Evaluation of Association between Perceived Stress, Anxiety, Depression, Salivary Alpha-Amylase and Salivary Cortisol with Chronic Periodontitis

Abstract

Introduction: Chronic Periodontitis is a multifactorial inflammatory disease, which is caused by certain series of bacteria in oral biofilm and leads to teeth supporting tissue destruction. Stress, depression and anxiety can affect periodontium health through variable different mechanisms. Cortisol is secreted from adrenocorticotropic glands in pituitary gland and can be used as index to determine psychological stress rate. Alpha-amylase is an salivary gland enzyme which is regulated through sympatric nervous system. The aim of the following study is to compare between different biomarkers related to the emotional stress, anxiety and depression in saliva and their role on periodontal health and also the correlation between periodontal parameters, stress, depression and anxiety. Method: 90 patients with age ranged from 35 to 45 years were participated in the study. Salivary cortisol and alpha-amylase levels were measured in them. Levels of Stress, Anxiety and Depresion were evaluated using questionnaires. The relationship between psychological and biochemical factors with chronic Periodontitis were assessed. The results were analyzed by statistical analysis. Results: The mean concentration of salivary cortisol was 7.87±4.37 ng/ml in the case group and 4.33±2.11 ng/ml in the control group. The difference was statistically significant (p<0.001). The mean concentration of salivary alphaamylase was 3569.27±101.22 U/L in the case group and 3343.44±171.09 U/L in the control group. The difference was statistically significant (p<0.001). The mean stress score was 24.28±3.09 in the case group and 22.96±3.61 in the control group. The difference between two groups was statistically significant (p<0.001). The difference between two groups was statistically significant (p<0.001). The mean anxiety score was 44.11±4.59 in the case group and 36.47±4.30 in the control group, which was statistically significant (p<0.001). The mean depression score was 19.96±3.58 in the case group and 13.13±3.91 in the control group. The difference between two groups was statistically significant (p<0.001). Conclusion: The findings of these study showed that psychological factors like emotional stress, depression and anxiety and biochemical factors including salivary cortisol and alpha-amylase are higher in patients with moderate to severe chronic periodontitis in comparison to healthy people. also Anxiety and depression are stronger predictors of periodontitis than acute stress and cortisol.