Objectives: Several studies conducted in Western countries have shown significant associations between stress factors and periodontal disease. However, there have been only a few studies conducted in Asian countries. The present study was designed to identify possible relationship between stress and periodontal disease in residents of a rural area in Japan.
Material and Methods: Data were collected from 1,089 adults with at least six natural teeth in a typical farming district of Japan. Subjects were asked to complete a questionnaire on daily stresses in various aspects of life. Data on gender, occupation, smoking, alcohol drinking habits, dental health behavior and systemic disease status were obtained from the questionnaires. Periodontal disease status was assessed using clinical attachment loss (CAL), and the subjects were dichotomized according to mean CAL <1.5 mm (control group) and >= 1.5 mm (diseased group). Logistic regression was applied to assess the associations between stress and other factors with periodontal disease, and odds ratios (ORs) as well as 95% confidence intervals were calculated. Results: In bivariate analysis, significant relationships were found between periodontal disease and stress within 1 month (P<0.001), job stress (P<0.001), self-health-related stress (P <0.001) and family health-related stress (P<0.01). Logistic regression analysis revealed that subjects who felt job stress (OR = i.71, P<0.05) and those who felt stress due to self health (OR = 1.72, P<0.05) were more prone to have periodontal disease than were those who never or only rarely felt such stress. Significant correlations were also found between periodontal disease and smoking habit, frequency of dental clinic visits and hyperlipidemia (OR = 1.8, P<0.05, OR 2.0, P<0.001, OR = 2.1, P<0.05, respectively).
Conclusion: The results suggest that stress related to self health and job might be potential risk indicators for development of periodontal diseases. Intervention measures including stress reduction may provide adjunctive approaches for preventing and treating periodontal disease.