A literature review published in the August issue of the Journal of Periodontology (JOP) saw a strong relationship between stress and periodontal diseases; 57% of the studies included in the review showed a positive relationship between periodontal diseases and psychological factors such as stress, distress, anxiety, depression, and loneliness.

"More research is needed to determine the definitive relationship between stress and periodontal diseases," said study author Daiane Peruzzo, PhD. "However, patients who minimize stress may be at less risk for periodontal diseases."

Researchers speculate that the hormone cortisol may play a role in the possible connection between stress and periodontal diseases. A study in JOP found that increased levels of cortisol can lead to increased destruction of the gums and jaw bone due to periodontal diseases. It is well known that periodontal diseases, left untreated, can ultimately lead to bone loss or tooth loss.

"Individuals with high stress levels tend to increase their bad habits, which can be harmful to periodontal health. They are less attentive to their oral hygiene and may increase their use of nicotine, alcohol or drugs," explained Preston D. Miller, Jr., DDS, and President of the American Academy of Periodontology. "Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep, and maintaining a positive mental attitude."

Patients should to also keep in mind their 'pocket size guide' to periodontal health; periodontal probing depths of one to two millimeters with no bleeding are not a concern but probing depths of three and four millimeters may need a more in depth cleaning called scaling and root planing. Probing depths in excess of 5mm may require more advanced treatment and patients should talk to their dental specialist.



To find a periodontist or to find out if you are at risk for periodontal diseases take the Academy's risk assessment test. A referral to a periodontist, additional information, and brochure samples are available online at perio/.

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.