DEFINITION

Stress is a risk indicator of Periodontal

disease Risk Indicators are probable risk factors They may be Environmental , behavioural / biological factors which when present increase the likelihood of individual to develop the disease So , stress may increase the probability to develop the disease

 Good example of stress related disease is

ANUG perhaps because of effect of stress on immune function Presence of NUG in soldiers stressed by wartime conditions in the trenches lead the term TRENCH MOUTH Another eg : frequent occurrence of necrotizing diseases in individuals exposed to psychologic stress

 Due to New Recruits , college students

during exam period , patients with depression , emotional disorders , inadequate in handling life situations are more susceptible to Necrotising diseases However etiology and pathogenesis of periodontal diseases are multifactorial no single factor like stress leads to disease

 There is relationship between stress and chronic

forms of periodontal disease

Individuals with stable lifestyles and minimal

negative life had less periodontal disease destruction than individuals with less stable life styles and more negative life events

Not just the presence of Stress but it is the Type [

Chronic and Longterm which is uncontrollable ] of stress as well as ability of individual to cope with stress is correlated to destructive Periodontal disease

 Chronic stress leads to changes in daily

habits such as Poor oral hygiene , clenching and grinding , decreased salivary flow , suppressed immunity

 Stress has impact on periodontal diseases

due to complex interactions among Nervous , Endocrine and Immune systems

Behavioural changes like Clenching and

Grinding of teeth , Poor Oral hygiene , Smoking increases susceptability to periodontal disease destruction

 INFLUENCE OF STRESS ON

PERIODONTAL THERAPY OUTCOMES : Stress and Depression influence outcome of periodontal therapy Responsive gp of periodontal treatment are found to be of more rigid personality and less stressful compared to Non responsive gp

 Cardivascular accidents :

Stress associated with dental procedures

may precipitate Anginal pain or Congenital heart failure in patients with cardiovascular disease . Therefore every effort should be made to keep procedures short and control anxiety and pain in patient

 HYPOGLYCEMIA

may become aggrevated by the stress of periodontal surgery and hence precautions have to be taken to avoid hypoglycemic reactions in such patients
Stressful situations can be a predisposing factor for

the increase of VSCS in mouth air leading to Halitosis

 Many patients though interested to maintain

healthy oral condition seek regular dental care due to anxiety and apprehension regarding anxiety and pain threshold should be known

To prevent this , during history taking patient profile

So , Premedication is advised to apprehensive

patients using DIAZEPAMS [ Benzodiazepine , valium 2-5mg ] at night before , in the morning , half n hour before surgery

 Use of LOCAL ANESTHESIA - control of

pain Post operative Analgesics [ NSAIDS ] recommended to control post operative pain Eg : Diclofenac k active ingredient inhibits prostaglandin synthesis by interfering with action of prostaglandin synthetase

 But we should remember that stress is just a

predisposing factor and not an essential factor in the periodontal disease destruction