Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study

Tagger-Green‬‎, Nirit; Nemcovsky, Carlos E.; Fridenberg, Naama; Green, Orr; Chaushu, Liat; Kolerman, Roni

doi:10.3390/jcm11113249

Cited by 4 publications

(9 citation statements)

References 52 publications

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“…Green et al evaluated the effects of PTSD on oral care. The results showed a high prevalence of periodontitis [13]. Similar to this study, oral care deteriorated in the patient group with PTSD.…”

Section: Discussionsupporting

confidence: 87%

“…Post-traumatic stress disorder is a disorder that closely concerns the oral health of individuals. Poor oral care may cause TMJ dysfunctions, tooth loss, and tooth wear in people with this disease [13,24,38]. Tooth wear is a complex condition that requires a multidimensional approach to diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric disorders may affect eating and drinking habits, oral hygiene habits, and similar conditions along with the tooth wear process. In addition to facial pain in the temporomandibular joint (TMJ) in patients diagnosed with PTSD, intraoral ndings such as abfraction, abrasion, tooth fractures, and cracks can be seen [13,14]. Psychiatric disorders such as PTSD may give indirect or direct ndings in the mouth [15].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the relationship between earthquake-induced post-traumatic stress disorder and tooth wear

Öcal,

Talmaç,

Zayman

et al. 2024

Preprint

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Background: This study aimed to was to evaluate the effects of earthquake-induced post traumatic stress disorder on tooth wear and oral hygiene of individuals. Method: The study was conducted in a single centre and included 200 patients aged 18-70 years. The gender and age profile of the study participants was balanced. Voluntary consent forms were obtained from the participants and evaluated by a single operator. Post-traumatic Stress Disorder inventory (PTSD), Smith and Knight Tooth Wear Index and Simplified Oral Hygiene Index (OHI-S) were applied during the evaluation. Mann Whitney U test and Pearson Chi-Square Test were used to evaluate the data obtained. Bonferroni Corrected Z Test was applied for multiple comparisons. Results: In general, tooth wear was observed in all participants. The most common tooth wear surfaces were occlusal and cervical surfaces. The PTSD scores of the group which had experienced an earthquake were higher than those of the group which had not experienced an earthquake. There was no significant correlation between PTSD scores and tooth wear scores (p>0.05). The group with higher PTSD scores and those which had experienced an earthquake had significantly higher OHI-S scores (p<0.001). In the evaluation made according to gender, women's OHI-S scores were higher in the groups which had experienced an earthquake and in the groups who did not experience an earthquake. Individuals over 35 years of age had higher tooth wear scores and OHI-S scores than individuals under 35 years of age (p<0.001). Conclusion: Psychological stress in patients with post-traumatic stress symptoms was not found to cause direct non-caries wear on tooth surfaces. The high OHI-S scores obtained from the earthquake survivor group indicate that post-earthquake stress and changed lifestyle reduce oral care.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the relationship between earthquake-induced post-traumatic stress disorder and tooth wear

Öcal,

Talmaç,

Zayman

et al. 2024

Preprint

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“…Male PTS-f 2 was enriched for musculoskeletal traits at the level of genetic correlation and putative causality. Unlike male PTS-f 1 , these results highlight effects of stress on dental health and mid-to-low back pain (39,40). In sum, male PTS findings support the role of pain in PTS.…”

Section: Discussionmentioning

confidence: 75%

Sex-stratified genomic structural equation models of posttraumatic stress inform PTSD etiology

Moo-Choy,

Stein,

Gelernter

et al. 2023

Preprint

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Posttraumatic stress disorder (PTSD) affects 3.9%-5.6% of the worldwide population, with well-documented sex-related differences. While psychosocial and hormonal factors affecting sex differences in PTSD and posttraumatic stress (PTS) symptom etiology have been explored, there has been limited focus on genetic bases of these differences. Many symptom combinations may confer a PTSD diagnosis. We hypothesized that these symptom combinations have sex-specific patterns, the examination of which could inform etiological differences in PTSD genetics between males and females. To investigate this, we performed a sex-stratified multivariate genome-wide association study (GWAS) in unrelated UK Biobank (UKB) individuals of European ancestry. Using GWAS summary association data, genomic structural equation modeling was performed to generate sex-specific factor models using six indicator variables: trouble concentrating, feeling distant from others, irritability, disturbing thoughts, upset feelings, and avoidance of places/activities which remind the individual of a traumatic event. Models of male and female PTSD symptoms differed substantially (local standardized root mean square difference=3.12) and significantly (χ2(5)=28.03, p=3.6x10-5). Independent two-factor models best fit the data in both males and females; these factors were subjected to GWAS in each sex, revealing three genome-wide significant loci in females, mapping to SCAND3, WDPCP, and FAM120A. No genome-wide significant loci were identified in males. All four PTS factors (2 in males and 2 in females) were heritable (p<0.05): male PTS-f1h2-SNP=1.85%, male PTS-f2h2-SNP=1.47%, female PTS-f1h2-SNP=3.87%, female PTS-f2h2-SNP=3.53%. Male PTS-f1was enriched for medication-related putative causal relationships (3.73-fold, p=0.032) while male PTS-f2was enriched for body structure (2.84-fold, p=5.512x10-7) and cognitive (3.22-fold, p=0.009) putative causal relationships. In females, PTS-f1was enriched for metabolic putative causal relationships (28.08-fold, p=0.035). By assessing the relationship between sex and PTSD symptoms, this study informs correlative and putatively causal etiological differences between males and females which support further investigation of sex differences in PTSD genetics.

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“…Another meta-analysis found controversial results and concluded that more high-quality prospective studies are required to con rm the relationship, as there is currently signi cant heterogeneity in the literature [64]. A similar nding concerning medication was reported in PTSD patients [23]. Severe periodontal disease was more common among the PTSD patients taking medications (62.5%) compared to the nonmedicated PTSD group (30.0%) and the non-PTSD controls (27.2%) (p = 0.001) [23].…”

Section: Obesitymentioning

confidence: 82%

The influence of systemic condition and medications on alveolar bone loss and tooth attrition

Tagger-Green‬‎,

Refael,

Szmukler-Moncler

et al. 2023

Preprint

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Background Periodontitis is an infectious disease leading to reduced periodontal support, reflected radiographically as marginal bone loss (MBL). Periodontitis is linked to systemic conditions like cardiovascular disease, diabetes, arthritis, etc. Periodontitis elevates the bacterial load and spreads systemic inflammation through infection and inflammation. Risk factors, including medications, smoking, age, and gender, can influence periodontal health. Tooth wear, characterized by irreversible enamel and dentin changes like wear facets, cracks, or fractures, has limited documented systemic conditions and medication associations. Aim To assess the influence of systemic conditions and medication on radiographic signs of tooth wear (TW) and marginal bone loss (MBL). Materials and methods A retrospective analysis encompassed 3900 patients with detailed medical documentation, including systemic diseases and medication, and a full-mouth radiographic survey. Odds ratio and logistic regression analysis were applied to ascertain the correlation between systemic conditions and medication on MBL and TW. Results Most systemic conditions exhibited a significant effect on TW and/or MBL. Age, gender, and smoking exhibited an elevated odds ratio for TW occurrence. Age, gender, smoking, diabetes, and psychiatric conditions were associated with an increased odds ratio for MBL. Conclusion Most systemic conditions and medications notably impacted MBL, with TW showing a less pronounced impact.

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Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study

Cited by 4 publications

References 52 publications

Evaluation of the relationship between earthquake-induced post-traumatic stress disorder and tooth wear

Evaluation of the relationship between earthquake-induced post-traumatic stress disorder and tooth wear

Sex-stratified genomic structural equation models of posttraumatic stress inform PTSD etiology

The influence of systemic condition and medications on alveolar bone loss and tooth attrition

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