title: Anxiety, stress, depression, and patients' responses to periodontal treatment: periodontists' knowledge and professional behavior.
abstract: BACKGROUND
  Anxiety, stress, and depression affect the use of health care services, treatment decision-making, and responses to periodontal treatment. This study explored periodontists' confidence in detecting patient anxiety, stress, or depression, as well as their knowledge concerning the relationships between these factors and patients' pain, use of pain medication, and wound healing after periodontal treatment. In addition, this research surveyed if (and which) special accommodations were offered when treating patients with high levels of anxiety, stress, or depression.
  
  
  METHODS
  Data were collected from 171 members of the American Academy of Periodontology (response rate = 34.41%). Most respondents were male (82.2%), white (88.2%), and practiced in solo practices (60.9%).
  
  
  RESULTS
  The respondents were more knowledgeable about the effects of anxiety and stress on pain, the use of pain medication, and wound healing than about the impact of depression on these outcomes. They agreed more strongly with statements that they were more confident in their ability to perceive when patients were anxious and stressed than when they were depressed. They also offered more special accommodations for patients with anxiety and stress than for patients with depression.
  
  
  CONCLUSIONS
  The respondents were significantly less knowledgeable about the impact of depression on patients' responses to periodontal treatment than about the effect of anxiety and stress. Given the evidence concerning the relationships among depression, pain, pain medication use, and wound healing, it is important to educate periodontists about the role of anxiety and stress and the significance of depression on their patients' responses to periodontal therapy.
authors.affiliation: School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Kloostra
authors.forename: Robert M
authors.initials: RM
authors.lastname: Eber
authors.forename: Marita Rohr
authors.initials: MR
authors.lastname: Inglehart
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis*; D001291:Attitude of Health Personnel; D017742:Dental Care for Chronically Ill / Q000523:psychology*; D003815:Dentists / Q000523:psychology*; D003863:Depression / Q000175:diagnosis*; D005157:Facial Pain / Q000188:drug therapy / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010517:Periodontics; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014945:Wound Healing / Q000502:physiology
chemical_list: D000700:Analgesics