Influence of Stress on Periodontal Diseases

7/30/2019 Influence of Stress on Periodontal Diseases

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DEFINITION


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Stress is a risk indicator of Periodontaldisease

Risk Indicators are probable risk factors -

They may be Environmental , behavioural/ biological factorswhich when present increase thelikelihood of individual to develop the

disease So , stress may increase the probability to

develop the disease


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Good example of stress related disease isANUG perhaps because of effect of stress onimmune function

Presence ofNUG in soldiers stressed bywartime conditions in the trenches lead theterm TRENCH MOUTH

Another eg : frequent occurrence ofnecrotizing diseases in individuals exposedto psychologic stress


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Due to New Recruits , college students

during exam period , patients with

depression , emotional disorders ,inadequate in handling life situations aremore susceptible to Necrotising diseases

However etiology and pathogenesis ofperiodontal diseases are multifactorial nosingle factor like stress leads to disease


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There is relationship between stress and chronicforms of periodontal disease

Individuals with stable lifestylesand minimal

negative life had less periodontal disease destructionthan individuals with less stable life styles and morenegative life events

Not just the presence of Stress but it is the Type [Chronic and Longterm which is uncontrollable ] ofstress as well as ability of individual to cope withstress is correlated to destructive Periodontal disease


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Chronic stress leads to changes in dailyhabits such as Poor oral hygiene , clenchingand grinding , decreased salivary flow ,

suppressed immunity


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Stress has impact on periodontal diseasesdue to complex interactions among Nervous, Endocrine and Immune systems

Behavioural changes like Clenching andGrinding of teeth , Poor Oral hygiene ,

Smoking increases susceptability toperiodontal disease destruction


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INFLUENCE OF STRESS ONPERIODONTAL THERAPY OUTCOMES :

Stress and Depression influence outcome of

periodontal therapy

Responsive gp of periodontal treatment arefound to be of more rigid personality and

less stressfulcompared to Non responsive gp


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Cardivascular accidents :

Stress associated with dental proceduresmay precipitate Anginal pain or Congenital

heart failure in patients with cardiovasculardisease .

Therefore every effort should be made to

keep procedures short and control anxietyand pain in patient


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HYPOGLYCEMIA

may become aggrevated by the stress ofperiodontal surgery and hence precautions have to

be taken to avoid hypoglycemic reactions in suchpatients

Stressful situations can be a predisposing factor for

the increase of VSCS in mouth air leading toHalitosis


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Many patients though interested to maintainhealthy oral condition seek regular dental care dueto anxiety and apprehension

To prevent this , during history taking patient profileregarding anxiety and pain threshold should beknown

So , Premedication is advised to apprehensivepatients using DIAZEPAMS [ Benzodiazepine ,

valium 2-5mg ] at night before , in the morning , halfn hour before surgery


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Use of LOCAL ANESTHESIA - control ofpain

Post operative Analgesics [ NSAIDS ]

recommended to control post operative pain Eg : Diclofenac k active ingredient inhibits

prostaglandin synthesis by interfering with

action ofprostaglandin synthetase


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But we should remember that stress is just apredisposing factor and not an essentialfactor in the periodontal disease destruction


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Influence of Stress on Periodontal Diseases

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