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Stress and Periodontal Disease

Stress is a known precursor of periodontal disease (Boyapati & Wang 2000; Wimmer, Janda, Wieselmann-Penker, Jaske, Polansky & Pertl 2002; Davis & Jenkins 1962). Whether due to the effects of stress on intermediary factors like hormonal changes that in turn affect oral health, or to the direct effects of stress on disorders of the mouth and gums, psychology plays a considerable role in the prevention and treatment of disease. As early as the 1960s, research showed that interim factors like hormonal imbalance, diabetes, nutritional deficiencies, and blood dyscrasias all play a role in periodontal disease, and that stress is a precursor to each of these factors too (Davis & Jenkins 1962). Stress causes the release of adrenaline, increased heart rate, increased respiration, and other physiological signals. Boyapati & Wang (2000) point out that especially when stress is sustained over long periods of time it can lead to disease and periodontal disease in particular. Wimmer et al (2002) describe periodontal disease as "opportunistic infections" that take root well under the physiological conditions defined by stress. Therefore, the role of stress in periodontal illness has been confirmed and deserves further


Furthermore, the biochemical changes that take place when an individual experiences stress affect the salivary glands, in turn affecting the response to oral bacteria. Research on the connection between stress and oral hygiene is extensive. Stress and Periodontal Disease Stress is defined differently in medical literature. Periodontal disease is caused by "periopathogenic microorganisms and their metabolic products," leading to "a characteristic inflammatory reaction of the gingiva," (Wimmer et al 2002). In other words, stress might cause an individual to smoke more or eat a poorer diet, behaviors which in turn lead to the periodontal disease. Recent research shows that the biochemical changes that take place in the body when an individual is under stress can have an immediate impact on the immune system, which would affect how oral bacteria is dealt with. Whether the correlations are due to behavioral factors that are associated with those psychological disorders or if the disorders themselves are causal factors was not elucidated. Much of the research focusing on the effects of stress on oral health have been correlative only, or performed on laboratory animals. Dissatisfaction with work and other stressors can be ascertained by interview or written questionnaires but the deeper psychological components of stress may require psychological evaluations. Psychological definitions center on individual responses to psychological tests, surveys, and questionnaires. Whereas early research tended to find more correlations than causation, recent research reveals a causal relationship between stress and periodontal disease. So-called major life events are the most known causes of stress: factors known as stressors.

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