Psychological Stress: A Predisposing and Exacerbating Factor in Periodontitis
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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.
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Emerging evidence suggests that chronic stress and related diseases, such as depression and anxiety, may be significant factors contributing to the development of oral dysbiosis, progression of periodontal/peri-implant disease, and inconsistent wound healing following periodontal therapy.
“Emerging evidence suggests that chronic stress and related diseases, such as depression and anxiety, may be significant factors contributing to the development of oral dysbiosis, progression of periodontal/peri‐implant disease, and inconsistent wound healing following periodontal therapy.125, 224, 225, 226”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [226]
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- •• 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. · DOI
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The oral microbiome: Role of key organisms and complex networks in oral health and disease
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- Authors
- Spector, A. M., Postolache, T. T., Akram, F., Scott, A. J., Wadhawan, A., & Reynolds, M. A.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Reynolds, Mark A.
- Venue
- Current Oral Health Reports
- Published
- 2020-08-11
- Volume
- 7
- Issue
- 3
- Pages
- 208-215
- ISSN
- 2196-3002 (ISSN-L)
- OpenAlex
- W3048468792
- Cited by
- 47
- References
- 94
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 7 · 2023: 11 · 2022: 11 · 2021: 3
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Current Oral Health Reports (publishedVersion, cc-by)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
- Keywords
- psychological stress, periodontitis, host stress response, immune function, oral microbiota, biofilm formation, hypothalamic-pituitary-adrenal axis, catecholamines, inflammation, depression, bipolar disorder, anxiety disorders, sleep-wake disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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