Is there association between stress and periodontitis?

Clin Oral Investig. 2020 Jul;24(7):2285-2294. doi: 10.1007/s00784-019-03083-9. Epub 2019 Oct 25.

Abstract

Objective: This study estimated the association between stress and periodontitis.

Materials and methods: A cross-sectional study was conducted with a sample of 621 individuals. Information about individuals was obtained through a questionnaire. Stress was evaluated using the Perceived Stress Scale. The diagnosis of periodontitis was based on a complete periodontal examination including clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios (PR), crude and adjusted, and their respective 95% confidence intervals (95%CI) were estimated by Poisson regression analysis.

Results: In the final sample, 48.47% (301) of the individuals were classified as having stress, of which, 23.92% (72) had the diagnosis of periodontitis. Association measurements between stress and probing depth ≥ 4 mm (PRadjusted = 1.28, 95%CI [1.04 to 1.58]), stress and clinical attachment level ≥ 5 mm (PRadjusted = 1.15, 95%CI [1.01 to 1.31]), and stress and periodontitis (PRadjusted = 1.36, 95%CI [1.01 to 1.83]) showed that the frequency of these outcomes among those exposed to stress was 15-36% higher than those without the condition of stress, after adjustment for age, sex, schooling level, current smoking habit, pulmonary disease, and body mass index.

Conclusions: The findings showed positive association between exposure to stress and the presence of periodontitis, reaffirming the need to prevent and control stress.

Clinical relevance: Although there are limitations in this study, the results showed that an association exists between stress and periodontitis, signaling the necessity of a multidisciplinary attention when considering the psychological status in the management of oral and general health conditions of the individual.

Keywords: Chronic periodontitis; Epidemiology; Mental health; Oral health; Periodontitis; Psychological stress.

MeSH terms

  • Body Mass Index
  • Cross-Sectional Studies
  • Humans
  • Periodontal Attachment Loss
  • Periodontitis* / epidemiology
  • Periodontitis* / psychology
  • Prevalence
  • Smoking
  • Stress, Psychological*