Negative Life Events, Anxiety, Depression and Coping Ability (Stress) as Related to Chronic Periodontitis

In animal models it has been shown experimentally that psychological stress may negatively affect the outcome of periodontitis. Several studies in various populations have confirmed an association between negative life events, the level of depression and anxiety, as well as personality traits and periodontitis. The aim of the present study was to explore these relationships in a Norwegian adult population. Patients aged 40+ yr were selected on the basis of their periodontitis experience as assessed radiographically, and the participants were grouped in 2 groups: group 1 consisted of periodontally healthy subjects (no detectable bone loss); and group 2 consisted of subjects with >3mm radiographic bone loss in >3 sites. Four different questionnaires were employed to assess the participants’ level of anxiety, depression and neuroticism, as well as their Health Locus of Control. Negative life events and smoking habits were also recorded. The results revealed a statistically significant bivariate relationship between periodontitis and negative life events or the degree of anxiety among the selected psychosocial variables. However, these associations did not appear to be significant when smoking was introduced in a linear multiple regression model. One explanation offered is that good access to dental care and a high utilization of oral health services in Norway may have compensated for the possible underlying causal effects of psychosocial stressors on periodontal health. Thus, comparisons of such studies between different populations may not always be feasible.