Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study.

Catherine Petit,Jean-Luc Davideau,Victor Anadon-Rosinach,Nicolas Tuzin,Olivier Huck

doi:10.3390/ijerph18179394

Abstract

Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools.

Highlights

Periodontitis is a chronic inflammatory disease induced by oral dysbiosis and characterized by clinical symptoms, including gingival swelling, gingival bleeding, clinical attachment loss (CAL) and tooth mobility [1]
As the tools used to characterize the association between psychological status and periodontal treatment outcomes are diverse, the aim of this study was to determine the influence of depression and anxiety assessed by self-administered questionnaires i.e., State-Trait Inventory (STAI)
A recent meta-analysis pointed out that that subjects with periodontal disease had a higher depression scale score and anxiety score; the heterogeneity between studies highlighted the necessity of additional ones [37]

Summary

Introduction

Periodontitis is a chronic inflammatory disease induced by oral dysbiosis and characterized by clinical symptoms, including gingival swelling, gingival bleeding, clinical attachment loss (CAL) and tooth mobility [1]. This highly prevalent disease impacts the oral-health-related quality of life and its long-term management is at a high cost [2,3]. Periodontal pathogens will invade the gingival tissues and elicit an exacerbated inflammatory response mediated by cytokines and chemokines [5,6] Such an inflammatory process will modulate the bone homeostasis through the promotion of osteoclastogenesis, contributing to the destruction of the alveolar bone [7]. Several inflammatory mediators (IL-1b, IL-6 and IL-8) implicated in the development of periodontal diseases have correlated with the level of stress, emphasizing a link between periodontal status and psychological status [8,10,12,13]

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