Top

Current Oral Health Reports

Published in:

Open Access 01-09-2020 | Gingival Diseases | Systemic Diseases (N Buduneli, Section Editor)

Psychological Stress: A Predisposing and Exacerbating Factor in Periodontitis

Authors: Anna M. Spector, Teodor T. Postolache, Faisal Akram, Alison J. Scott, Abhishek Wadhawan, Mark A. Reynolds

Published in: Current Oral Health Reports | Issue 3/2020

Abstract

Purpose of Review

This review focuses on recent advances in our understanding of the interactions between psychological stress, the immune system, and periodontitis, including the dynamic role of host stress responses in altering immune function, altering the oral microbiome and biofilm formation, and promoting local and systemic disease progression.

Recent Findings

Within the context of periodontal health and disease, stress leads to an impairment of effective antimicrobial defense, shifts in oral microbiome profiles toward more pathogenic gene expression and taxa composition, increased translocation, and biofilm formation. The link between stress and periodontitis is multiform and includes hypothalamic–pituitary–adrenal (HPA) axis and catecholamine activation, production of immune mediators of inflammation and, clinically, syndromes of depression, bipolar disorder, anxiety disorders, and sleep-wake disorders.

Summary

Psychological stress appears to be an important modifiable risk factor for the development and progression of periodontitis and other periodontal diseases.

Reynolds MA. Modifiable risk factors in periodontitis: at the intersection of aging and disease. Periodontol 2000. 2014;64(1):7–19. https://doi.org/10.1111/prd.12047.CrossRefPubMed

Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci U S A. 2012;109(16):5995–9. https://doi.org/10.1073/pnas.1118355109.CrossRefPubMedPubMedCentral

Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. 2007;298(14):1685–7. https://doi.org/10.1001/jama.298.14.1685.CrossRefPubMed

Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction: implications for health. Nat Rev Immunol. 2005;5(3):243–51. https://doi.org/10.1038/nri1571.CrossRefPubMed

•• Netea MG, Balkwill F, Chonchol M, Cominelli F, Donath MY, Giamarellos-Bourboulis EJ, et al. A guiding map for inflammation. Nature Immunol. 2017;18(8):826–31. https://doi.org/10.1038/ni.3790. Concise review of immunological mechanisms involved in the induction, regulation, and resolution of inflammation.

Johnson BD, Engel D. Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment. J Periodontol. 1986;57(3):141–50. https://doi.org/10.1902/jop.1986.57.3.141.CrossRefPubMed

Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol. 2018;45:S78–94. https://doi.org/10.1111/jcpe.12941.CrossRefPubMed

Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86(5):611–22. https://doi.org/10.1902/jop.2015.140520.CrossRefPubMedPubMedCentral

Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Gruen RJ. Dynamics of a stressful encounter. Cognitive appraisal, coping, and encounter outcomes. J Pers Soc Psychol. 1986;50(5):992–1003. https://doi.org/10.1037/0022-3514.50.5.992.CrossRefPubMed

10.

Tugade MM, Fredrickson BL. Regulation of positive emotions: emotion regulation strategies that promote resilience. J Happiness Stud. 2007;8(3):311–33. https://doi.org/10.1007/s10902-006-9015-4.CrossRef

11.

•• Danese A, Lewis SJ. Psychoneuroimmunology of early-life stress: the hidden wounds of childhood trauma? Neuropsychopharmacology. 2017;42(1):99–114. https://doi.org/10.1038/npp.2016.198. Review examines the long-term influence of early-life trauma and stress on the developing immune system, inflammation, and risk of psychopathology in adulthood.

12.

Miller GE, Chen E. Harsh family climate in early life presages the emergence of a Proinflammatory phenotype in adolescence. Psychol Sci. 2010;21(6):848–56. https://doi.org/10.1177/0956797610370161.CrossRefPubMedPubMedCentral

13.

• Felitti VJ, Anda RF, Williamson DF, Spitz AM, Edwards V, Marks JS, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 2019;56(6):774–86. https://doi.org/10.1016/j.amepre.2019.04.001. Study reports a strong, graded relationship between exposure to abuse or household dysfunction during childhood and risk factors for leading causes of death in adults.

14.

Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med. 2009;71(2):243–50. https://doi.org/10.1097/PSY.0b013e3181907888.CrossRefPubMedPubMedCentral

15.

DuMont KA, Widom CS, Czaja SJ. Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics. Child Abuse Negl. 2007;31(3):255–74. https://doi.org/10.1016/j.chiabu.2005.11.015.CrossRefPubMed

16.

Flores E, Cicchetti D, Rogosch FA. Predictors of resilience in maltreated and nonmaltreated Latino children. Dev Psyc. 2005;41(2):338–51. https://doi.org/10.1037/0012-1649.41.2.338.CrossRef

17.

McEwen BS. Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008;583(2–3):174–85. https://doi.org/10.1016/j.ejphar.2007.11.071.CrossRefPubMedPubMedCentral

18.

Seeman TE, McEwen BS, Rowe JW, Singer BH. Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci U S A. 2001;98(8):4770–5. https://doi.org/10.1073/pnas.081072698.CrossRefPubMedPubMedCentral

19.

Afzal N, Thakore J. Stress axis dysfunction: a common finding in schizophrenia and the metabolic syndrome? In Thakore J, Leonard BE (eds): Metabolic Effects of Psychotropic Drugs. Mod Trends Pharmacopsychiatry. Basel, Karger. 2009;26:82–9.CrossRef

20.

Chandola T, Brunner E, Marmot M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ. 2006;332(7540):521–5. https://doi.org/10.1136/bmj.38693.435301.80.CrossRefPubMedPubMedCentral

21.

• Decker A, Askar H, Tattan M, Taichman R, Wang HL. The assessment of stress, depression, and inflammation as a collective risk factor for periodontal diseases: a systematic review. Clin Oral Investig. 2019. https://doi.org/10.1007/s00784-019-03089-3. Review addresses the interconnection between stress, depression, and inflammation and the potential for the combination of these factors to impact risk for periodontal diseases.

22.

Guerry JD, Hastings PD. In search of HPA Axis Dysregulation in child and adolescent depression. Clin Child Fam Psychol Rev. 2011;14(2):135–60. https://doi.org/10.1007/s10567-011-0084-5.CrossRefPubMedPubMedCentral

23.

Heim C, Newport DJ, Mletzko T, Miller AH, Nemeroff CB. The link between childhood trauma and depression: Insights from HPA axis studies in humans. Psychoneuroendocrinology. 2008;33(6):693–710. https://doi.org/10.1016/j.psyneuen.2008.03.008.CrossRefPubMed

24.

Joels M, Baram TZ. The neuro-symphony of stress. Nat Rev Neurosci. 2009;10(6):459–66. https://doi.org/10.1038/nrn2632.CrossRefPubMedPubMedCentral

25.

Kessler RC. The effects of stressful life events on depression. Ann Rev Psychol. 1997;48(1):191–214. https://doi.org/10.1146/annurev.psych.48.1.191.CrossRef

26.

Leserman J, Petitto JM, Golden RN, Gaynes BN, Gu H, Perkins DO, et al. Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS. Am J Psychiatry. 2000;157(8):1221–8. https://doi.org/10.1176/appi.ajp.157.8.1221.CrossRefPubMed

27.

Marsland AL, Bachen EA, Cohen S, Rabin B, Manuck SB. Stress, immune reactivity and susceptibility to infectious disease. Physiol Behav. 2002;77(4–5):711–6. https://doi.org/10.1016/s0031-9384(02)00923-x.CrossRefPubMed

28.

Parwani R, Parwani SR. Does stress predispose to periodontal disease? Dent Update. 2014;41(3):260–4, 7–8, 71–2. https://doi.org/10.12968/denu.2014.41.3.260.CrossRefPubMed

29.

Yehuda R, Seckl J. Minireview: stress-related psychiatric disorders with low cortisol levels: a metabolic hypothesis. Endocrinol. 2011;152(12):4496–503. https://doi.org/10.1210/en.2011-1218.CrossRef

30.

Genco RJ, Ho AW, Grossi SG, Dunford RG, Tedesco LA. Relationship of stress, distress, and inadequate coping behaviors to periodontal disease. J Periodontol. 1999;70(7):711–23. https://doi.org/10.1902/jop.1999.70.7.711.CrossRefPubMed

31.

•• Coelho JMF, Miranda SS, da Cruz SS, Trindade SC, Passos-Soares JS, Cerqueira EMM, et al. Is there association between stress and periodontitis? Clin Oral Investig. 2019. https://doi.org/10.1007/s00784-019-03083-9. Cross-sectional study shows a positive association between stress and perioodontitis, independent of other factors, such as smoking.

32.

Croucher R, Marcenes WS, Torres MC, Hughes F, Sheiham A. The relationship between life-events and periodontitis. A case-control study. J Clin Periodontol. 1997;24(1):39–43. https://doi.org/10.1111/j.1600-051x.1997.tb01182.x.CrossRefPubMed

33.

Dolic M, Bailer J, Staehle HJ, Eickholz P. Psychosocial factors as risk indicators of periodontitis. J Clin Periodontol. 2005;32(11):1134–40. https://doi.org/10.1111/j.1600-051X.2005.00838.x.CrossRefPubMed

34.

Freeman R, Goss S. Stress measures as predictors of periodontal disease—a preliminary communication. Community Dent Oral Epidemiol. 1993;21(3):176–7. https://doi.org/10.1111/j.1600-0528.1993.tb00748.x.CrossRefPubMed

35.

Green LW, Tryon WW, Marks B, Huryn J. Periodontal disease as a function of life events stress. J Hum Stress. 1986;12(1):32–6. https://doi.org/10.1080/0097840X.1986.9936764.CrossRef

36.

•• Coelho JMF, Miranda SS, da Cruz SS, Trindade SC, Passos-Soares JS, Cerqueira EMM, et al. Is there association between stress and periodontitis? Clin Oral Investig. 2020;24(7):2285–94. https://doi.org/10.1007/s00784-019-03083-9. Crosssectional study showed a positive association between exposure to stress and the presence of periodontitis, after adjustment for age, sex, education, current smoking, pulmonary disease, and body mass index.

37.

Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016;8:35–50. https://doi.org/10.2147/CCIDE.S63626.CrossRefPubMedPubMedCentral

38.

•• Blander JM, Longman RS, Iliev ID, Sonnenberg GF, Artis D. Regulation of inflammation by microbiota interactions with the host. Nat Immunol. 2017;18(8):851–60. https://doi.org/10.1038/ni.3780. Review examines the effects of the intestinal microbiome on innate and adaptive immune responses as well as the effects of microbiota-derived bioactive molecules on inflammation.

39.

•• Godoy LD, Rossignoli MT, Delfino-Pereira P, Garcia-Cairasco N, de Lima Umeoka EH. A comprehensive overview on stress neurobiology: basic concepts and clinical implications. Front Behav Neurosci. 2018;12(127). https://doi.org/10.3389/fnbeh.2018.00127. Review presents a comprehensive overview of stress neurobiology as well as the clinical implications of dysregulation of the stress system.

40.

• Mulkey SB, du Plessis AJ. Autonomic nervous system development and its impact on neuropsychiatric outcome. Pediatr Res. 2019;85(2):120–6. https://doi.org/10.1038/s41390-018-0155-0. Review presents an overview of autonomic nervous system development and maturation, including aspects influenced by activation of the central stress response (HPA axis) and glucocorticoids, that have been related to neuropsychiatric outcomes in children.

41.

Ramot A, Jiang Z, Tian J-B, Nahum T, Kuperman Y, Justice N, et al. Hypothalamic CRFR1 is essential for HPA axis regulation following chronic stress. Nat Neurosci. 2017;20(3):385–8. https://doi.org/10.1038/nn.4491.

42.

Won E, Kim Y-K. Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Curr Neuropharmacol. 2016;14(7):665–73. https://doi.org/10.2174/1570159x14666151208113006.

43.

Chrousos GP. Stress and disorders of the stress system. Nat Rev Endocrinol. 2009;5(7):374–81. https://doi.org/10.1038/nrendo.2009.106.CrossRefPubMed

44.

• Silverman MN, Sternberg EM. Glucocorticoid regulation of inflammation and its functional correlates: from HPA axis to glucocorticoid receptor dysfunction. Ann N Y Acad Sci. 2012;1261:55–63. https://doi.org/10.1111/j.1749-6632.2012.06633.x. Review examines the role of impairments in the stress response (HPA axis activity), including hypocortisolism and glucocorticoid resistance, and enhanced susceptibility to inflammatory and autoimmune diseases.

45.

Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5(10):617–25. https://doi.org/10.1016/S1470-2045(04)01597-9.CrossRefPubMed

46.

Goldstein DS. Adrenal responses to stress. Cell Mol Neurobiol. 2010;30(8):1433–40. https://doi.org/10.1007/s10571-010-9606-9.CrossRefPubMedPubMedCentral

47.

Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, cortisol, and periodontitis in a population aged 50 years and over. J Dent Res. 2006;85(4):324–8. https://doi.org/10.1177/154405910608500408.CrossRefPubMed

48.

Leserman J, Pence BW, Whetten K, Mugavero MJ, Thielman NM, Swartz MS, et al. Relation of lifetime trauma and depressive symptoms to mortality in HIV. Am J Psychiatry. 2007;164(11):1707–13. https://doi.org/10.1007/s10571-010-9606-9.CrossRefPubMed

49.

Hofer MA, Wolff CT, Friedman SB, Mason JW. A psychoendocrine study of bereavement: part I. 17-Hydroxycorticosteroid excretion rates of parents following death of their children from leukemia. Psychosom Med. 1972;34(6):481–91. https://doi.org/10.1097/00006842-197211000-00001.CrossRefPubMed

50.

Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004;130(4):601–30. https://doi.org/10.1037/0033-2909.130.4.601.

51.

Haroon E, Raison CL, Miller AH. psychoneuroimmunology meets neuropsychopharmacology: translational implications of the impact of inflammation on behavior. Neuropsychopharmacology. 2012;37(1):137–62. https://doi.org/10.1038/npp.2011.205.CrossRefPubMed

52.

Yang J, Wu J, Liu Y, Huang J, Lu Z, Xie L, et al. Porphyromonas gingivalis infection reduces regulatory T cells in infected atherosclerosis patients. PloS One. 2014;9(1):e86599–e. https://doi.org/10.1371/journal.pone.0086599.CrossRefPubMedPubMedCentral

53.

• Lu H, Xu M, Wang F, Liu S, Gu J, Lin S. Chronic stress enhances progression of periodontitis via alpha1-adrenergic signaling: a potential target for periodontal disease therapy. Exp Mol Med. 2014;46:e118. https://doi.org/10.1038/emm.2014.65. Experimental animal model suggests that chronic stress contributes to the progression of periodontitis by an α1-adrenergic signaling-mediated inflammatory response.

54.

Takada T, Yoshinari N, Sugiishi S, Kawase H, Yamane T, Noguchi T. Effect of restraint stress on the progression of experimental periodontitis in rats. J Periodontol. 2004;75(2):306–15. https://doi.org/10.1902/jop.2004.75.2.306.CrossRefPubMed

55.

Peruzzo DC, Benatti BB, Ambrosano GMB, Nogueira-Filho GR, Sallum EA, Casati MZ, et al. A systematic review of stress and psychological factors as possible risk factors for periodontal disease. J Periodontol. 2007;78(8):1491–504. https://doi.org/10.1902/jop.2007.060371.CrossRefPubMed

56.

Botelho J, Machado V, Mascarenhas P, Rua J, Alves R, Cavacas MA, et al. Stress, salivary cortisol and periodontitis: a systematic review and meta-analysis of observational studies. Arch Oral Biol. 2018;96:58–65. https://doi.org/10.1016/j.archoralbio.2018.08.016.CrossRefPubMed

57.

Bauer ME, Wieck A, Lopes RP, Teixeira AL, Grassi-Oliveira R. Interplay between neuroimmunoendocrine systems during post-traumatic stress disorder: a minireview. Neuroimmunomodulation. 2010;17(3):192–5. https://doi.org/10.1159/000258721.CrossRefPubMed

58.

Gárate I, Garcia-Bueno B, Madrigal JLM, Caso JR, Alou L, Gomez-Lus ML, et al. Stress-induced Neuroinflammation: role of the toll-like Receptor-4 pathway. Biol Psychiatry. 2013;73(1):32–43. https://doi.org/10.1016/j.biopsych.2012.07.005.CrossRefPubMed

59.

Graham JE, Christian LM, Kiecolt-Glaser JK. Stress, age, and immune function: toward a lifespan approach. J Behav Med. 2006;29(4):389–400. https://doi.org/10.1007/s10865-006-9057-4.CrossRefPubMedPubMedCentral

60.

Herbert TB, Cohen S. Stress and immunity in humans: a meta-analytic review. Psychosom Med. 1993;55(4):364–79. https://doi.org/10.1097/00006842-199307000-00004.CrossRefPubMed

61.

Merlot E, Couret D, Otten W. Prenatal stress, fetal imprinting and immunity. Brain Behav Immun. 2008;22(1):42–51. https://doi.org/10.1016/j.bbi.2007.05.007.CrossRefPubMed

62.

Nakata A. Psychosocial job stress and immunity: a systematic review. In: Yan Q, editor. Psychoneuroimmunology: methods and protocols. Totowa: Humana Press; 2012. p. 39–75.CrossRef

63.

Steptoe A, Hamer M, Chida Y. The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis. Brain Behav Immun. 2007;21(7):901–12. https://doi.org/10.1016/j.bbi.2007.03.011.CrossRefPubMed

64.

Masada MP, Kenney JS, Lee SW, Allison AC, Persson R, Page RC. Measurement of interleukin-1α and -1β in gingival crevicular fluid: implications for the pathogenesis of periodontal disease. J Periodontal Res. 1990;25(3):156–63. https://doi.org/10.1111/j.1600-0765.1990.tb01038.x.CrossRefPubMed

65.

Page RC. The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res. 1991;26(3):230–42. https://doi.org/10.1111/j.1600-0765.1991.tb01649.x.CrossRefPubMed

66.

Manouchehr-Pour M, Spagnuolo PJ, Rodman HM, Bissada NF. Comparison of neutrophil chemotactic response in diabetic patients with mild and severe periodontal disease. J Periodontol. 1981;52(8):410–5. https://doi.org/10.1902/jop.1981.52.8.410.CrossRefPubMed

67.

Hajishengallis G, Lamont RJ. Breaking bad: manipulation of the host response by porphyromonas gingivalis. Eur J Immunol. 2014;44(2):328–38. https://doi.org/10.1002/eji.201344202.CrossRefPubMedPubMedCentral

68.

• Wadhawan AR, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, et al. Periodontal pathogens and neuropsychiatric health. Curr Top Med Chem. 2020. https://doi.org/10.2174/1568026620666200110161105 Review summarizes current evidence on the association between Porphyromonas gingivalis and neruopsychiatric health as well as potential underlying mechanisms of bacterial pathogenicity.

69.

Deng Z-L, Sztajer H, Jarek M, Bhuju S, Wagner-Döbler I. Worlds apart—transcriptome profiles of key Oral microbes in the periodontal pocket compared to single laboratory culture reflect synergistic interactions. Front Microbiol. 2018;9:124. https://doi.org/10.3389/fmicb.2018.00124.CrossRefPubMedPubMedCentral

70.

Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134–44. https://doi.org/10.1111/j.1600-051x.1998.tb02419.x.CrossRefPubMed

71.

Almerich-Silla JM, Montiel-Company JM, Pastor S, Serrano F, Puig-Silla M, Dasí F. Oxidative stress parameters in saliva and its association with periodontal disease and types of Bacteria. Dis Markers. 2015;2015:653537. https://doi.org/10.1155/2015/653537.CrossRefPubMedPubMedCentral

72.

Hajishengallis G, Darveau RP, Curtis MA. The keystone-pathogen hypothesis. Nature Rev Microbiol. 2012;10(10):717–25. https://doi.org/10.1038/nrmicro2873.CrossRef

73.

Ardila CM, Guzman IC. Association of Porphyromonas gingivalis with high levels of stress-induced hormone cortisol in chronic periodontitis patients. J Investig Clin Dent. 2016;7(4):361–7. https://doi.org/10.1111/jicd.12175.CrossRefPubMed

74.

Costalonga M, Herzberg MC. The oral microbiome and the immunobiology of periodontal disease and caries. Immunol Lett. 2014;162(2 Pt A):22–38. https://doi.org/10.1016/j.imlet.2014.08.017.CrossRefPubMedPubMedCentral

75.

•• Duran-Pinedo AE, Solbiati J, Frias-Lopez J. The effect of the stress hormone cortisol on the metatranscriptome of the oral microbiome. Npj Biofilms and Microbiomes. 2018;4(1):25. https://doi.org/10.1038/s41522-018-0068-z. Study demonstrates that cortisol directly induces shifts in gene expression profiles of the oral microbiome that reproduce shifts in gene expression observed in periodontal disease and progression.

76.

Yost S, Duran-Pinedo AE, Teles R, Krishnan K, Frias-Lopez J. Functional signatures of oral dysbiosis during periodontitis progression revealed by microbial metatranscriptome analysis. Genom Medicine. 2015;7(1):1–19. https://doi.org/10.1186/s13073-015-0153-3.CrossRef

77.

• Akcali A, Huck O, Buduneli N, Davideau JL, Kose T, Tenenbaum H. Exposure of Porphyromonas gingivalis to cortisol increases bacterial growth. Arch Oral Biol. 2014;59(1):30–4. https://doi.org/10.1016/j.archoralbio.2013.09.003. Study shows that cortisol directly induces an increase the the growth of P. gingivalis in vitro.

78.

Akcali A, Huck O, Tenenbaum H, Davideau JL, Buduneli N. Periodontal diseases and stress: a brief review. J Oral Rehabil. 2013;40(1):60–8. https://doi.org/10.1111/j.1365-2842.2012.02341.x.CrossRefPubMed

79.

Slavish DC, Szabo YZ. The effect of acute stress on salivary markers of inflammation: a systematic review protocol. Syst Rev. 2019;8(1):108. https://doi.org/10.1186/s13643-019-1026-4.CrossRefPubMedPubMedCentral

80.

Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151–61. https://doi.org/10.2147/NSS.S134864.CrossRefPubMedPubMedCentral

81.

Trakada G, Chrousos G, Pejovic S, Vgontzas A. Sleep apnea and its association with the stress system, inflammation, insulin resistance and visceral obesity. Sleep Med Clin. 2007;2(2):251–61. https://doi.org/10.1016/j.jsmc.2007.04.003.CrossRefPubMedPubMedCentral

82.

Yap Y, Slavish DC, Taylor DJ, Bei B, Wiley JF. Bi-directional relations between stress and self-reported and actigraphy-assessed sleep: a daily intensive longitudinal study. Sleep. 2019;43. https://doi.org/10.1093/sleep/zsz250.

83.

Nollet M, Hicks H, McCarthy AP, Wu H, Möller-Levet CS, Laing EE, et al. REM sleep's unique associations with corticosterone regulation, apoptotic pathways, and behavior in chronic stress in mice. Proc Natl Acad Sci U S A. 2019;116(7):2733–42. https://doi.org/10.1073/pnas.1816456116.CrossRefPubMedPubMedCentral

84.

Sanford LD, Fang J, Tang X. Sleep after differing amounts of conditioned fear training in BALB/cJ mice. Behav Brain Res. 2003;147(1):193–202. https://doi.org/10.1016/S0166-4328(03)00180-3.CrossRefPubMed

85.

Lo Martire V, Caruso D, Palagini L, Zoccoli G, Bastianini S. Stress & sleep: a relationship lasting a lifetime. Neurosci Biobehav Rev. 2019. https://doi.org/10.1016/j.neubiorev.2019.08.024.

86.

Palagini L, Drake CL, Gehrman P, Meerlo P, Riemann D. Early-life origin of adult insomnia: does prenatal–early-life stress play a role? Sleep Med. 2015;16(4):446–56. https://doi.org/10.1016/j.sleep.2014.10.013.CrossRefPubMed

87.

Slopen N, Kubzansky LD, McLaughlin KA, Koenen KC. Childhood adversity and inflammatory processes in youth: a prospective study. Psychoneuroendocrinology. 2013;38(2):188–200. https://doi.org/10.1016/j.psyneuen.2012.05.013.CrossRefPubMed

88.

Krueger JM. The role of cytokines in sleep regulation. Curr Pharm Des. 2008;14(32):3408–16. https://doi.org/10.2174/138161208786549281.CrossRefPubMedPubMedCentral

89.

Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev. 2019;99(3):1325–80. https://doi.org/10.1152/physrev.00010.2018.CrossRefPubMedPubMedCentral

90.

• Karaaslan F, Dikilitas A. The association between stage-grade of periodontitis and sleep quality and oral health-related quality of life. J Periodontol. 2019;90(10):1133–41. https://doi.org/10.1002/jper.19-0034. Study shows that periodontitis is associated with short sleep duration and low-sleep quality, suggesting a bidirectional relationship between sleep disorders and periodontal disease.

91.

Nakada T, Kato T, Numabe Y. Effects of fatigue from sleep deprivation on experimental periodontitis in rats. J Periodontal Res. 2015;50(1):131–7. https://doi.org/10.1111/jre.12189.CrossRefPubMed

92.

Tsuchiya M, Aida J, Hagiwara Y, Sugawara Y, Tomata Y, Sato M, et al. Periodontal disease is associated with insomnia among victims of the great East Japan earthquake: a panel study initiated three months after the disaster. Tohoku J Exp Med. 2015;237(2):83–90. https://doi.org/10.1620/tjem.237.83.

Title: Psychological Stress: A Predisposing and Exacerbating Factor in Periodontitis
Authors: Anna M. Spector
Teodor T. Postolache
Faisal Akram
Alison J. Scott
Abhishek Wadhawan
Mark A. Reynolds
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keyword: Gingival Diseases
Published in: Current Oral Health Reports / Issue 3/2020
Electronic ISSN: 2196-3002
DOI: https://doi.org/10.1007/s40496-020-00282-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Psychological Stress: A Predisposing and Exacerbating Factor in Periodontitis

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 3/2020

Risk Factors for Peri-implantitis

The Use of PRF for Hard and Soft Tissue Grafting

Current Approaches for the Non-surgical Management of Peri-implant Diseases

Insights into the Clinical Diagnosis of Peri-implantitis: to Probe or Not to Probe

Etiology of Peri-Implantitis

Communication Skills of the Clinician and Patient Motivation in Dental Practice