Is there an association between depression and periodontitis? A birth cohort study

Abstract

Aim To investigate the association between depression and periodontitis among adults enrolled in the 1982 Pelotas Birth Cohort, Brazil. Materials and methods Major depressive episode (MDE) and severity of depressive symptoms obtained in 2012 were considered the exposure of this study. In 2013, periodontitis, the outcome of interest, was clinically assessed and two different case definitions were used: the CDC/AAP and a combination of clinical attachment loss (CAL) and bleeding on probing (BOP) simultaneously. Serum levels of C‐reactive protein and frequency of dental flossing were defined as mediators while confounders comprised a set of variables collected throughout the life‐course of the participants. The parametric g‐formula was used to test the direct, indirect and total effects of depression on periodontitis. Results 539 participants were clinically examined. Individuals with depressive symptoms presented higher risk of periodontitis (risk ratio [RR] 1.19). The presence of depressive symptoms was also associated with moderate/severe periodontitis (total effect RR 1.18). None of the associations was mediated by flossing or C‐reactive protein levels. Finally, neither the presence of depressive symptoms nor the presence of major depression was associated with the combination of CAL+BOP. Conclusions A positive association between depressive symptoms and periodontitis and moderate/severe periodontitis was found. MDE was not associated with periodontitis.

Possible Involvement of Vitamin C in Periodontal Disease-Diabetes Mellitus Association

“…Depression prevalence is two to three times higher in patients with DM, with some cases remaining underdiagnosed [76]. Depression is also a risk factor for PD [77][78][79]. This is the reason some future research must be done to minimize the influence of this confounding factor and evaluate its strength using different questionnaires [80,81].…”

Predictive Model of Clinical Attachment Loss and Oral Health-Related Quality of Life through Depressive Symptomatology, Oral Hygiene Habits, and Proinflammatory Biomarkers: A Pilot Study

“…The second hypothesis to specify the model stated that a higher level of depressive symptomatology would be a predictor of loss of OHRQoL [16], clinical attachment loss [8,9,11], poor oral hygiene habits [13], and increased proinflammatory immune response [1,2]. The hypothesis was fulfilled very partially.…”

“…In a study with participants from Brazil, Australia and Denmark, it is concluded that depressive symptomatology is a risk factor with a small effect size on periodontal disease [8]. In another study conducted in Japan, it is pointed out that depressive disorders are related to a decrease in oral health care consultations and an increased risk of periodontal disease and tooth loss; In addition, early onset mental disorders increase the probability of suffering from oral diseases over time [9].…”

“…A greater depressive symptomatology is a predictor of poor oral hygiene habits [13], clinical attachment loss [8,9,11], loss of OHRQoL, and increased proinflammatory immune response [1,2]. 3.…”

Toll-like receptor 4 agonist and antagonist lipopolysaccharides modify innate immune response in rat brain circumventricular organs

“…An excellent example of this is the LPS from Porphyromonas gingivalis (PG-LPS), a weak TLR4 agonist, with a pentaacyl lipid A, less endotoxic properties compared to EC-LPS that induces the expression of TNF-α, IL-1β, and MIP-2, but not IL-12 p40 and IFN-γ [13], but with significant relevance in the inflammatory response in periodontal disease. Recently, inflammation derived from periodontitis has been related to the neuroinflammation state in neurodegenerative [15] and psychiatric diseases [16,17]. Oral infection with P. gingivalis in mice can produce an impairment of learning and memory abilities by the release of proinflammatory cytokines in the brain [18], as well as depression-like behavior and a reduction of brainderived neurotrophic factor (BDNF ) [19].…”