Work stress and oral conditions: a systematic review of observational studies

Abstract

ObjectivesAlthough psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss.DesignA systematic review of published observational studies.Data sourcesA systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020.Study selectionArticles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss.Data extractionData were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.ResultsOf 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality.ConclusionsThere is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.

Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan

“…Work stress was associated with an increased risk of poor periodontal status, which is consistent with previous studies ( Sato, Saijo & Yoshioka, 2021 ). Eight of nine previous studies reported a significant association between work stress and periodontal status, but only one study used the accepted measure for work stress and adjusted for potential confounders ( Segura Marcenes & Sheiham, 1992 ; Sato, Saijo & Yoshioka, 2021 ). Our results support the previous study results.…”

“…The current results show a negative association between work stress and the number of decayed and filled teeth (caries experienced teeth). There is only one previous study on work stress and the number of teeth with caries ( Segura Marcenes & Sheiham, 1992 ; Sato, Saijo & Yoshioka, 2021 ). In a previous study, work stress was assessed using the demand-control model, and the dependent variable was DMF tooth surfaces.…”

“…In the present study, work stress was negatively associated with tooth loss. There were two previous cross-sectional studies in which the dependent variables were self-reported tooth loss and having four or more lost teeth ( Hayashi et al, 2001 ; Sato et al, 2020 ; Sato, Saijo & Yoshioka, 2021 ). Two studies have reported an increased risk of tooth loss due to work stress.…”

“…Based on a previous review, the following variables were selected as covariates ( Sato, Saijo & Yoshioka, 2021 ): age, sex (men and women), smoking status (never, former, and current), annual household income (less than 5 million yen, 5 to 7.9 million yen, 8 to 9.9 million yen, and over 10 million yen), education (high school or lower, professional training college, junior college, technical college, and university or higher). Work characteristics included were, years of service with the current company, job type (administrative and managerial, professional and engineering, clerical, and others), occupational status (untitled and titled), and working hours per week.…”

“…Our previous systematic review revealed a lack of evidence on the association of work stress with oral diseases ( Sato, Saijo & Yoshioka, 2021 ). Notably, most previous studies did not use the widely accepted measures for work stress assessment and did not include potential confounders, such as socioeconomic status and work-related variables ( Freeman & Goss, 1993 ; Linden, Mullally & Freeman, 1996 ; Genco et al, 1999 ; Hayashi et al, 2001 ; Akhter et al, 2005 ; Bandar, 2009 ; Ramji, 2011 ; Mahendra et al, 2011 ; Islam et al, 2019 ).…”