Stressful Life Events in Relation to Dental Caries and Selected Salivary Constituents among Secondary School Students in Baghdad City

Abstract

Background: stress is the reactions of the body to forces of a deleterious nature, infections and various abnormal states that tend to disturb its normal physiological equilibrium; It is described as adverse emotions or reactions to unpleasant experiences; Thus, any real or perceived physical, social, or psychological event or stimulus that causes bodies to react or respond have deleterious effects on the general and oral health. The aims of this study were to assess the severity of dental caries among the students with different categories of stressful life events in relation to physicochemical characteristics of whole stimulated saliva. Materials and Methods: the total sample is composed of 300 students (males only) aged 17-18 years old, who are randomly selected from 10 school in the First Al-Karkh/Baghdad. The total sample classified into three categories (less stress, more stress, accumulative stress) according to stressful life events scale (SLE); the sub sample consist of 60 students who are randomly selected from the total sample each category composed of 20 students. Diagnosis and recording of dental caries was assessed according to Decay, Missed, Filled surface index (D1-4MFS) of Muhlemann (1976). Stimulated salivary samples were collected from the 60 students then measuring salivary flow rate; and chemically analyzed to determine salivary interlukin-6 (IL-6), cortisol, and total protein. All data were analyzed using SPSS version 21. Results: Results recorded the highest mean rank value of (DMFS) was among the accumulative stress category of stressful life events scale followed by more stress category, the lowest mean rank value was among less stress category with statistically high significant difference (P< 0.001). For the severity of dental caries (DS) Fraction was higher among the accumulative stress category than more stress and less stress categories respectively (P< 0.001). According to the grades of lesion severity, for all fractions the higher mean rank values was among accumulative stress category with no statically differences except for (D2) was significant (P< 0.05). The data from salivary analysis showed that, the highest values of salivary total protein and (IL-6) were among the accumulative stress category, followed by more stress then the lowest value among less stress category, while the cortisol showed the opposite picture, however all these differences were not significant. DMFS correlated positively with flow rate among less stress and accumulative stress categories and negatively with more stress category, while for (DS) correlated negatively with flow rate with highly significant for more stress category and accumulative category and positively related with significant for low stress category. The salivary constituents showed negative correlation with (DMFS) for all categories of stressful life events scale except for IL-6 and cortisol were positively correlated for accumulative category with nonsignificant difference. Conclusion: The study revealed that, stressful life events hav...

The impact of dental environment stress on dentition status, salivary nitric oxide and flow rate

“…The value of P > 0.05 was not statistically significant, and this agreed with other studies. [ 9 ] This may be because of the important action of salivary flow rate as washing action and the defensive components of saliva that increase with increasing salivary flow rate,[ 8 ] whereas among mild stress category, the flow rate was positively correlated with DS, which was statistically not significant ( P > 0.05); this agreed with other study. [ 9 ] This may be related to fact that salivary flow rate flow rate may have little effect on the activity of caries at a specific point in time and determination of salivary flow rate at one-time may not be thorough estimation of salivary flow actions.…”

“…The increase of dental caries prevalence with increased stressful situation was agreed with other studies. [ 9 15 ] This may be due to the stress has an effect on the immunity and can weaken the host defense to cariogenic bacteria,[ 16 ] by unhealthy eating habits like frequent snacking and increase the intake of sugar rich diet,[ 15 ] poor oral health behavior (flossing teeth, brushing teeth) making great condition for microbes,[ 17 ] by diminishing salivary flow prompting diminished removal of cariogenic bacteria, subjective oral dryness and unstimulated salivary flow were connected with stress so decrease the protective functions of saliva increasing the vulnerability to dental caries. [ 18 ] Although a lower unstimulated salivary flow rate was found in the severe stress group, this difference did not reach statistical significance; same result was found by other studies.…”

“…[ 8 ] Another study found that there is no relation between stress and salivary flow rate. [ 9 ] Nitric oxide (NO) is a free radical gas and a detrimental chemical in the atmosphere; however, it presents in little well-controlled concentrations in the body and plays a key role in several physiological and pathological processes. NO is implicated in the stress physiology and is involved in disease processes related to stress; it counteracts norepinephrine activity and sympathetic reactivity.…”

Gingival Health Status and Dental Anomalies In Relation To Height For Age Among Children With Congenital Heart Disease

“…Ten index teeth were examined on the buccal surface only, if any index tooth is missing, the area was excluded. These teeth include: 11,12,13,14,21,22,23,24,36,46 for permanent teeth and 51, 52, 53, 54, 61, 62, 63, 64, 75, 85 for primary teeth. The buccal surface which extend from incisal edge or cuspal point to gingival, and from the mesial to the distal embrasure was inspected visually for the defect and if there was any doubt, area such as hypoplastic pits were checked with periodontal probe to confirm diagnosis, any gross plaque or food deposits were removed and the teeth were examined in wet condition.…”

“…Gingivitis is an inflammatory condition of the gingiva which is almost always present in all form of gingival disease, because bacterial plaque, which causes inflammation and irritating factors which favor plaque accumulation are often present in the gingival environment (5). Mild form of gingivitis is the most common form of gingivitis in pediatric population which is the reversible form, during puberty; gingivitis may be a response to hormonal changes in the developing adolescent, though more pronounced when there is plaque accumulation (6)(7)(8)(9)(10)(11). Gingival disease and other oral symptoms may occur in children with congenital heart disease, the oral changes include a purplish red discoloration of the lips and gingiva and sometimes sever marginal gingivitis and periodontal destruction.…”