Towards the question of inter-relations between periodontitis and psycho-emotional stress
DOI:
https://doi.org/10.32782/2786-7684/2023-3-4Keywords:
periodontitis, psycho-emotional stress, literature reviewAbstract
In the specialized literature, several directions of the psycho-emotional stress impact on changes within the structure of periodontal tissues are currently singled out: due to changes in the metabolism of the microbiome of the oral cavity, due to changes in the levels of the intensity of inflammation, due to changes in the homeostasis of bone tissue of the jaws. In addition, the influence of psycho-emotional factors on the probability of developing periodontal pathology is also possible due to a change in a number of behavioral components (failure to observe proper oral hygiene, adequate diet, activity and rest regime, and sleep deprivation). Objective. To assess the significance of the available evidence regarding the presence of relationships between the features of the pathology of periodontitis and the influence of psycho-emotional stress as a risk factor. Materials and methods. In order to form the primary cohort of publications, the search was conducted using the Google Scholar service (https://scholar.google.com/) and a set of the following keywords: «psychological stress», «emotional stress», «periodontitis». Results and their discussion. The prevalence of periodontitis among patients with a high level of stress is 36% higher than among individuals without pronounced negative changes in emotional state. The parameter of the clinical attachment loss is an indicator that, according to the data of a systematic review, correlates to the greatest extent with the registered influence of various psychological factors noted among patients. Psycho-emotional stress is a modified risk factor for the development of periodontitis, and it is subject to full or partial relief during the implementation of appropriate therapeutic and preventive approaches, which differ in the methodology of their implementation, depending on the chronic or acute nature of the impact. Compromise of the immunological balance in the structure of periodontal tissues due to psychological stress can be realized due to the influence of the latter on the hypothalamic-pituitary-adrenal system, the system of the locus coeruleus, sympathetic and medulla of the adrenal glands, and on the peptidergic nervous system. Conclusions. Available literature data indicate that psycho-emotional stress is a factor that can provoke deterioration of the clinical course of periodontitis pathology, and reduce the effectiveness of non-surgical treatment methods, especially in patients with severe forms of pathology, as well as in areas of deep periodontal pockets and severe bleeding. The available evidence is insufficient to confirm the importance of stress as an independent, separate etiological factor of periodontitis, however, it is known that the influence of a number of psychoemotional factors in combination with other factors can increase the risk of the development of pathology.
References
The assessment of stress, depression, and inflammation as a collective risk factor for periodontal diseases: a systematic review / A. Decker, H. Askar, M. Tattan et al. Clinical oral investigations. 2020. Vol. 24. P. 1-12.
Bakri I., Douglas C. W. I., Rawlinson A. The effects of stress on periodontal treatment: a longitudinal investigation using clinical and biological markers. Journal of clinical periodontology. 2013. Vol. 40(10). P. 955-961.
Psychological stress: neuroimmune roles in periodontal disease / J. Zhang, S. Lin, L. Luo et al. Odontology. 2023. Vol. 111(3). P. 554-564.
Chronic stress and depression in periodontitis and peri-implantitis: a narrative review on neurobiological, neurobehavioral and immune–microbiome interplays and clinical management implications / F. D’Ambrosio, M. Caggiano, L. Schiavo et al. Dentistry Journal. 2022. Vol. 10(3). P. 49.
Periodontal emotional stress syndrome: Review of basic concepts, mechanism and management / J. Bansal, A. Bansal, M. Shahi et al. Open Journal of Medical Psychology. 2014. Vol. 3. P. 250-261.
Psychological stress delays periodontitis healing in rats: the involvement of basic fibroblast growth factor / Y.J. Zhao, Q. Li, B.X. Cheng et al. Mediators of Inflammation. 2012. Vol. 2012. P. 732902-732902.
Impact of Stress on Periodontal Health: Literature Revision / D. Corridore, M. Saccucci, G. Zumbo et al. Healthcare. 2023. Vol. 11(10). P. 1516.
Unveiling the role of stress in periodontal etiopathogenesis: An evidence‐based review / C. Preeja, R. Ambili, K.J. Nisha et al. Journal of investigative and clinical dentistry. 2013. Vol. 4(2). P. 78-83.
Periodontal diseases and stress: a brief review / A. Akcali, O. Huck, H. Tenenbaum et al. Journal of oral rehabilitation. 2013. Vol. 40(1). P. 60-68.
Effect of anxiety and psychologic stress on periodontal health: a systematic review and meta-analysis / K. Aggarwal, J. Gupta, R.K. Kaur et al. Quintessence International. 2022. Vol. 53(2). P. 144-54.
Stress, salivary cortisol and periodontitis: A systematic review and meta-analysis of observational studies / J. Botelho, V. Machado, P. Mascarenhas et al. Archives of Oral Biology. 2018. Vol. 96. P. 58-65.
Association between psychological stress and periodontitis: a systematic review / M.M. Castro, R.D.O. Ferreira, N.C. Fagundes et al. European journal of dentistry. 2020. Vol. 14(01). P. 171-179.
Kisely S. Periodontal Health and Psychiatric Disorders. Current Oral Health Reports. 2023. Vol. 10(3). P. 111-116.
Is there association between stress and periodontitis? / J.M.F. Coelho, S.S. Miranda, S. S. da Cruz et al. Clinical oral investigations. 2020. Vol. 24. P. 2285-2294.
Relationship of Periodontal Health and Multiple Common Stress Factors Among The Socially Deprived Women: Periodontal Health and Multiple Common Stress Factors / A. Malik, A. Shafi, B. Khalid et al. Pakistan Journal of Health Sciences. 2023. Vol. 4(1). P. 118-121.
Aggravating Effects of Psychological Stress on Ligature-Induced Periodontitis via the Involvement of Local Oxidative Damage and NF-κB Activation / Q. Li, Y. Zhao, D. Deng et al. Mediators of inflammation. 2022. Vol. 2022. P. 6447056.
Relationship between psychological stress determined by voice analysis and periodontal status: a cohort study / T. Maruyama, D. Ekuni, M. Higuchi et al. International journal of environmental research and public health. 2022. Vol. 19(15). P. 9489.
Assessment of Psychological Stress as a Risk Factor for Periodontal Disease: Systematic Review and Meta-Analysis / I.I. Badia, L.C. Aparicio, M.R. Aranda et al. Journal of International Dental and Medical Research. 2022. Vol. 15(3). P. 1330-1339.
A systematic review of stress and psychological factors as possible risk factors for periodontal disease / D.C. Peruzzo, B.B. Benatti, G.M. Ambrosano et al. Journal of periodontology. 2007. Vol. 78(8). P. 1491-1504.
Effect of psychosocial stress and coping strategies on non-surgical periodontal therapy in patients with generalized stage III/IV periodontitis: a longitudinal intervention study / F. Romano, A. Bebars, V. Ortu et al. Clinical Oral Investigations. 2023. P. 1-9.
Influence of psychological stress on non‐surgical periodontal treatment outcomes in patients with severe chronic periodontitis / C. Petit, V. Anadon‐Rosinach, L. Rettig et al. Journal of periodontology. 2021. Vol. 92(2). P. 186-195.
Is psychological stress a possible risk factor for periodontal disease? a systematic review / H.S. Halawany, N.B. Abraham, V. Jacob et al. African Journal of Psychiatry (South Africa). 2015. Vol. 18(1). P. 217.
Psychological stress: a predisposing and exacerbating factor in periodontitis / A.M. Spector, T.T. Postolache, F. Akram et al. Current Oral Health Reports. 2020. Vol. 7. P. 208-215.
Models to evaluate the role of stress in periodontal disease / R.J. Genco, A.W. Ho, J. Kopman et al. Annals of periodontology. 1998. Vol. 3(1). P. 288-302.
