61 Questions
What is the primary function of the parasympathetic nervous system in response to stress?
To return the body to a normal state
What is the term for the physical changes that occur in the body in response to exercise?
Exercise stress
What is a potential long-term effect of chronic stress on the immune system?
Suppression of the immune system
What is the term for the type of stress that is characterized by short-term responses to specific events?
Acute stress
What is the potential long-term effect of chronic stress on the cardiovascular system?
Increased risk of heart attack
Which system is responsible for regulating the body's response to stress, including the release of hormones such as cortisol?
Endocrine system
What is the primary reason why dental practitioners should learn about stress?
To avoid burnout and maintain their own well-being
What is the physiological response to stress in the short term?
Release of cortisol and adrenaline hormones
What is the effect of prolonged stress on the body's immune system?
It weakens the immune system
What is the primary function of the adrenal gland in response to stress?
Releasing hormones such as cortisol and adrenaline
What is the effect of exercise stress on the body?
It causes changes in the cardiovascular, respiratory, endocrine, and nervous systems
What stimulates the release of adrenocorticotropic hormone (ACTH) from the pituitary gland?
Corticotropin-releasing hormone (CRH)
What is a result of cortisol levels being present for an extended period of time?
Reduced immune system function
What is released from the adrenal cortex in response to ACTH stimulation?
Cortisol
What is the result of a lack of cortisol in the body, such as in Addison's disease?
Severe symptoms during stress, including low blood pressure and hypoglycaemia
What is the primary function of cortisol in the body?
To play a key role in the stress response
What is released in response to strenuous exercise, in addition to cortisol?
Antidiuretic hormone (ADH) and aldosterone
What is the effect of cortisol on the immune system?
Suppression of the immune system
What is the function of the hypothalamus in the stress response?
To release corticotropin-releasing hormone (CRH)
What is the result of prolonged stress on the body?
Damaging effects, including immunosuppression and increased risk of infection
What is the relationship between stress and oral health, according to Vasiliou and Shankardass (2016)?
Inverse relationship
What is a potential consequence of chronic stress on wound healing and bone formation?
Decreased wound healing rate
Which oral disease has been associated with stress and has a multifactorial etiology?
Periodontal Disease
What is a potential side effect of certain medications used to treat stress or co-morbidities?
All of the above
What is the term used to describe the influence of external factors on gene expression and susceptibility to disease?
Epigenetics
Which oral condition has been linked to psychological factors, including stress?
Oral Lichen Planus
What is a potential consequence of chronic stress on the immune system?
Decreased cytokine production
Which oral disease has been associated with stress and has a high incidence in individuals with co-morbidities?
Periodontal Disease
What is the term used to describe the relationship between stress and oral diseases?
Psychoneuroimmunology
What is a potential consequence of chronic psychological stress on periodontal disease?
Increased production of inflammatory cytokines
Which psychological factor is associated with recurrent aphthous ulcers?
Stress
What is a proposed mechanism by which stress contributes to oral disease?
All of the above
What is the relevance of mental health to oral disease, according to the text?
Mental health can affect oral disease through various mechanisms
What is a clinical implication of the relationship between stress and oral disease?
Taking a full medical history, including mental health
What is a potential consequence of reduced salivary peroxidase levels?
Increased cell damage from hydrogen peroxide
What is a proposed mechanism by which stress affects oral disease?
Increased responsiveness of M1 macrophages to oral pathogens
What is a potential consequence of chronic psychological stress on the immune system?
Reduced immune responsiveness to oral pathogens
What is the primary motivator for dental practitioners to learn about stress physiology?
To better understand patient anxiety
What is a common consequence of prolonged stress on the oral cavity?
Periodontal disease
What is the underlying mechanism by which stress contributes to recurrent aphthous ulcers?
Increased cortisol levels
Which of the following oral diseases is influenced by psychological factors, including stress?
Oral lichen planus
What is a potential side effect of medication used to manage stress, which can impact oral health?
Dry mouth
What is the relationship between epigenetics and stress in oral diseases?
Stress can influence gene expression through epigenetic mechanisms
What is the primary mechanism by which stress contributes to periodontal disease?
Impaired immune response
What is the initial response of the body when encountering a stressor?
Sympathetic response
What is the relationship between stress and gene expression in oral diseases?
Stress can alter gene expression through epigenetic mechanisms
What is the role of the amygdala in the stress response?
Stimulates the hypothalamus
Which system is responsible for the 'rest, digest, recover, restore' response?
Parasympathetic nervous system
What is the effect of cortisol on gut motility and secretion?
Decreases gut motility and secretion
What is the longer-term response to stress, also known as the resistance reaction?
Resistance reaction
What is the role of the hypothalamus in the stress response?
Activates the sympathetic nervous system
What is the effect of cortisol on saliva secretion?
Decreases saliva secretion
What is the effect of the sympathetic nervous system on heart rate and force?
Increases heart rate and force
What is the primary mechanism by which cortisol release is stimulated in response to stress?
Release of corticotropin-releasing hormone (CRH) from the hypothalamus
What is the consequence of cortisol levels being present in the body for an extended period of time?
Reduced wound healing and bone formation
According to Vasiliou and Shankardass (2016), what is the relationship between current stress and oral health?
Inverse correlation
What is released in response to strenuous exercise, in addition to cortisol?
Antidiuretic hormone (ADH) and aldosterone
What is the effect of cortisol on the immune system?
Suppression of immune response
What is the function of the hypothalamus in the stress response?
Release of corticotropin-releasing hormone (CRH)
What is the result of a lack of cortisol in the body, such as in Addison's disease?
Severe symptoms during stress, including low blood pressure and hypoglycemia
What is the primary function of cortisol in the body?
Key role in the stress response
Study Notes
Physiological Stress
- Physiological stress is the response of an organism to stressors, which is counteracted by physiological and behavioral responses involving the sympathetic (fight or flight) and parasympathetic (returning to normal) nervous systems and several other systems in the body.
Types of Stress
- Acute stress: a short-term response to a specific event or situation, which can be exciting and not damaging by itself; examples include cycling down a hill fast, a job interview, or a looming deadline.
- Chronic stress: ongoing issues that can't be resolved, such as poverty, war, abuse, or unhappy relationships, which can have damaging effects on the body.
Physiological Response to Stress
- The hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH).
- ACTH stimulates the adrenal cortex to release cortisol, a steroid hormone that plays a key role in the stress response.
- Cortisol levels can be measured in saliva and can have damaging effects if present in high levels for a long time.
Effects of Chronic Stress
- Increased risk of heart attack, high blood pressure, suicide, and cancer
- Suppression of the immune system
- Reduced inflammation and wound healing
- Bone loss and muscle wasting
- Anxiety, depression, and mood disorders
Physiology of Exercise Stress
- Increased delivery of oxygen and energy to muscles is needed
- ATP stores are depleted in muscle and replenished through creatine phosphate, anaerobic and aerobic respiration
- Sympathetic nervous system increases heart rate and force of contraction
- Local vasodilation in muscles allows increased oxygen delivery
- Ventilation increases to remove excess CO2
Stress and Oral Health
- Chronic stress can negatively impact oral health and increase oral pain
- Stress can affect oral health in two ways: systemically, through the body's response to stress, and locally, through the effects of stress on oral health behaviors
Importance of Understanding Stress
- As a practitioner, understanding stress can help avoid burnout
- Patients may be stressed about dental procedures or have underlying long-term stress that affects their health
- Understanding the physiology of stress helps practitioners provide better care for their patients
Physiological Stress and Oral Health
- Unhealthy coping strategies for stress include alcohol, smoking, poor diet, substance use, sedentary behavior, and self-neglect.
- These behaviors can affect oral health and increase the risk of disease.
- Chronic stress can lead to:
- Increased pro-inflammatory cytokines
- Suppression of the immune system
- Decreased wound healing and bone formation
- Chronic inflammation
- Decreased antibody production
Effects of Stress on the Body
- Stress can lead to:
- Increased cortisol levels
- Suppression of the immune system
- Reduced wound healing and bone formation
- Chronic inflammation
- Decreased antibody production
- Cortisol is a steroid hormone required for survival, but high levels can be damaging.
- Prolonged stress can lead to:
- Emotions – anger, irritability, anxiety, depression
- Tension headaches, migraines
- Immunosuppression and increased risk of infection
- Increased risk of type 2 diabetes
- Gut problems – heartburn, ulcers, constipation, diarrhea, IBS
- Muscular pains, tension, increased chance of injury, muscle wasting
Physiology of Stress
- The hypothalamic-pituitary-adrenal (HPA) axis is activated during stress.
- Corticotropin-releasing hormone (CRH) is released from the hypothalamus, stimulating the pituitary gland to release adrenocorticotropic hormone (ACTH).
- ACTH stimulates cortisol release from the adrenal cortex.
- Cortisol levels can be measured in saliva.
- The physiology of stress involves the release of other hormones, including growth hormone-releasing hormone (GHRH) and thyrotropin-releasing hormone (TRH).
Stress and Oral Health
- Stress is associated with:
- Periodontal disease
- Bruxism
- Oral Lichen Planus
- TMJ PDS
- RAU
- ANUG
- Dry mouth
- Recurrent Aphthous Ulcers (RAU) may be associated with stress, but the data is conflicting.
- Proposed mechanisms for RAU include:
- Behaviors – cheek biting/chewing/parafunction
- Poor diet and deficiencies of Iron, B12, folic acid
- Reduced salivary peroxidase levels leading to increased cell damage
- Reduced wound healing
Clinical Implications
- Take a full medical history, including mental health and medications.
- Explain to patients why mental health may be relevant to oral disease.
- Understand that oral health is part of systemic health.
- Consider whether patients with chronic stress or poor mental health may be at higher risk of oral diseases.
- Use preventive measures as appropriate.
Learn about the physiological response to stress, including the sympathetic and parasympathetic nervous systems, and the different types of stress, such as acute stress.
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