05 December 2022

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Periodontal diseases and emotional disorders

Lara Figini

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Periodontal disease is an inflammatory disease and if untreated can lead to tooth loss, compromising chewing and aesthetic function. The disease causes a local oral inflammatory response and is potentially associated with various systemic diseases, such as diabetes, cardiovascular disease, stroke, rheumatoid arthritis, tumors, obesity and brain disorders. 

Emotional disorders are common mental illnesses caused by various genetic and environmental factors. The prevalence of anxiety disorder is estimated to range from 0.9% to 29.8% worldwide, and the prevalence of emotional problems in adolescents has increased dramatically in recent decades. According to published literature, putative links between periodontal disease and emotional disorders have been reported (Decker et al., 2019; Kurushima et al., 2019). 

However, because of heterogeneity in age, sex, disease severity, smoking status, alcohol consumption, work types and other factors among study populations, the previous evidence on the relationship between periodontal disease and emotional disorders was contradictory in population-based studies.

Materials, methods

In a systematic review with meta-analysis, published in the Journal of Clinical Periodontology, the authors evaluated the relationship between periodontal disease and depression and anxiety.

The authors performed a literature search of relevant studies, using EMBASE, PubMed, Web of Science, PsycINFO Database, and SinoMed in English and Chinese. 

Case–control, cross-sectional, and cohort studies that calculated the risk ratio (RR), odds ratio (OR)/prevalence OR (POR), and hazard ratio (HR) of depression/anxiety with periodontal disease or the OR/POR/RR/HR of periodontal disease caused by depression/anxiety were included. 

Observational studies that reported the depression/anxiety scale score of patients with periodontal disease and healthy periodontal subjects aged ≥14 years were also included. The Newcastle–Ottawa scale was used to ascertain the quality of the included citations.

Results

Researchers included 40 studies in this study. Meta-analysis of case-control studies showed that periodontal disease is positively associated with depression. A meta-analysis of 12 studies showed that periodontal disease is significantly correlated with anxiety. Meta-analysis of 18 studies showed that subjects with periodontal disease developed a higher score on the depression scale and the anxiety scale.

Conclusions

Periodontal disease is associated with emotional disorders. However, the high degree of heterogeneity among studies should be considered. More high-quality prospective studies are required to confirm the relationship.

De-Xiu Zheng, Xiao-Ning Kang, Yi-Xi Wang, Yi-Na Huang, Chun-Feng Pang, Yu-Xuan Chen, Zhi-Li Kuang and Yun Peng. "Periodontal disease and emotional disorders: A meta-analysis." J Clin Periodontol. Feb 2021; 48: 180–204. https://doi.org/10.1111/jcpe.13395