The Effect of Psychological Stress on Periodontal Disease During COVID-19 Virus Threat: Relation to Salivary Immunoglobulin A (SIgA)

Abstract

Purpose: The present study aimed to examine serum cortisol concentrations and salivary immunoglobulin A (S-IgA) levels under psychological stress during the COVID-19 virus threat and its relationship to periodontal condition. Materials and methods: A total of 30 participants who had particularly high scores on the perceived stress scale (PSS) were involved in this study. Psychological stress was assessed via the PSS questionnaire. The Clinical periodontal evaluation included assessment of gingival index (GI), probing depth (PD) and clinical attachment level (CAL). Biochemical quantification of serum cortisol concentrations and S-IgA levels was performed using the enzyme-linked immunosorbent assays method (ELIZA). Every step was performed at the baseline during the lockdown, 3 and 6 months follow up after lockdown. Results: An increase in stress levels was detected over the course of the study and was statistically significant. Clinically, worsening of GI, PD and CAL records was observed over the follow-ups, yet this increase is non-significant for all indices (P>0.05). The correlation between serum cortisol and stress was positive and statistically significant over the three pickups (P<0.05). A weak negative correlation between stress and S-IgA was reported and wasn’t statistically significant. Conclusion: The impact of stress caused by lockdown and fear of pandemic was a continuous process where the time factor was very crucial in this study. High cortisol levels as a stress response and consequently S-IgA diminution were associated with worsening of the periodontal condition. Prolonged periods of stress may have an exaggerated impact on the periodontal condition of the subjects.