Periodontitis: An Experimental Study

Various risk factors influence the progression of periodontitis and contribute towards the ability of bacteria to invade periodontal tissue. Consequently, the inflammatory process caused by bacterial infection, causes soft tissue destruction and bone loss (Berezow & Darveau, 2011). Stress and anxiety cause an increased level of adrenocorticotropic hormones, such as cortisol in blood and saliva. Cortisol has an immunosuppressive effect on the host, strengthening the ability for pathogenic bacteria to manifest in the gingival sulcus (Refulio, Rocafuerte, de la Rosa, Mendoza, & Chambrone, 2013). This may indicate that stress and anxiety are part of the spectrum of multifactorial risk factors for periodontitis. In order to ascertain the effect …show more content…
Two studies emphasise that stress plays a crucial role in the severity of periodontitis, owed to the release of cortisol in the event of a traumatic life situation (Goyal , Jajoo, Nagappa, & Rao, 2011;Mannem et al., 2012). The study conducted by (Goyal et al. 2011) consists of two groups of periodontitis patients and highly stressed individuals, respectively. Furthermore, all participants are from lower socioeconomic backgrounds. As mentioned in the previous discussion, Mannem et al. (2012) restricts their study to individuals who are 40 years and older and argue that periodontitis sufferers among this age group are more exposed to negative life events. As a result, the alteration of the hypothalamic-pituitary-adrenal axis causes the release of immunosuppressive cortisol to deal with stress. Consequently the restricted study of Goyal et al. (2011) on individuals who are challenged by socioeconomic hardships, show that cortisol levels are highly significant among those who suffer from a clinical stress syndrome along with positive correlation between periodontal clinical measurements and cortisol levels. Although these studies identify the reason for elevated cortisol levels among the participants, demographic limitations of both regarding age and socioeconomic status shows insufficient evidence. The comparison of stress levels among younger individuals to those of the existing participants in the study conducted by Mannem et al. (2011), may be helpful to better comprehend the role of stress-induced cortisol in the severity of periodontitis. Furthermore, the limitation to include a wider range of socioeconomic situations by Goyal et al. (2011), creates inconsistent evidence on how