Association between psychological stress and the clinical conditions of the periodontium

Abstract

This study investigated the association between psychological stress and periodontal disease. Forty systemically healthy volunteers (mean age: forty years) were selected from a population of patients that attend the undergraduate and graduate periodontal clinics at the School of Dentistry in Araraquara (UNESP). These patients were submitted to a periodontal evaluation, which included scoring of: visible plaque, marginal bleeding, probing depth and attachment loss. The social readjustment scale that evaluates the number and impact of stressful events occurred in the last 12 months was used to assess the stress on these patients. The patients were divided into two groups according to their stress severity: mild stress (15 patients, 37.5%) and moderate to severe stress (25 patients, 62.5%). Comparisons between these groups were performed using t-test and revealed that the moderate to severe stress patients presented a significantly greater percentage of sites with moderate probing depths (p=0.03), while the presence of plaque, marginal bleeding and mean attachment loss did not differ. The association between higher levels of stress and greater extent and severity of periodontal disease was also significant when assessed by a Chi-square test (p < 0.05) that compared the proportion of patients presenting attachment loss greater than 3 mm at more than 20% of the sites. The results suggest the possibility of an association between stress and destructive periodontal disease. However, further studies on a larger sample of patients should confirm this association as well as address the possible biological mechanisms supporting this association.