Effect of Psychological Stress on Salivary Cortisol and Periodontitis

Abstract

Objective: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factorssuch as stress or anxiety that affect host response. This study evaluates the potential associations between psychosocial stress, salivary cortisol and periodontitis.Methods: In this cross-sectional study, 80 adult participants (41 males and 39 females) aged 20-45 years were included. Participantscompleted a stress self-assessment using a PSS scale questionnaire. Samples of saliva were collected for testing cortisol levels byELISA. The participants were then divided into four groups established on periodontal parameters (plaque index (PI), bleeding onprobing (BOP), probing pocket depth, and clinical attachment level), and stress levels: Group 1 (healthy periodontium without stress),Group 2 (periodontitis without stress), Group 3 (healthy periodontium with stress), and Group 4 (periodontitis with stress).Results: Statistically significant differences were observed between the values detected in the four experimental groups for PI, BI, PD,and CAL (p≤0.05). The highest means of cortisol level were revealed in the stressed healthy group and stressed with periodontitisgroup, at 39.7 and 40.5, respectively. Hence there were statistically significant differences overall across the four groups (p≤0.05).Conclusions: This study demonstrates that psychosocial stress is a risk factor for periodontal diseases, and in cortisol, as one of theelements that enhance periodontal damage, increases were recorded for all four clinical parameters, BI, PI, PD, CAL, which are usedas diagnostic tools for periodontitis.