Impact of chronic stress on periodontal health

Abstract

--Introduction: Periodontal diseases are caused by pathogenic microorganisms that induce increases in of local and systemic proinflammatory cytokines, resulting in periodontal damage. The onset and evolution of periodontal diseases are influenced by many local and systemic risk factors. Educational objective: In this article, we aim to review the results of the research on the impact of chronic stress on the occurrence, development, and response to periodontal disease treatments and on the pathophysiological mechanisms of periodontal disease. Conclusion: Chronic stress has a negative impact on the occurrence, development, and response to the treatment of periodontal disease via indirect actions on the periodontium. This can result from behavioral changes caused by stress (poor dental hygiene, smoking, etc.) and a direct neuroimmunoendocrinological action related to the consequences (particularly immunological) of the secretion of certain chemicals (e.g., cortisol) induced by the activation of the hypothalamus and the autonomic nervous system in response to stress. These factors necessitate multidisciplinary management (e.g., physician, oral surgeon, and psychologist) of patients to identify subjects with chronic stress and to employ countermeasures to decrease the impact of stress on the periodontium.

Association of Self-Perceived Psychological Stress with the Periodontal Health of Socially Deprived Women in Shelter Homes

“…The association of stress with periodontal health is difficult to prove as many factors influence the incidence and severity of periodontitis. Negative life events among socially deprived women can be linked with the onset or exacerbation of illness, and the relationship between important negative life events and disease can be mediated by the immune system [ 7 ]. Research has shown that emotional stress can modulate the immune system through the neural and endocrine systems [ 23 ].…”

“…Stress is defined as a state of disharmony in body homeostasis, counteracted by an intricate repertoire of physiologic and behavioral responses that aim to maintain and re-establish the threatened homeostasis (adaptive stress response) [ 6 ]. Psychological stress triggers the neuro-endocrine system, resulting in the continued release of pro-inflammatory mediators and an alteration in normal microbiota, thereby leading to periodontal inflammation [ 7 , 8 , 9 ]. The effect of different aspects of psychological stress, including emotional stress, work-related stress, and dissatisfaction at home or in society, is associated with compromised oral health as suggested by previous studies [ 10 , 11 ].…”

Oral Hygiene Status and Gingivitis in Overweight and Obese Children

“…Physiological responses to stress may alter blood and salivary flow and decrease the immune response to oral pathogens. 24 It is believed that emotional status has serious impact on personal oral health, because selfcare attitude is strongly influenced by the psychological profile. 25,26 According to other researchers, the oral hygiene status can be affected by behavior factors, linked to obesity.…”

Tobacco Use and Periodontal Disease—The Role of Microvascular Dysfunction

“…Periodontal disease severity depends on several risk factors that are both modifiable and non-modifiable. Non modifiable factors consist mainly in age and genetic susceptibility [ 10 ], whereas modifiable ones include poor oral hygiene [ 11 ], stress [ 12 ], and diseases like diabetes [ 13 , 14 ], although the most recognizable risk factor today is tobacco use [ 15 , 16 ].…”