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Stress, Oral diseases and Integrative approach with Ayurveda

Stress-a state of mental or emotional strain or tension resulting from adverse or demanding circumstances.

As per the 2016 report of National Institute of Mental Health and Neurosciences (NIMHANS), common mental disorders (CMDs) like depression, stress, anxiety and substance use affect 10% of Indian population. Prevalence is twice more in females compared to males and 2-3 times more in urban population compared to rural.

It is well established by scientific evidence that stress can have variety of impacts on various organs of our body, due to series of chemical changes resulting in disturbances in metabolic, immunologic, endocrinal and other body functions. This affects homeostasis or equilibrium among various functions of our body and mind. The category is called psychosomatic disorders. We consider them different from other pathological conditions affecting only the body.

The mouth also exhibits many menifestations of stress like Oral lichen planus, Myofascial pain and dysfunction (unexplained aches and pains), recurrent aphthous stomatitis (mouth ulcers), burning mouth syndrome, bruxism (grinding/clenching of teeth) and xerostomia (dry mouth).

   

Fig 1: Oral lichen planus                 Fig 2: Recurrent mouth ulcers                       Fig 3: burning mouth

Ayurveda looks at physical body (tissues, organs and their functions), mind (mental status and handling of emotions), and consciousness (life force-energy, Prana) as various components of one system, that are intricately interconnected wherein each affecting the other in case of any disturbance. According to Ayurveda, sickness arises in the system due to disturbance in homeostasis and eventually manifest in the weakest body part as disease.

If we apply this logic, it becomes clear as to why there is no single disease manifestation due to stress. People suffer from variety of illnesses in different organs/systems of the body due to stress like oral ulcers, burning mouth, dry mouth, lack of appetite, stomach ulcers, acidity, headaches and migraine, sleeplessness, diabetes and many other chronic illnesses.

Where as the Allopathy primarily focuses on addressing the symptoms of the physical body, e.g. local steroidal applications, multivitamins, antioxidants etc. for oral conditions, Ayurveda handles the situation at systemic level. Apart from dietary and lifestyle changes, medicines and Panchakarma treatments, there are specific yog-asanas and pranayama practices that a Shalakya doctor would prescribe.

How long would it take to cure them?

Well, it depends on many factors, but treating all chronic conditions take longer time so as to retore the lost homeostasis in the system. It is better to get cured in 3-6 months than live with recurring conditions throughout life.

Integrative approaches help a lot to a dentist when handling stress related oral lesions.

To share my experience, let me take an example of recurrent oral ulcers. When we work with integrative approach, the intensity of the condition dicreases by the day and the frequency of recurrence reduce over a period of time and eventually these conditions stop appearing in the mouth with Ayurveda treatments. During this entire period when my patients are under Ayurveda care, I handle their symptoms of pain/burning with local applications, as and when ulcers appear.

It is interesting to know that there is another category of people who seem to handle stressful situations in daily life in a much better manner without manifesting any disease conditions of the body and mind. They have a better coping mechanism in the form of strong mind and sound body. Ayurveda doctors try to achieve that for their patients suffering from stress related oral conditions, so that patients can develop better coping mechanisms with right kind of food, daily routine and right frame of mind.

Scientic evidence for Ayurveda treatment for sress induced oral conditions:                    

  1. Umamaheswari M, Asokkumar K, Rathidevi R, Sivashanmugam AT, Subhadradevi V, Ravi TK. Antiulcer and in vitroantioxidant activities of Jasminum grandiflorum J Ethnopharmacol. 2007;110:464–70. [PubMed]
  2. Date BB, Kulkarni PH. Assessment of Rasa dantiin various oral disorders. Ayurveda Res Pap. 1995;2:175–97.
  3. Dharmani P, Palit G. Exploring Indian medicinal plants for antiulcer activity. Indian J Pharmacol 2006;38:95-9.
  4. Visavadia BG, Honeysett J, Danford M. Manuka honey dressing: An effective treatment for chronic wound infections. Br J Oral Maxillofac Surg 2008;46:696-7.
  5. Rai S, Wahile A, Mukherjee K, Saha BP, Mukherjee PK. Antioxidant activity of Nelumbo nucifera (sacred lotus) seeds. J Ethnopharmacol 2006;104:322-7.
  6. Marwick C. Researchers investigate potential use of plant as a pain killer. BMJ 2005;331:1104.
  7. Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont 2011;20:251-60.
  8. Messier C, Epifano F, Genovese S, Grenier D. Licorice and its potential beneficial effects in common oro-dental diseases. Oral Dis 2012;18:32-9.
  9. Ngari FW, Wanjau RN, Njagi EN, Gikonyo NK. Herbal materials used in management of oral conditions in Nairobi, Kenya. J Oral Health Comm Dent 2014;8:36-42.
  10. Sumit B, Geetika A. Therapeutic benefits of holy basil (Tulsi) in general and oral medicine: A review. Int J Res Ayurveda Pharm 2012;3(6):761-4.
  11. Chaturvedi TP. Uses of turmericin dentistry: An update. Indian J Dent Res. 2009;20:107–9. [PubMed: 19336870]
  12. Bhowmik D, Chiranjib B, Sampath Kumar KP, Chandira M, Jayakar B. Turmeric: A herbal and traditional medicine. Arch Appl Sci Res. 2009;1:86–108.
  13. Yagi A, Kabash A, Okamura N, Haraguchi H, Moustafa SM, Khalifa TI. Antioxidant, free radical scavenging and anti-inflammatory effects of aloesin derivatives in Aloe vera. Planta Med 2002; 68:957-60.
  14. Dhanalakshmi S, Devi RS, Srikumar R, et al. Protective effect of Triphala on cold stress-induced behavioral and biochemical abnormalities in rats. Yakugaku Zasshi 2007; 127:1863–1867.
  15. Srikumar R, Parthasarathy NJ, Manikandan S, et al. Effect of Triphala on oxidative stress and on cell-mediated immune response against noise stress in rats. Mol Cell Biochem 2006;283:67–74.
  16. Kumari N, et al. Effects of ionizing radiation on microbial decontamination, phenolic contents, and antioxidant properties of triphala. J Food Sci 2009;74: M109–M113.
  17. Naik GH, et al. In vitro antioxidant studies and free radical reactions of triphala, an ayurvedic formulation and its constituents. Phytother Res 2005;19:582–586.
  18. Kaur S, Michael H, Arora S, et al. The in vitro cytotoxic and apoptotic activity of Triphala—An Indian herbal drug. J Ethnopharmacol 2005;97:15–20.

Dr. Vaibhavi Joshipura

Periodontist (Gum Specialist) MDS, Periodontics/Periodontology, PhD. Periodontics/Periodontology