title: Approximal plaque and gingival sulcus bleeding in routine dental care patients: relations to life stress, somatization and depression.
abstract: OBJECTIVE
  Previous research on relations between life stress and periodontal conditions was often based on indicators of periodontal destruction history and stimulus-specific measures of life stress. The present study was undertaken to compare patients showing different degrees of gingival sulcus bleeding with patients without signs of bleeding, using an instrument measuring cognitive impacts of events and assessing reported symptoms of depression and somatization. Additionally the patient groups were compared with regard to dental status and dental visiting behaviour. Analog comparisons were conducted in patients with different degrees of approximal plaque.
  
  
  METHODS
  140 routine dental care patients attending a private dental practice were examined. Measurement devices were the sulcus bleeding index (SBI), the approximal plaque index (API), the Dental Avoidance Scale, the Life Experience Survey (LES), the Impact of Event Scale with the subtests cognitive intrusion and cognitive avoidance, and the SCL-90-R subscales somatization and depression.
  
  
  RESULTS
  Patients with high API scores differed from their zero-score counterparts in dental avoidance and time since last visit only. By contrast, subjects scoring high in the SBI not only had more missing teeth and reported more dental avoidance than their zero-score counterparts but also had elevated scores in intrusive and avoidant thoughts related to a stressful event as well as in symptoms of somatization and depression. No difference was found for the measure of stimulus specific recent life events (LES).
  
  
  CONCLUSIONS
  The results suggest that cognitive preoccupation with adverse events and the presence of somatization and depression symptoms might play a role in gingival inflammation.
authors.affiliation: Department of Orthodontics, School of Dental Medicine, University of Mainz, Mainz, Germany. klages@kieferortho.klinik.uni-mainz.de
authors.forename: Ulrich
authors.initials: U
authors.lastname: Klages
authors.forename: Andreas Gordon
authors.initials: AG
authors.lastname: Weber
authors.forename: Heinrich
authors.initials: H
authors.lastname: Wehrbein
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003729:Dental Care; D003773:Dental Plaque / Q000523:psychology*; D003774:Dental Plaque Index; D003863:Depression / Q000523:psychology*; D005260:Female; D005891:Gingivitis / Q000523:psychology*; D006801:Humans; D008297:Male; D010512:Periodontal Index; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000523:psychology*