The influence of psychological stress on periodontal disease.

This paper reviews studies that investigated the association between psychosocial stress and periodontal disease. The impact of stress on the immune system has been well established, and a possible influence on a chronic inflammatory disease like periodontitis appears probable. Yet, a direct association between periodontal disease and stress remains to be proven, which is partly due to lack of an adequate animal model and the difficulty in quantifying amount and duration of stress and the detrimental effects of inadequate coping with stress. Multiple variables affecting the severity of periodontal disease and the uncertainty about the individual onset of periodontal disease complicate the issue further. Nevertheless, more recent studies indicate that psychosocial stress represents a risk indicator for periodontal disease and should be addressed before and during treatment.