Relationships of Stress and Coping Styles to Periodontal Disease: A Case-Control Study

Statement of Problem: The effects of individual variations in coping strategies have been debated in studies of the association between stress and chronic periodontitis، with conflicting results. To investigate the associations between stress، coping styles and periodontal disease in a sample of Iranian population. Forty patients with chronic periodontitis and forty control subjects with a healthy periodontium were enrolled in this study and matched for age and gender. Participants were patients undergoing periodontal treatment at the Department of Periodontics، Guilan University of Medical Sciences. A single examiner performed periodontal examination. Psychological assessments، including the Life Events Questionnaire and the Ways of Coping Questionnaire were done by a second examiner; both examiners were blind to the study. Bi-variate and multivariate logistic regression analyses were used to compare results for patients and control subjects. Statistically significant differences in the problem-focused coping (p< 0. 01)، intensity of stress (p< 0. 006)، as well as escape-avoidance (p< 0. 01)، and accepting responsibility (p< 0. 001) subscales were observed between the patient and control groups. Multivariate logistic regression identified a negative association between periodontitis and tooth-brushing frequency (OR= 3. 3، 95% CI: 1. 22- 8. 69)، as well as the accepting responsibility coping style (OR= 1. 5، 95% CI: 1. 14- 1. 98)، and a positive association with stress intensity (OR= 1. 081، 95% CI: 1. 023-1. 143). The results suggest that psychological stress associated with various life events is a significant risk indicator for periodontal disease. Although statistically small، there was a clinically important link between coping strategies and periodontal disease.