Journal of periodontology vol:82 issue:2 pages:287-92
Background: Some cross-sectional and longitudinal studies have attempted to link periodontitis with stress. Only one small study has been published on the mechanism by which stress may influence periodontal diseases suggesting behavioral and physiological mechanisms and investigating the role of inflammation as a potential mediator. Objectives: this study was planned to explore the associations between - periodontal disease, psychological factors, and salivary markers of stress, psycho-neuro-immunologic variables and health behavior. Materials and methods: One hundred periodontitis patients were selected. Participants provided information on general health, chronic stress and demographics. Stress markers (choromogranin-A, cortisol, alpha-amylase and beta-endorphin) were measured from saliva. A dentist assessed the presence of dental plaque on lingual and buccal surfaces, gingival index and the number of remaining teeth of periodontal disease. Results: Stress and salivary stress markers were significantly correlated with clinical parameters of periodontal disease (ranging from 0.19 to 0.59, P <0.001). Neglect of brushing teeth during stress was associated with missing teeth. After adjusting for stress variables, salivary cortisol and beta-endorphin were significantly associated with tooth loss and with clinical parameters of periodontal (P <0.001, 95% CI, R(2)=0.59). Conclusions: This study suggests that stress might be associated with periodontal disease through physiological and behavioural mechanisms. The association between salivary stress markers and periodontal disease need to be included. Further exploration of relationships between periodontitis and stress is warranted.