Relationship between stress factors and periodontal disease.
OBJECTIVE
In addition to bacterial infections, adverse effects of immunological changes, in particular, stress factors may represent precipitating parameters of inflammatory periodontal diseases. The purpose of the present clinical study was to identify a possible relationship between an increase in life stress and the development of the loss of periodontal attachment.


METHODS
A total number of 120 patients with chronic periodontitis (PA group) were examined and compared with a control group of 122 patients (exclusion criterion: pathological periodontal changes) matched for age and gender. The individual life situation and possible stress factors were evaluated by the use of a questionnaire, which comprised questions on various aspects of everyday life.


RESULTS
The comparison of the results obtained for the two groups yielded statistically significant differences on all except one question. The control group achieved substantially lower scores on a scale from 0 (positive attitude) to 10 (negative attitude) in the evaluation of the degree to which a life event was perceived as stressful than the group with periodontal disease. For example, the average intensity score on the subjective assessment of emotional equilibrium ranged at 5.8 +/- 2.2 in the group of patients with periodontal disease (PA group) compared to 3.6 +/- 2.0 in the control group. The question regarding significant familial changes was answered positively by 37.5% of patients in the PA group, and by 22.9% of the controls. From among the questions designed to provide information on specific dental problems, those regarding clenching or grinding of the teeth were answered positively by 45.0% of the PA group and by 22.3% of the patients from the control group.


CONCLUSIONS
The results of the present study suggest that life event stress may exert an unfavourable effect on the course of chronic periodontitis.
Pistorius
A
A
Department of Operative Dentistry, Johannes Gutenberg-University Mainz, Germany. willersh@mail.zdv.Uni-Mainz.de
Krahwinkel
T
T
Willershausen
B
B
Boekstegen
C
C
D000328:Adult; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007588:Job Satisfaction; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000209:etiology / Q000523:psychology*; D010510:Periodontal Diseases / Q000209:etiology / Q000523:psychology*; D010549:Personal Satisfaction; D010551:Personality; D011788:Quality of Life; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D013997:Time Factors