Hatice BALCI YÜCE, Osman DEMİR, Özge GÖKTÜRK, Sema İNANIR, Hümeyra AYDEMİR TÜRKAL

The effect of periodontal treatment on depression, bodyimage, self esteem and anxiety in individuals:A randomized controlled clinical trial

Aim: Depression is a multi-factorial disease characterized by a variety of symptoms. Individuals with psychiatric disorders areseem to be more prone to periodontitis. However, depression and periodontal disease can be considered bidirectional risk factors.Periodontal diseases can also be an effect on depression. The aim of this study is to determine the effect of non-surgical mechanicalperiodontal treatment on psychological state.Materials and Methods: Two randomized groups were established from depressed patients with non-treated periodontal diseases.Test (n = 92) and control group (n = 92). Clinical periodontal and psychological measures were administered at baseline and at 6weeks in the control and test group. Periodontal treatment was applied to the test group.Results: After 6 weeks (the end of the periodontal therapy) there was a significant decrement in the results of Beck DepressionInventory (pa= 0.038) and a significant increment in Body Cathexis Scale (pa< 0.001) results in the test group. However, the resultsof Rosenberg Self-Esteem Scale (pa= 0.820) and Beck Anxiety Inventory (pa= 0.071) is similar between test and control groups.Conclusion: Within the limits of present study, the results suggest that periodontal treatment might be useful to improve depressivepatients’ psychological conditions.

PDF

___

1. Lepine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat 2011;7:3-7.
2. Engler H, Brendt P, Wischermann J, et al. Selective increase of cerebrospinal fluid IL-6 during experimental systemic inflammation in humans: association with depressive symptoms. Mol Psychiatry 2017;22:1448- 54.
3. Hodes GE, Menard C, Russo SJ. Integrating Interleukin-6 into depression diagnosis and treatment. Neurobiol Stress 2016;4:15-22.
4. Bluthe RM, Dantzer R, Kelley KW. Effects of interleukin-1 receptor antagonist on the behavioral effects of lipopolysaccharide in rat. Brain Res 1992;573:318-20.
5. Akcali A, Huck O, Tenenbaum H, Davideau JL, Buduneli N. Periodontal diseases and stress: a brief review. J Oral Rehabil 2013;40:60-8.
6. Dantzer R. Cytokine, sickness behavior, and depression. Immunol Allergy Clin North Am 2009;29:247-64.
7. Johannsen A, Rydmark I, Soder B, et al. Gingival inflammation, increased periodontal pocket depth and elevated interleukin-6 in gingival crevicular fluid of depressed women on long-term sick leave. J Periodontal Res 2007;42:546-52.
8. Saletu A, Pirker-Fruhauf H, Saletu F, Linzmayer L, Anderer P, Matejka M. Controlled clinical and psychometric studies on the relation between periodontitis and depressive mood. J Clin Periodontol 2005;32:1219-25.
9. Sertoz OO, Doganavsargil O, Elbi H. Body image and self-esteem in somatizing patients. Psychiatry Clin Neurosci 2009;63:508-15.
10. American Academy of Periodontology. Parameter on plaque-induced gingivitis. J Periodontol 2000;71:851- 2.
11. Solis AC, Lotufo RF, Pannuti CM, Brunheiro EC, Marques AH, Lotufo-Neto F. Association of periodontal disease to anxiety and depression symptoms, and psychosocial stress factors. J Clin Periodontol 2004;31:633-8.
12. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
13. Hisli N. The validity and reliability of Beck Depression Inventory in University students. J Turk Psychol 1989;7:3-13.
14. Secord PF, Jourard SM. The appraisal of bodycathexis: body-cathexis and the self. J Consult Psychol 1953;17:343-7.
15. Hovardaoglu S. Body Cathexis Scale. J Psychiatry Psychol Psychopharmacol 1993;1:26–32 .
16. Rosenberg M. Society and the adolescent self-image 1965:Princeton University Press, Princeton.
17. Cuhadaroglu F. Self esteem in adolescents 1986: Thesis. Hacettepe University, Ankara, Turkey.
18. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-7.
19. Ulusoy M, Sahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother 1998;12:163-72.
20. Castro GD, Oppermann RV, Haas AN, et al. Association between psychosocial factors and periodontitis: a case-control study. J Clin Periodontol 2006;33:109- 14.
21. Cakmak O, Alkan BA, Ozsoy S, et al. Association of gingival crevicular fluid cortisol/ dehydroepiandrosterone levels with periodontal status. J Periodontol 2014;85:287-94.
22. Cakmak O, Tasdemir Z, Aral CA, et al. Gingival crevicular fluid and saliva stress hormone levels in patients with chronic and aggressive periodontitis. J Clin Periodontol 2016;43:1024-31.
23. Ng SK, Keung Leung W. A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss. Community Dent Oral Epidemiol 2006;34:252-66.
24. Muniz F, Melo IM, Rosing CK, et al. Use of antidepressive agents as a possibility in the management of periodontal diseases: A systematic review of experimental studies. J Investig Clin Dent 2018;9:1-7.
25. Maes M, Bosmans E, Meltzer HY, et al. Interleukin-1 beta: a putative mediator of HPA axis hyperactivity in major depression? Am J Psychiatry 1993;150:1189- 93.
26. Thunell DH, Tymkiw KD, Johnson GK, et al. A multiplex immunoassay demonstrates reductions in gingival crevicular fluid cytokines following initial periodontal therapy. J Periodontal Res 2010;45:148-52.
27. O'Neil A, Berk M, Venugopal K, et al. The association between poor dental health and depression: findings from a large-scale, population-based study (the NHANES study). Gen Hosp Psychiatry 2014;36:266- 70.
28. Deinzer R, Hilpert D, Bach K, et al. Effects of academic stress on oral hygiene--a potential link between stress and plaque-associated disease? J Clin Periodontol 2001;28:459-64.
29. Zanatta FB, Ardenghi TM, Antoniazzi RP, et al. Association between gingival bleeding and gingival enlargement and oral health-related quality of life (OHRQoL) of subjects under fixed orthodontic treatment: a cross-sectional study. BMC Oral Health 2012;12:53.
30. 3Dumitrescu AL, Toma C, Lascu V. Self-liking, selfcompetence, body investment and perfectionism: associations with oral health status and oral-healthrelated behaviours. Oral Health Prev Dent 2009;7:191- 200.
31. Moore R, Brodsgaard I, Rosenberg N. The contribution of embarrassment to phobic dental anxiety: a qualitative research study. BMC Psychiatry 2004;4:10.
32. Hagglin C, Hakeberg M, Ahlqwist M, et al. Factors associated with dental anxiety and attendance in middle-aged and elderly women. Community Dent Oral Epidemiol 2000;28:451-60.