Stress + poor sleep = even more periodontitis …?

PD Dr. Kristina Bertl, PhD MSc MBA

Stress, defined as a state in which the affected individual perceives a sense of threat or lack of control, as well as sleep disorders and poor sleep quality, are both undeniably issues that cause a significant degree of difficulty in today’s society.

Stress and poor sleep quality negatively impact our health, both directly and indirectly.
For example, both can have a direct negative impact on the functioning of the immune system. Stress and poor sleep quality can also have indirect negative impacts on our health; by exacerbating unhealthy habits, such as reduced physical activity and increased tobacco and alcohol consumption.

In the medical field, it has already been shown that the simultaneous presence of stress and impaired sleep quality can have a multiplicative negative effect, for example on mortality rates, due to cardiovascular diseases. But what effect do they have on periodontitis?

This is the exact question recently addressed by an Italian research group (Marruganti et al. 2024). To investigate this, dental examinations were carried out on 235 participants in a cross-sectional study. In addition, stress levels and sleep quality were recorded using validated questionnaires.

The study population consisted of approximately 58% women and 46% smokers.
The following interesting results emerged:

Both moderate to high levels of stress and poor sleep quality have a negative impact on the occurrence of periodontitis, and this is likely to be exacerbated if both risk factors are present together. We should take this into account in stage 1 of periodontal therapy, in which our aim is to work with the patient to reduce risk factors for periodontitis as much as possible.

Reference

1. Marruganti C, Gaeta C, Romandini M, et al. Multiplicative effect of stress and poor sleep quality on periodontitis: A university-based cross-sectional study. J Periodontol. 2024;95:125–134.