great for teeth but also have anti-inflammatory effects, helping manage stress-related inflammation.

● Foods for strong teeth and relaxation: Whole grains, lean proteins, and magnesium-rich foods (like bananas and spinach) support both dental health and relaxation.

● Avoiding trigger foods: Reducing sugar and acidic drinks can prevent cavities and keep inflammation down. Avoiding caffeine may also help with anxiety symptoms.

The connection between PTSD and oral health is clear and impactful, especially for veterans who frequently encounter distinct health challenges. The stress, anxiety, and physiological changes tied to PTSD can deeply affect oral health, elevating the risks of gum disease, tooth decay, bruxism, and other dental concerns.

Recognizing these connections timely emphasizes the importance of self-care, including routine dental practices, hydration, stress management, and proper nutrition, to safeguard oral and overall well-being.

Therefore, this Veterans Day, we would like to honor and support veterans by understanding the full scope of their experiences and encouraging them to seek comprehensive care—including psychological and dental health—that can help enhance their quality of life and demonstrate our respect for their service.