Effect of Psychological Stress on Salivary Cortisol and Periodontitis


  • Nakhshaw Sh. Ahmed Periodontic Department, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. Author
  • Shokhan H. Azeez Dental Nursing Department, Sulaimani Technical Institute, Sulaimani Polytechnic University, Kurdistan Region, Iraq. Author




Psychological stress, Periodontal disease, Salivary cortisol levels


Objective: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factors
such as stress or anxiety that affect host response. This study evaluates the potential associations between psychosocial stress, salivary cortisol and periodontitis.

In this cross-sectional study, 80 adult participants (41 males and 39 females) aged 20-45 years were included. Participants
completed a stress self-assessment using a PSS scale questionnaire. Samples of saliva were collected for testing cortisol levels by
ELISA. The participants were then divided into four groups established on periodontal parameters (plaque index (PI), bleeding on
probing (BOP), probing pocket depth, and clinical attachment level), and stress levels: Group 1 (healthy periodontium without stress),
Group 2 (periodontitis without stress), Group 3 (healthy periodontium with stress), and Group 4 (periodontitis with stress).

Statistically significant differences were observed between the values detected in the four experimental groups for PI, BI, PD,
and CAL (p≤0.05). The highest means of cortisol level were revealed in the stressed healthy group and stressed with periodontitis
group, at 39.7 and 40.5, respectively. Hence there were statistically significant differences overall across the four groups (p≤0.05).

This study demonstrates that psychosocial stress is a risk factor for periodontal diseases, and in cortisol, as one of the
elements that enhance periodontal damage, increases were recorded for all four clinical parameters, BI, PI, PD, CAL, which are used
as diagnostic tools for periodontitis.


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How to Cite

Effect of Psychological Stress on Salivary Cortisol and Periodontitis. (2023). Sulaimani Dental Journal, 10(2), 9. https://doi.org/10.17656/sdj.10172

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