Gingival inflammation, increased periodontal pocket depth and elevated interleukin-6 in gingival crevicular fluid of depressed women on long-term sick leave

J Periodontal Res. 2007 Dec;42(6):546-52. doi: 10.1111/j.1600-0765.2007.00980.x.


Background and objective: The aim of this work was to investigate periodontal status, in relation to inflammatory markers and cortisol, in the gingival crevicular fluid and saliva of a homogenous group of women on long-term sick leave for job-stress related depression in comparison to nondepressed women.

Material and methods: The participants comprised 20 women with depression (DSM-IV) (mean age 48.5 +/- 6.9 years) and 29 healthy controls (mean age 54.5 +/- 2.9 years). Clinical examination was performed. Gingival crevicular fluid was collected by an intracrevicular washing technique. Interleukin-1 beta, interleukin-6, matrix metalloproteinase (MMP)-8 and MMP-9 were determined with enzyme-linked immunosorbent assay and cortisol was determined by using a radioimmunoassay. One-way analysis of covariance was used as the statistical method.

Results: The depressed patients had significantly higher gingival inflammation (p < 0.001), and deeper pockets (p < 0.003), than the healthy controls, after adjusting for age and smoking. The levels of interleukin-6 in the gingival crevicular fluid were significantly higher in the patients than in the controls: 3.84 +/- 1.58 pg per site and 0.79 +/- 1.83 pg per site, respectively, p < 0.003. There were no significant differences in the levels of interleukin-1 beta, MMP-8 and MMP-9. The patients had lower cortisol values in gingival crevicular fluid than the controls, whereas the levels of cortisol in saliva were similar in both groups.

Conclusion: Women on long-term sick-leave for depression had more severe periodontitis and higher concentrations of interleukin-6 in gingival crevicular fluid than healthy controls. An alteration of the immune system in these patients might be interpreted as reflecting the consequences of long-term stress exposure and might contribute to worse periodontal conditions in these particular patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Depression / complications*
  • Depression / immunology
  • Depression / metabolism
  • Female
  • Gingival Crevicular Fluid / chemistry
  • Gingivitis / complications*
  • Gingivitis / immunology
  • Gingivitis / metabolism
  • Humans
  • Hydrocortisone / analysis
  • Interleukin-6 / analysis
  • Middle Aged
  • Periodontal Pocket / complications*
  • Periodontal Pocket / immunology
  • Periodontal Pocket / metabolism
  • Saliva / chemistry
  • Sick Leave
  • Stress, Psychological / complications
  • Stress, Psychological / immunology
  • Stress, Psychological / metabolism


  • Interleukin-6
  • Hydrocortisone