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 perio-dontitis, with conflicting results. Purpose: To investigate the associations between stress, coping styles and perio-dontal disease in a sample of Iranian population. Materials and Method: 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. Results: 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). Conclusion: The results suggest that psychological stress associated with various life events is a significant risk indicator for periodontal disease. Although statisti-cally small, there was a clinically important link between coping strategies and periodontal disease.