Stress is bad for almost every system in the body, from the digestive tract to the cardiovascular system. And though there isn’t a direct connection between gum disease and stress, researchers are starting to connect the two. Stress increases the level of cortisol in the body. Cortisol is a hormone produced by the adrenal glands. It’s released in response to stress and helps the body handle physical and emotional demands.

The problem is that too much cortisol can weaken the immune system and lead to a host of other problems, including diabetes, heart disease, and gum disease. Gum disease also weakens the teeth, which puts people at increased risk for tooth loss. “Stress makes us more susceptible to disease and infections,” says Dr. Zainab Rangwala.

A study published in 2014 showed that periodontal disease is linked with stress. Patients who had periodontal disease reported higher levels of stress than those who did not. But the researchers didn’t find any connection between stress and the severity of gum disease.

It’s not surprising that periodontal disease is associated with stress. Gum disease causes irritation in the gums, which can be quite painful. It’s also possible that people with poor dental health are more likely to develop problems related to stress, such as anxiety and depression.