Evaluation of the association between stress, depression and periodontitis – a clinicobiochemical study.

Abstract

ABSTRACT: Background: Stress and depression may affect the onset and progression of periodontal disease. Only few studies has been established whether the mechanisms by which stress and depression influence periodontal disease are physiologic, behavioral, or both. Objectives: This cross-sectional pilot study explored the associations between periodontal disease, psychologic factors, salivary markers of periodontal disease, psychoneuroimmunologic variables, and behavior. Methods: The study includes 12 control group (healthy individuals) and 13 recall periodontal patients aged 30-80 years visiting Out Patient Department of Periodontology, AECS Maaruti College of Dental Sciences and Research Centre, Bangalore. Psycho-neuro-immunologic variables like stress and depression assessed through Derogatis Stress Profile (DSP) and Center of Epidemiologic Studies Depression scale (CES-D). Stress marker (Chromogranin- A) have been measured from saliva. Evaluation of the presence of dental plaque on lingual and buccal surfaces, gingival index, and probing depth were assessed. Results: Stress and salivary stress marker chromogranin A was significantly correlated with clinical parameters of periodontal disease. Neglecting to brush teeth during stress was associated with missing teeth. After adjusting for stress variables, salivary chromogranin A was significantly associated with tooth loss and periodontal clinical parameters. Conclusions: This study suggests that stress might be associated with periodontal disease through physiologic and behavioral mechanisms. In making diagnoses of psychiatric patients, the association between salivary stress markers and periodontal disease needs to be included.