Dr. Al Danenberg ● Nutritional Periodontist
November 15, 2020 [printfriendly]
Stress can cause serious damage to your body. It also can cause havoc in your mouth.
Stress is one of those things that most people know about, occasionally think about, and often never do anything about. Yet stress can be the most important factor that can destroy your body slowly without you knowing it – until it’s too late.
I want to drive this point home with the story about a patient whom I will call Emma. Then I’ll discuss some recent research about the potential effects of stress on the body.
Emma
Let me tell you about Emma – her stress, the damage it caused, and her total recovery.
Years ago, I was working with Dr. J. Daulton Keith in his periodontal office. Dr. Keith is a well-respected periodontist where I live. He shared this story of his patient with me, but I’ll tell it in my own words. So, it may differ slightly from the facts.
Let me introduce you to Emma.
Emma is a 30ish-year-old woman who came to the dental office with the complaint of sore, bleeding gums. From a dental standpoint, there were no obvious causes for her oral problem. She had very little dental plaque around her gum tissues. And her dental x-rays did not indicate any active periodontal destruction in her jawbone.
Below are a “before photograph” and an “after photograph” of Emma’s mouth. They may seem disturbing because they look unnatural. However, the photography was done with the lips pulled back to show the teeth and gums for better viewing.
Here is how Emma’s mouth looked when she first came to the periodontal practice. You are looking at her red and swollen gum tissues around her teeth:
Since there were no obvious dental reasons for these lesions, Dr. Keith referred her to her medical doctor to check for possible systemic diseases that could be the cause. We were concerned that Emma’s inflamed, raw-looking gum tissues could have been the result of side effects from medications or blood disorders. But none of these were her problem.
After she returned to the dental office, she broke down emotionally and confided her secrets to Daulton.
Emma described the emotional and sexual abuse inflicted by her employer! And she explained that this abuse was ongoing for a couple months. Unfortunately, Emma wanted to keep her job and allowed this employer to subject her to his despicable exploitation.
Dr. Keith is one of the most empathetic people I know. He listened to Emma, consoled her, and sincerely offered his help. He convinced her to make a life change.
Emma had no family ties in the city. But Daulton was aware of a job offer in another state that might interest her. Emma loved the idea.
She applied for the job and was hired. She then immediately quit her current job with her abusive employer and relocated to start her new life.
Four months later, she returned to our periodontal office. From the time she originally was seen until the time she returned after her move, she did not receive any medical or dental treatment for her mouth lesions. Her only treatment was the removal of her emotional stress 100%.
Here is the picture of her mouth after she returned to the office. All of the gum lesions were gone – no soreness, no bleeding, no lesions. Her original mouth condition was caused by severe emotional stress; her cure was the direct result of totally eliminating this stress from her life:
Unfortunately, most people who experience emotional stress from whatever sources are unable to reduce that stress completely. But Emma is a real-life example of a person who suffered the manifestation of severe psychological stress and healed completely after totally removing that stress from her life.
Stress & the Body
Emotional stress damages the gut microbiome, increases intestinal permeability, and increases inflammatory cytokine levels. Cytokines are small proteins that talk to and regulate different tissues in the body. Primarily, they are produced from cells in the immune system and have two conflicting actions:
- They can be proinflammatory.
- They can be anti-inflammatory.
Cytokines modulate the immune system and its overall function. I’ve described how important the immune system is to overall health in my previous Blog.
If you were able to reduce your stress levels, you could improve your gut health and lower the levels of inflammatory cytokines circulating in your body. That would improve your immune system’s ability to fight the fight that it is designed to fight.
Animal and human research has routinely showed how the body functions and what causes the body to do what it does. Especially when investigations compare an experimental group of individuals to a control group of individuals to determine causal relationships in the experimental group. Here are a few medical papers that explain how emotional stress can affect the body.
1. This study[1], published in 2013, looked at 37 military troops. They were involved in prolonged and intense combat-training. As expected, this training induced increases in stress, anxiety, and depression. However, the results also showed gastrointestinal (GI) symptoms, pro-inflammatory immune activation, and increased intestinal permeability – all resulting from acute stress.
2. In this study[2], published in 2017, 73 soldiers were subjected to intense military training, which created significant emotional stress. No matter what these soldiers ate, stress caused unhealthy changes in the gut bacteria and the way bacteria metabolized nutrients. These changes resulted in increased markers of inflammation and leaky gut.
3. In this third 2019 peer-reviewed paper[3], researchers used a mouse model to study the effects of stress. The investigators divided the mice into a control group and an experimental group which was subjected to severe emotional stress.
This research showed that stress can cause negative and long-term changes to the gut microbiome by altering the composition and behavior of specific gut bacteria. These changes in the garden of gut bacteria could lead to destructive changes in the body’s immune system. Changes to both the gut microbiome and the immune system could make the mice more vulnerable to many chronic diseases.
Specifically, changes in bacteria in the mouse gut affected the cells in their lymph system. Changes in the lymph system confused the immune system to begin an attack on its own tissues, which is the beginning of an autoimmune reaction. According to Alessio Fasano, autoimmune disease requires damage to the gut microbiome, damage to the epithelial barrier in the gut, and a genetic predisposition in the affected tissue.[4]
Interestingly, if the severe emotional stresses were eliminated, the bacterial changes returned to normal levels after 14 days in this mouse model. However, the damaged immune system caused by the altered gut bacteria could become permanent even if the stress was reduced and the bacteria returned to normal.
If we can relate these effects to the human, we can appreciate the importance of stress on overall wellness.
The results of these three studies help explain how Emma’s stress affected her gut microbiome, her immune system, and ultimately her gum tissues. And when Emma was able to completely remove the emotional stress that affected her gut and immune system, the lesions in her gum tissues totally resolved. For Emma, these immune system changes were not permanent, probably because the stress was completely removed in short order.
However, for those who are under severe emotional stress for extended periods of time, their body might experience permanent autoimmune damage. It becomes obvious to me that stress must be reduced as soon as it is recognized.
Reduce Your Stress
A number of years ago, I wrote several articles about stress and how to deal with it. What was true then is truer today. Especially with the stress of the worldwide pandemic, the political divide in our country, and the loss of jobs for so many people because of COVID-19. With my blog, A Unique Way To Handle Stress, I found an insightful metaphor that I hope is helpful for you or for someone who means everything to you. If you find yourself struggling to reduce your stress levels, these 11 tips are great starting points.
[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=Combat-training+increases+intestinal+permeability%2C+immune+activation+and+gastrointestinal+symptoms+in+soldiers
[2] https://www.ncbi.nlm.nih.gov/pubmed/?term=Changes+in+intestinal+microbiota+composition+and+metabolism+coincide+with+increased+intestinal+permeability+in+young+adults+under+prolonged+physiological+stress
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517692/
[4] https://link.springer.com/article/10.1007%2Fs12016-011-8291-x
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