title: Occupational Stress, Salivary Cortisol, and Periodontal Disease: A Clinical and Laboratory Study.
abstract: BACKGROUND
  Periodontitis is a multifactorial disease, commonly associated with most of the lifestyle diseases. In the recent years, the association between periodontitis with occupational stress has evolved in various studies in many developed settings. This study aims at studying the prevalence of periodontal disease and its relationship with job stress among industrial labor workers covered under Employee's State Insurance Corporation Scheme.
  
  
  METHODS
  The study included 180 subjects who were informed about the research goals, and also requested to sign consents. The questionnaire included parts from the generic job stress questionnaire from the National Institute of Job Stress and Health. Dental examinations based on community periodontal index protocol were done using WHO probe. Participants with moderate to severe periodontitis (score 3, 4) were informed about the salivary cortisol test. The saliva samples were collected and transported to the lab. Data were entered in EPI info 3.1.1 and analyzed in SPSS 14. The Chi-square analysis was done to measure association, and logistic regression analysis was done to identify the independent association of job stress to periodontitis.
  
  
  RESULTS
  The study shows that 48% of the participants reported to have job stress, and 55% had periodontitis. The mean salivary cortisol level was 3.42 ng/dl. The results also indicated a higher odds of having low levels of salivary cortisol among those who reported job stress. Bi-variant regression analyses show the relationship of periodontitis with job stress to be much higher on controlling for other risk factors. The odds of having periodontitis in relation to positive job stress were 6 times higher than those who did not have positive job stress.
  
  
  CONCLUSIONS
  This study shows a high prevalence of job stress related periodontitis among industrial workers in India. This research recommends the health and labor ministry to improve access to dental care especially in rural areas and include psychiatric units and oral health care as a part of primary health care. The factories administration should encourage recreation and retreat of the workers so as to reduce the level of stress at work. The factory administrations were recommended to have counselors to help their employees.
authors.affiliation: Assistant Professor, Department of Public Health Dentistry, Employee's State Insurance Corporation Dental College & Hospital, New Delhi, India.
authors.forename: Mansi
authors.initials: M
authors.lastname: Atri
authors.affiliation: Dean, Employee's State Insurance Corporation Dental College and Hospital, New Delhi, India.
authors.forename: Dhirendra
authors.initials: D
authors.lastname: Srivastava
authors.affiliation: Associate Professor, Department of Oral Pathology, Employee's State Insurance Corporation Dental College & Hospital, New Delhi, India.
authors.forename: Jitin
authors.initials: J
authors.lastname: Kharbanda
authors.affiliation: Assistant Professor, Department of Conservative Dentistry, Rajasthan Dental College, Jaipur, Rajasthan, India.
authors.forename: Anupriya
authors.initials: A
authors.lastname: Bugalia
authors.affiliation: Registrar, Department of Public Health Dentistry, Government Dental College, Srinagar, Jammu and Kashmir, India.
authors.forename: Asif
authors.initials: A
authors.lastname: Yousuf
authors.affiliation: Professor and Head, Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India.
authors.forename: N
authors.initials: N
authors.lastname: Anup
keywords: Alcoholism; Employee’s State Insurance Corporation; community periodontal index and treatment needs; cortisol; oral hygiene; periodontitis; psychosocial disorders; smoking