Could exams cause tooth decay?

A recent scientific study has suggested academic stress, often as its highest during exams, could cause tooth decay, with younger students at greater risk than older students.

The study1 looked at the oral health of 73 students before, during and after their exams. Results showed that students under stress had higher levels of tooth decay than students with a low stress level. It also found 18 year old students were almost twice more likely to develop tooth decay than 22 year old students.

The research also highlighted that women were more likely to suffer tooth decay when under academic stress than their male counterparts.

The findings are food for thought for the 2.5 million students in higher education. While plenty of information is readily available about how to combat exam-related stress and anxiety, keeping a good oral health routine is one piece of advice seldom associated with stress.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, said: “Exams are a stressful time for anyone, regardless of age. There is often quite a lot resting on them, and it is only normal for students to experience some degree of stress and anxiety over their results.

“However tired you may feel, ensuring you brush your teeth for two minutes twice a day using a fluoride toothpaste – first thing in the morning and night – is really important for a number of reasons. Good oral health has been proven to stave off a number of nasty bugs, many of which if you caught them would seriously hamper your ability to give your best during exams.

“Many students also choose to snack during revision sessions, not to mention consuming sugary energy drinks ahead of exams. While these may give you a short-term boost, the long-term effects on oral health could end up being a failure.

“Every time we eat or drink anything sugary, teeth are under attack for up to one hour. Saliva plays a major role in neutralising acid in the mouth, and it takes up to an hour for that to happen. If sugary items are constantly being consumed, the mouth is constantly under attack and does not get the chance to recover. The key thing to remember is that it is how often sugar is consumed, rather than how much sugar, which heightens the risk of tooth decay. That is why one of the Foundation’s key messages is to cut down on how often you have sugary foods and drinks.

“Practical solutions such as chewing on sugar-free gum can help to speed up the time that is takes for the saliva to neutralise plaque acids and lessen the damage that these can cause. By chewing sugar-free gum for around 10 minutes and keeping to a good, healthy balanced diet during the revision and exam period will not only be beneficial to your overall health, but it will help to maintain your oral health. Snacking on sugary sweets may get you through a night’s revision, but repeating the practice night after night is harmful to your oral health. Consider foods such as cheese and nuts to graze on, while water or diluted juice drinks are an excellent alternative to sugary energy drinks.”


1. Mejía-Rubalcava, C., Alanís-Tavira, J., Argueta-Figueroa, L. and Legorreta-Reyna, A. (2012), Academic stress as a risk factor for dental caries. International Dental Journal, 62: 127-131. doi: 10.1111/j.1875-595X.2011.00103.x