Categories: Dental Blog

Effective Care for PTSD Dental Symptoms in Veterans

PTSD dental symptoms in oral health and how to manage them?

Post-traumatic stress disorder (PTSD) is a mental health condition that arises after experiencing or witnessing a traumatic event. The disorder manifests symptoms such as anxiety, intrusive memories, and avoidance of situations reminiscent of the trauma. Although PTSD is primarily recognized for its effects on mental health, the physical consequences are equally significant, affecting the quality of life and overall well-being of those who suffer from it. Emotional stress and constant body alertness can lead to physical symptoms such as muscle pain, sleep disorders, and gastrointestinal problems that demonstrate the comprehensive impact of PTSD on a person’s health.

An often overlooked aspect of PTSD is its impact on dental health. People with PTSD may develop habits such as bruxism (teeth grinding) or neglect their oral hygiene due to a lack of motivation or difficulties in establishing routines, which can lead to serious dental problems. In addition, chronic stress can weaken the immune system, increasing susceptibility to periodontal diseases. Recognizing and addressing dental symptoms in people with PTSD is essential to providing comprehensive care and improving their quality of life.

 

 

What are PTSD dental symptoms?

PTSD increases chronic stress levels, which can have multiple adverse effects on oral health. Prolonged stress increases the production of cortisol and other hormones that generate inflammation in the body, including oral tissues, and can lead to conditions such as xerostomia and bruxism. Dry mouth, in particular, is concerning, as saliva plays a crucial role in protecting against oral bacteria and neutralizing acids in the mouth. Without enough saliva, people with PTSD are more prone to cavities and gum disease, given the more acidic oral environment with less protection against harmful bacteria.

Medications commonly prescribed for PTSD, such as antidepressants and anti-anxiety medications, can cause side effects related to oral health. Xerostomia is a well-documented side effect of several antidepressants, which further exacerbates the risk of cavities and gum problems by reducing the mouth’s ability to clean itself naturally. Periodontal disease has been shown to be the most prevalent condition in these individuals, which is related to three main characteristics: poor oral hygiene, decreased natural immunity, and smoking habits. It is more frequent in patients under psychiatric medication.

Common PTSD Dental Symptoms

● Caries.

Missing teeth.

● Advanced periodontal disease.

● Facial pain.

● Headache.

● TMJ disorders.

● Tooth wear.

● Xerostomia.

● Taste changes.

● Glossitis.

● Decreased natural immunity.

Managing PTSD Dental Symptoms at Home

For patients with PTSD, maintaining a dental care routine at home can be challenging due to anxiety, a lack of motivation, and medication side effects. However, there are practical strategies that can help protect oral health and reduce the PTSD dental symptoms. Here are some specific tips:

Establish a daily routine: It is important to maintain a short and simple daily oral hygiene routine to avoid increasing anxiety. This should include brushing twice a day with fluoride toothpaste and flossing.

Combating dry mouth: Stress or medication can cause xerostomia; it is advisable to drink water frequently, use alcohol-free mouthwashes, and sugar-free gum or candy that stimulates saliva production.

Protecting teeth from bruxism: The anxiety present in patients with PTSD increases the possibility of grinding their teeth, so it is advisable to use a guard when sleeping; if you notice grinding during the day, you can also use it during the day.

Products for sensitivity and inflammation: In case gum inflammation or dental sensitivity is a problem, the use of a toothpaste for sensitive teeth and mouthwashes with anti-inflammatory ingredients, such as chlorhexidine, is recommended. You can also opt for brushes with ultra-soft bristles to avoid irritating the gums.

Emotional resilience through self-care and mindfulness

For post-traumatic stress, the following exercises may be useful according to scientific evidence, and help to reduce PTSD dental symptoms:

Diaphragmatic breathing exercises

Also known as abdominal breathing, it helps reduce anxiety and physiological hyperarousal. This type of breathing involves expanding the abdomen instead of the chest when inhaling.

Progressive muscle relaxation

It involves tensing and then relaxing different muscle groups in the body. This exercise helps reduce muscle tension and anxiety.

Mindfulness or full attention

Mindfulness involves focusing attention on the present moment in a non-critical way. This approach can help people with PTSD reduce rumination and avoidance.

Regular physical exercise

Regular physical activity can improve mood and reduce PTSD dental symptoms. Exercises such as walking, running, swimming or practicing yoga can be beneficial.

It is important to remember that each person is unique and may react differently to these situations;it is recommended to go to a specialist to obtain personalized attention.

Managing PTSD dental symptoms requires a combination of mindful self-care, structured routines, and support from mental health professionals. While at-home strategies can mitigate some of the oral health problems associated with PTSD, they are not a substitute for professional dental care. Regular dental visits are essential to monitor, address, and prevent the progression of problems such as tooth decay, gum disease, and tooth wear, which, if left untreated, can lead to significant oral and overall health complications. By prioritizing dental checkups, people with PTSD can prevent serious dental problems and improve their quality of life.

Frequently Asked Questions (FAQ)

Yes, PTSD can significantly impact dental health. The chronic stress associated with PTSD may lead to habits like bruxism (teeth grinding) and neglect of oral hygiene, increasing the risk of tooth wear, cavities, gum disease, and other dental issues. Additionally, medications for PTSD can cause dry mouth (xerostomia), which reduces saliva production and elevates the risk of oral bacteria growth and dental decay. Regular dental care and professional support can help mitigate these effects.


To support someone experiencing a PTSD attack, remain calm and encourage grounding techniques. You can help them focus on their breathing or guide them to practice mindfulness by engaging with their immediate surroundings (noticing textures, sounds, or sights around them). Avoid pressing for details about their trauma, and offer a reassuring, quiet presence. If needed, seek assistance from mental health professionals.


The three main symptoms of PTSD are re-experiencing (such as flashbacks or intrusive memories of the traumatic event), avoidance of trauma reminders, and hyperarousal, which includes symptoms like irritability, difficulty sleeping, and feeling constantly “on alert.”


Establishing a simple, consistent dental routine is key. This can include brushing twice daily with fluoride toothpaste, using floss, and staying hydrated to combat dry mouth. Products such as alcohol-free mouthwash and sensitive toothpaste can also help manage symptoms like dry mouth, inflammation, and sensitivity. A mouth guard can be beneficial for those experiencing bruxism.


Regular dental visits allow for early detection and treatment of PTSD dental symptoms, such as tooth wear, gum disease, and cavities, preventing more severe complications. Dentists can also offer customized recommendations for managing specific symptoms and side effects of PTSD and its medications, ensuring comprehensive oral health care for individuals with PTSD.

References

1. Estrés postraumático, estrategias de intervención. (s. f.). Revista Psicología Científica. https://psicologiacientifica.com/estres-postraumatico-estrategias-intervencion/

2. Impact of post-traumatic stress disorder on oral health. (s. f.). Science Direct. https://www.sciencedirect.com/science/article/abs/pii/S0165032716312162

3. Rdh, T. (2022, 8 julio). Researchers Look at Oral Health of Patients with Combat-induced PTSD. Today’s RDH. https://www.todaysrdh.com/researchers-look-at-oral-health-of-patients-with-combat-induced-ptsd/

4. Settineri, S., Rizzo, A., Liotta, M., & Mento, C. (2017). Clinical Psychology of Oral Health: The Link Between Teeth and Emotions. SAGE Open, 7(3), 215824401772831. https://doi.org/10.1177/2158244017728319

5. Tagger-Green, N., Nemcovsky, C., Fridenberg, N., Green, O., Chaushu, L., & Kolerman, R. (2022). Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study. Journal Of Clinical Medicine, 11(11), 3249. https://doi.org/10.3390/jcm11113249

Dr Gustavo Assatourians DDS

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Dr Gustavo Assatourians DDS

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