28 June 2021

---

Correlation between periodontal diseases and emotional disorders

Lara Figini

---

Periodontal disease is an inflammatory disease and if  untreated can lead to tooth loss, compromising chewing and aesthetic function.

Periodontal 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, as a result 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 and methods
In a recent systematic review with meta-analysis, published on Journal of Clinical Periodontology, February 2021, 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 until August 4, 2019, 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
40 studies were included. 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
From the data of this systematic review, which must be confirmed in other similar reviews, it can be concluded that 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.

Clinical implications
The presence of the relationship may be instructive for the clinical prevention and treatment of periodontal disease and emotional disorders; however, further evidence is still needed to verify the effectiveness of clinical interventions. Additionally, more high-quality prospective studies are required to confirm the association between periodontal disease and emotional disorders.

For additional information:  Periodontal disease and emotional disorders: A meta-analysis