Oral health impact of periodontal diseases in adolescents.

The need for treatment of destructive periodontal diseases is based on observations made by oral health professionals, who, prompted by clinical findings, recommend treatment. We hypothesized that clinical signs of periodontal destruction have an impact on the oral-health-related quality of life of adolescents. We conducted a cross-sectional study among 9203 Chilean high school students sampled by a multistage random cluster procedure. We recorded clinical attachment levels and the presence of necrotizing ulcerative gingivitis. The students answered the Spanish version of the Oral Health Impact Profile and provided information on several socio-economic indicators. The results of multivariable logistic regression analyses (adjusted for age, gender, and tooth loss) showed that both attachment loss [OR = 2.0] and necrotizing ulcerative gingivitis [OR = 1.6] were significantly associated with higher impact on the Oral Health Related Quality of Life of adolescents. Individuals in lower socioeconomic positions systematically reported a higher impact on their oral-health-related quality of life.

The influence of psychological stress on periodontal disease.

This paper reviews studies that investigated the association between psychosocial stress and periodontal disease. The impact of stress on the immune system has been well established, and a possible influence on a chronic inflammatory disease like periodontitis appears probable. Yet, a direct association between periodontal disease and stress remains to be proven, which is partly due to lack of an adequate animal model and the difficulty in quantifying amount and duration of stress and the detrimental effects of inadequate coping with stress. Multiple variables affecting the severity of periodontal disease and the uncertainty about the individual onset of periodontal disease complicate the issue further. Nevertheless, more recent studies indicate that psychosocial stress represents a risk indicator for periodontal disease and should be addressed before and during treatment.

Psychosocial factors in inflammatory periodontal diseases. A review.

Reviewing the literature concerning the possible rôle of psychosocial factors in the aetiology of inflammatory periodontal diseases, it may be concluded that there is evidence which strongly suggests that emotional stress is one of the predisposing factors to ANUG. On the other hand, it is not clear that the scientific evidence is sufficient to substantiate the hypothesis that psychosocial factors are of aetiological importance in periodontitis. The proposed mechanisms which may mediate the putative relationship between psychosocial conditions and inflammatory periodontal diseases remain to be tested. However, psychoneuroimmunologic studies make lowered host resistance especially interesting as a possible mechanism. Although available studies do not definitively support causal relationships, they suggest that psychosocial factors may be involved in the aetiology of inflammatory periodontal diseases, which, in turn, would relate to clinical management of these conditions.

Demographic and clinical data associated with acute necrotizing ulcerative gingivitis in a dental school population (ANUG-demographic and clinical data).

This study was undertaken to determine the prevalence of demographic and clinical factors of patients diagnosed as having ANUG as determined by the presence of painful, bleeding, necrotic and ulcerated interproximal gingival papillae. Results showed that ANUG patients were evenly divided between males and females relative to the general clinic population. 58% of the patients with ANUG were under 25 years of age as compared to 31% under 25 in the general clinic population. Overall, the ANUG group accounted for 1.4% of the under 34 age group in the general clinic population. 76% of the ANUG group had a high school education or less with 67% having less than $5,000 annual income. Only 20% presented with elevated temperature. Only 6% of the patients with ANUG were non-smokers as compared to 63% in a matched control group. Of great significance was the fact that only 1 patient with ANUG was black as compared to a 41% black population in the clinic population.

Stress, adaptation, and immunity: studies in humans.

The notion that some combination of excessive "stress" and inadequate coping may increase susceptibility to illness has long been part of our conventional wisdom. Yet, until recently, there have been few data to support this contention. During the past decade, the relationship between stress, adaptation, and human immunity has come under closer scrutiny. There is now considerable evidence that certain types of experimental and naturally-occurring stress are associated with alterations of human cellular immune function. Furthermore, these observed changes generally are immunosuppressive. However, the mediating mechanisms underlying this relationship remain poorly understood. Critical factors in the stress-adaptation-immunity relationship are: the duration and proximity of the stressor, the adaptive capacity of the individual, and the differential effects of certain stressors on immunologic components.

Stress, anxiety and the dental patient: the missing specification.

The importance of stress and anxiety as contributing to the complex aetiology of dental disease is becoming more widely recognized. Clinical examples of organic dental disease which were relieved when their psychological causes had been uncovered are described. It suggested that specialized psychiatric skills are not always necessary in dealing with such cases. The dentist's own personal life experience, his human understanding and his interest his patients' well-being are usually sufficient. Equal attention must be given to all data in both physical and psychological spheres if the patient's best interests are to be served.