Investigation of the Association Between Psychological Parameters and Periodontal Disease in a Greek Adult Population: A Case - Control Study

Objective: Epidemiologic studies provide strong evidence that chronic psychosocial stress and depression increase the risk of several systemic diseases and disorders. The current research aimed to investigate the association between stress, and depression with Periodontal Disease indices. Material and Methods: The study counted with 280 individuals, males and females, 40–65 years of age, and were collected through a clinical examination and a modified standardized questionnaire. Case group included 140 individuals suffering from periodontal disease and control group consisted of 140 individuals with no history of periodontal disease. Psychological factors assessment included the following inventories, Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Periodontal disease was assessed based on the following indices, Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), Gingival Index (GI) and Bleeding on Probing (BOP). Univariate and multivariate logistic regression analyses were carried out to compare cases and controls. Results: Mean probing depth and clinical attachment level were 4.60 ± 0.32 mm and 4.72 ± 1.12 mm in cases and 2.10 ± 0.50 mm and 1.86 ± 0.31 mm in controls, respectively (p < 0.05 and p< 0.01, respectively). Multivariate logistic regression model, controlling for confounding factors, demonstrated significant association between BAI and BDI with deeper periodontal pockets [p = 0.028 and p = 0.032, respectively], and moderate/severe CAL [p = 0.018 and p = 0.048, respectively]. The outcomes also revealed no significant associations between the mentioned psychological parameters with gingival inflammation (GI) and BOP. Those associations were confirmed after adjusting for possible confounders such as smoking, educational and socio-economic status. Conclusion: Within the limits, the current research revealed significant associations between BAI and BDI and deeper periodontal pockets and moderate/severe CAL.