Association between Bipolar Affective Disorder and Periodontal Diseases

Abstract

Periodontitis, an inflammatory disease of periodontal tissues, is characterized by the progressive loss of support tissue and the insertion of teeth. It derives from the infection and interaction of specific bacterial species with host response components in susceptible individuals. A growing number of observational and epidemiological studies have been published, in the last decades, pointing to a possible association between stress, anxiety, and depression with the development and progression of periodontal diseases. One of the possible mechanisms of influence of stress and of the psychosocial factors, in the periodontal conditions, is the modification of the individual's behavior. The studies that assessed the association between stress, depression, and periodontal disease are numerous in different types of design, yet their data are still conflicting. Another recurrent serious condition of mental health, frequently associated with high rates of morbidity and mortality, is the bipolar affective disorder (BPAD). Although little investigated and with conflicting data, BPAD is a behavioral factor associated to the periodontal disease. In addition, little is known about its interference with the microbial and immunological response to periodontitis. The aim of this chapter is to describe the main scientific evidence of the association between BPAD and periodontitis.

Dental and medical management of the patient with bipolar disorder

“…27 On the contrary, during the manic phase, patients may exacerbate oral hygiene measures leading to abrasive lesions and recession due to traumatic brushing techniques. 28 In addition, patients may have increased parafunctional habits which may lead to structural tooth loss via attrition. 29 Medications used to treat the symptoms may also result in xerostomia due to anticholinergic effects which may worsen the oral health conditions.…”

“…Prostheses may also become ill fitting and discarded 27 . On the contrary, during the manic phase, patients may exacerbate oral hygiene measures leading to abrasive lesions and recession due to traumatic brushing techniques 28 . In addition, patients may have increased parafunctional habits which may lead to structural tooth loss via attrition 29 .…”