title: Coping with stress: its influence on periodontal disease.
abstract: BACKGROUND
  Various forms of stress behavior were documented and in patients with periodontitis their relationship with periodontal disease was investigated.
  
  
  METHODS
  Eighty-nine patients with different forms of chronic periodontitis were included in this retrospective case-control study. They were all undergoing periodontal treatment at the Department of Dental Prosthetics, University of Graz, or a private dental practice. The control group consisted of 63 persons employed in health care at the Clinic of Graz. All participants completed a stress coping questionnaire of 114 items and 19 actional and intrapsychic stress coping modes. The questionnaire served as a psychodiagnostic survey aimed at collecting data on stress coping strategies. Clinical attachment loss (CAL) served as the clinical parameter.
  
  
  RESULTS
  With the help of a factor analysis with a factorization and Varimax rotation, 5 factors were extracted from the 19 subtests. The reliability of the questionnaire was less than 0.70 only for subtests "escape" and "pharmaceutical drugs." Otherwise the internal consistency ranged between 0.74 and 0.92, and the retest reliability between 0.72 and 0.84. Subsequent assessment with the t test for independent random samples at the 5% level showed that patients differ significantly from controls in regard of factor 2 (active coping, P = 0.40) and 3 (distractive coping, P = 0.033), and that they differ very significantly from controls in regard of factor 4 (defensive coping, P = 0.000) and 5 (coping through aggression and pharmaceutical drugs, P = 0.007). In the statistical analysis of factors with regard to the severity of periodontal disease, the patients were divided into 2 groups (mild to moderate and severe). The t test for independent random samples showed significance for factor 4 (defensive coping) in that patients with a defensive coping style had greater attachment loss (pF4 = 0.04).
  
  
  CONCLUSIONS
  The data corroborate the thesis that periodontitis patients with inadequate stress behavior strategies (defensive coping) are at greater risk for severe periodontal disease. However, further investigations are required to confirm the significance of inappropriate coping styles with respect to the advancement of periodontal disease.
authors.affiliation: Department of Prosthetics and Periodontology, Karl Franzens University of Graz, School of Dental Medicine, Graz, Austria. gernot.wimmer@uni-graz.at
authors.forename: Gernot
authors.initials: G
authors.lastname: Wimmer
authors.forename: Michaela
authors.initials: M
authors.lastname: Janda
authors.forename: Karin
authors.initials: K
authors.lastname: Wieselmann-Penkner
authors.forename: Norbert
authors.initials: N
authors.lastname: Jakse
authors.forename: Raoul
authors.initials: R
authors.lastname: Polansky
authors.forename: Christof
authors.initials: C
authors.lastname: Pertl
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000374:Aggression; D016022:Case-Control Studies; D003674:Defense Mechanisms; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology; D010518:Periodontitis / Q000209:etiology* / Q000523:psychology*; D012907:Smoking; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D011795:Surveys and Questionnaires; D014149:Tranquilizing Agents / Q000627:therapeutic use
chemical_list: D014149:Tranquilizing Agents