Figure 1.

Interactions between mastication, cognition, stress and pain. Mastication has a regulatory effect on stress and also has positive effects on cognition and pain perception.12 In animals, reduced masticatory activity is linked to cognitive decline.5 Excessive mastication, however, can also cause pain.17 Pain causes stress32 and has a negative influence on masticatory activity,33 and on cognition.34 Cognitive changes such as dementia can both alter pain perception and limit pain communication.33 Cognitive decline can also have a negative effect on oral health.33 Research has not yet clearly revealed the nature of the influence that cognition may have on stress.35 Stress can lead to bruxism and/or oral parafunction12 and can also heighten sensitivity to pain (hyperalgesia).36 Although short‐term stress has a performance‐heightening effect, chronic stress has a negative effect on cognition12