Stress, allostatic load, and periodontal diseases

Sabbah, Wael; Gomaa, Noha; Gireesh, Aswathikutty

doi:10.1111/prd.12238

Cited by 47 publications

(49 citation statements)

References 71 publications

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“…Our results support an important role of perceived stress in perceived oral health outcomes. In other words, individuals with higher levels of perceived stress experienced worse OHRQoL, being in accordance with previous studies [22,63,64]. Furthermore, our findings suggest a negative link between 'enabling' factors (stress and income) and 'oral health behaviors'.…”

Section: Discussionsupporting

confidence: 92%

Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis

Machado

Proença²,

Alves

et al. 2020

BMC Oral Health

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Background: To determine if periodontal risk assessment (PRA), the number of missing teeth, diabetes mellitus (DM), perceived stress and interproximal cleaning are associated with oral health-related quality of life (OHRQoL), using Andersen's behavioral modelling (ABM). Material and methods: Data derived from 472 adults derived from a representative population of the Study of Periodontal Health in Almada-Seixal (SoPHiAS) was used. Socioeconomic status, perceived stress scale (PSS-10), oral health behaviors and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal conditions were assessed with a full-mouth periodontal examination. PRA was computed through behavioral and clinical information. Variables were grouped into Predisposing Factors, Enabling, Need, Oral Health Behaviors and Perceived Health Outcome latent variables. Confirmatory factor analysis, structural ABM and model fitness were conducted. Results: ABM applied to OHIP-14 showed acceptable model fit (χ 2 = 2.75, CFI = 0.92, TLI = 0.90, RMSEA = 0.05, CI 90% [0.04-0.07]). The average of OHRQoL was 9.5 ± 11.3. Patient with periodontitis and with a high number of missing teeth experienced worse OHRQoL. Uncontrolled DM participants had more periodontal treatment necessity and poorer OHRQoL. Characteristic like aging and lower levels of education were directly associated with better OHRQoL, but in indirect path the OHRQoL was diminishes. Good oral hygiene and preventative measures were associated to lower periodontal treatment necessity. Lower periodontal treatment necessity was associated to higher OHRQoL. Age, tooth loss and interproximal cleaning were the most associated items to Predisposing, Need and Oral Health Behaviors, respectively. Conclusion: ABM confirmed age, number of missing teeth, DM, interproximal cleaning and perceived stress as associated factors for OHRQoL. Uncontrolled DM was associated to higher Need and poorer OHRQoL. Good oral hygiene habits promote a healthy periodontium and, consequently, increases OHRQoL.

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Section: Discussionsupporting

confidence: 92%

Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis

Machado

Proença²,

Alves

et al. 2020

BMC Oral Health

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“…They found systemic inflammation to be a significant predictor of periodontal tissue loss [40]; thus activation of pro-inflammatory pathways is a possible mechanism by which short sleep duration could affect periodontitis. In addition, sleep is linked to psychosocial stress and obesity which have been shown to be associated with higher periodontitis prevalence [41][42][43]. Since the present study was cross sectional, it could also be possible that insufficient sleep is a consequence rather than a cause of periodontitis or that the reported association between the two conditions is coincidental.…”

Section: Plos Onementioning

confidence: 85%

Is inadequate sleep a potential risk factor for periodontitis?

Alhassani

Al-Zahrani

2020

PLoS ONE

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This study was undertaken to investigate the potential association between sleep duration and periodontitis. The study population consisted of 10,291 individuals who participated in the United States National Health and Nutrition Examination Survey (NHANES) from the 2009-2014 cycles. Sleep duration was categorized into sleep deficient (< 7 hours), sleep adequate (7-8 hours), and sleep excessive (> 8 hours). We used the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) periodontitis case definition. Descriptive statistics and logistic regression models were used for data analyses. The prevalence of periodontitis was 36% higher in individuals who reported sleep deficiency when compared to the sleep adequate group (odds Ratio (OR) = 1.36, 95% confidence interval (CI): 1.23-1.50). Those who reported excessive sleep had 41% higher odds of periodontitis (OR: 1.40, 95% CI: 1.16-1.71). After adjusting for confounding factors, sleep deficient individuals were 19% more likely to have periodontitis when compared to sleep adequate individuals (OR: 1.19, 95% CI: 1.06-1.38). Among sleep excessive individuals, the association was non-significant (OR: 1.16, 95% CI: 0.94-1.43). Sleep deficiency was associated with a higher prevalence of periodontitis in this study population. The association however needs to be confirmed in longitudinal studies.

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“…Allostatic overload can be caused by chronic stress, and the consequences of allostatic load include increased risk of cardiovascular disease, abnormal hepatic metabolism, atrophy of neurons in the whole brain, and poor kidney outcomes [12][13][14] . The underlying pathologic mechanisms of diseases associated with allostatic overload may be involved in oxidative stress and systemic inflammation, disturbances in the autonomic nervous system and circadian rhythm, as well as metabolite abnormalities in the main stress-targeted tissues 2,5 .…”

Section: Discussionmentioning

confidence: 99%

Systematic impacts of chronic unpredictable mild stress on metabolomics in rats

Geng

Guo

Wang³

et al. 2020

Sci Rep

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Depression is the most common disabling psychiatric disease, with a high prevalence and mortality. Chronic unpredictable mild stress (CUMS) is a well-accepted method used to mimic clinical depression. Recent evidence has consistently suggested that the cumulative effects of CUMS could lead to allostatic overload in the body, thereby inducing systemic disorders; however, there are no previous systematic metabonomics studies on the main stress-targeted tissues associated with depression. A non-targeted gas chromatography-mass spectrometry (GC-MS) approach was used to identify metabolic biomarkers in the main stress-targeted tissues (serum, heart, liver, brain, and kidney) in a CUMS model of depression. Male Sprague-Dawley rats were randomly allocated to the CUMS group (n = 8) or a control group (n = 8). Multivariate analysis was performed to identify the metabolites that were differentially expressed between the two groups. There were 10, 10, 9, 4, and 7 differentially expressed metabolites in the serum, heart, liver, brain and kidney tissues, respectively, between the control and CUMS groups. These were linked to nine different pathways related to the metabolism of amino acids, lipids, and energy. In summary, we provided a comprehensive understanding of metabolic alterations in the main stress-targeted tissues, helping to understand the potential mechanisms underlying depression. An increasing body of evidence has revealed that the cumulative effect of stress can trigger allostatic overload 1-3. "Allostatic load" refers to the effects of prolonged continuous or intermittent activation of effectors involved in allostasis 4-6. Allostatic load has been associated with many diseases, such as cardiovascular disease, diabetes, stroke, chronic kidney disease, abdominal obesity, and depression 7,8. These all involve the whole body. Thus, the stress-induced allostatic overload involved in depression is focused on in our study. Depression is a seriously debilitating psychiatric disease, characterized by high mortality and morbidity. The chronic unpredictable mild stress (CUMS) model, a well-accepted animal model of depression, is used to explore the mechanisms underlying depression 9-11. One proposed mechanism involves allostatic load, a multidimensional biologic construct that involves biomarkers across the physiologic domains of neuroendocrine, autonomic, immune, and metabolic function 7. Allostatic overload resulting from CUMS in animal models causes atrophy of neurons in the hippocampus and prefrontal cortex 4,5 , myocardial ischemia 9 , abnormal hepatic metabolism 12 , and poor kidney outcomes 8,13. Thus, the impact of stress involves the whole body and depression is linked to multiple diseases such as cardiovascular disease 9. However, there are no previous systematic metabonomics studies focusing on the main stress-targeted tissues. Thus, the aim of the present study was to provide a panoramic and systematic view of metabolic alterations in stress-targeted tissues (serum, heart, liver, brain, and kidney) in the conte...

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Stress, allostatic load, and periodontal diseases

Cited by 47 publications

References 71 publications

Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis

Periodontal status, perceived stress, diabetes mellitus and oral hygiene care on quality of life: a structural equation modelling analysis

Is inadequate sleep a potential risk factor for periodontitis?

Systematic impacts of chronic unpredictable mild stress on metabolomics in rats

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