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Anxiety, Depression, Stress, and Oral Health

Course Number: 573

References / Additional Resources

  1. Ritchie H, Roser Max. Mental Health. 2018 Apr. Accessed November 11, 2022.

  2. Pratt LA, Brody DJ. Depression in the US Household Population, 2009-2012. CDC. NCHS Data Brief No. 172, 2014 Dec. November 11, 2022.

  3. Cademartori MG1, Gastal MT1, Nascimento GG1,. Is dIs depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis.Clin Oral Investig. 2018 Nov;22(8):2685-2702. doi: 10.1007/s00784-018-2611-y. Epub 2018 Sep 6.

  4. Genco RJ, Ho AW, Grossi SG, et al. Relationship of stress, distress and inadequate coping behaviors to periodontal disease. J Periodontol. 1999 Jul;70(7):711-23. doi: 10.1902/jop.1999.70.7.711.

  5. Warren KR, Postolache TT, Groer ME, et al. Role of chronic stress and depression in periodontal diseases. Periodontol 2000. 2014 Feb;64(1):127-38. doi: 10.1111/prd.12036.

  6. Hwang SH, Park SG. The relationship between depression and periodontal diseases. Community Dent Health. 2018 Mar 1;35(1):23-29. doi: 10.1922/CDH_4150Hwang07.7.

  7. McFarland M, Ingelhart M. Depression, self efficacy, and oral health – an exploration. Oral Health Dent Manag 2010; 9: 214-222. November 11, 2022.

  8. Delgado-Angulo EK, Sabbah W, Suominen AL, et al. The association of depression and anxiety with dental caries and periodontal disease among Finnish adults. Community Dent Oral Epidemiol. 2015 Dec;43(6):540-9. doi: 10.1111/cdoe.12179. Epub 2015 Jul 1.

  9. Muniz FWMG, Melo IM, Rösing 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 Feb;9(1). doi: 10.1111/jicd.12291. Epub 2017 Sep 1.

  10. Ciancio SG. Medications' impact on oral health. J Am Dent Assoc. 2004 Oct;135(10):1440-8; quiz 1468-9. doi: 10.14219/jada.archive.2004.0055.

  11. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602. doi: 10.1001/archpsyc.62.6.593.

  12. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA. American Psychiatric Publishing. 2013.

  13. Kaufman J, Charney D. Comorbidity of mood and anxiety disorders. Depress Anxiety. 2000;12 Suppl 1:69-76. doi: 10.1002/1520-6394(2000)12:1+<69::AID-DA9>3.0.CO;2-K.

  14. Hsu WY, Tsai HJ, Yu SH, et al. Association of Periodontitis and Subsequent Depression: A Nationwide Population-Based Study. Medicine (Baltimore). 2016 Aug;95(31):e4419. doi: 10.1097/MD.0000000000004419.

  15. Rugulies R. Depression as a predictor for coronary heart disease. A review and meta-analysis. Am J Prev Med. 2002 Jul;23(1):51-61. doi: 10.1016/s0749-3797(02)00439-7.

  16. Sullivan MD, O'Connor P, Feeney P, et al. Depression predicts all-cause mortality: epidemiological evaluation from AACORD HRQL substudy. Diabetes Care. 2012 Aug;35(8):1708-15. doi: 10.2337/dc11-1791. Epub 2012 May 22.

  17. Wulsin LR, Valliant GE, Wells VE. A systematic review of the mortality of depression. Psychosom Med. 1999 Jan-Feb;61(1):6-17. doi: 10.1097/00006842-199901000-00003.

  18. Lawrence D, Hancock KJ, Kisely S. The gap in life expentacy from preventable physical illness in psychiatric patietns in Western Australia: retrospective analysis of population based registers. BMJ. 2013 May 21;346:f2539. doi: 10.1136/bmj.f2539.

  19. Banasr M, Valentine GW, Li XY, et al. Chronic unpredictable stress decreases cell proliferation in the cerebral cortex of the adult rat. Biol Psychiatry. 2007 Sep 1;62(5):496-504. Epub 2007 Jun 21. doi: 10.1016/j.biopsych.2007.02.006.

  20. Duman RS, Monteggia LM. A neurotropic model for stress-related mood disorders. Biol Psychiatry. 2006 Jun 15;59(12):1116-27. Epub 2006 Apr 21.

  21. Duman RS, Voleti B. Signaling pathways underlying the pathophysiology and treatment of depression: novel mechanisms for rapid-acting agents. Trends Neurosci. 2012 Jan;35(1):47-56. doi: 10.1016/j.tins.2011.11.004.

  22. Krishnan V, Nestler EJ. The molecular neurobiology of depression. Nature. 2008 Oct 16;455(7215):894-902. doi: 10.1038/nature07455.

  23. McEwen BS. Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85. doi: 10.1016/j.ejphar.2007.11.071. Epub 2008 Jan 30.

  24. Shansky RM, Morrison JH. Stress-induced dendritic remodeling in the medial prefrontal cortex: effects of circuit, hormones, and rest. Brain Res. 2009 Oct 13;1293:108-13. doi: 10.1016/j.brainres.2009.03.062. Epub 2009 Apr 8.

  25. Koob GF. Stress, corticotropin-releasing factor and drug addiction. Ann N Y Acad Sci. 1999;897:27-45. doi: 10.1111/j.1749-6632.1999.tb07876.x.

  26. Liu F, Wen YF, Zhou Y, et al. A meta-analysis of emotional disorders as possible risk factors for chronic periodontitis. Medicine (Baltimore). 2018 Jul;97(28):e11434. doi: 10.1097/MD.0000000000011434.

  27. Baxter AJ, Scott KM, Vos T, et al. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013 May;43(5):897-910. doi: 10.1017/S003329171200147X. Epub 2012 Jul 10.

  28. World Helath Organization. Depression and other common mental disorders: Global health estimates. Accessed November 11, 2022.

  29. United States: Institute for Health Metrics and Evaluation (IHME), 2018. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, WA. Accessed November 11, 2022.

  30. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017 Jun;19(2):93-107.

  31. Thibaut F. Anxiety disorders: a review of current literature. Dialogues Clin Neurosci. 2017 Jun;19(2):87-88.

  32. Musazzi L, Tornese P, Sala N, et al. Acute or Chronic? A Stressful Question. Trends Neurosci. 2017 Sep;40(9):525-535. doi: 10.1016/j.tins.2017.07.002. Epub 2017 Aug 1.

  33. Marshall RD, Garakani A. Psychobiology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder. Psychiatr Clin North Am. 2002 Jun;25(2):385-95. doi: 10.1016/s0193-953x(01)00005-3.

  34. McEwen BS. Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur J Pharmacol. 2008 Apr 7;583(2-3):174-85. doi: 10.1016/j.ejphar.2007.11.071. Epub 2008 Jan 30.

  35. Sterlemann V, Ganea K, Liebl C, et al. Long-term behavioral and neuroendocrine alterations following chronic social stress in mice: implications for stress-related disorders. Horm Behav. 2008 Feb;53(2):386-94. Epub 2007 Nov 19. doi: 10.1016/j.yhbeh.2007.11.001.

  36. McEwen BS. Neurobiological and Systemic Effects of Chronic Stress. Chronic Stress (Thousand Oaks). 2017 Jan-Dec;1. doi: 10.1177/2470547017692328. Epub 2017 Apr 10.

  37. American Psychiatric Association. Anxiety Disorders. What Are Anxiety Disorders? Accessed November 11, 2022.

  38. National Institute of Mental Helath. Anxiety Disorders: Overview. Accessed November 11, 2022.

  39. National Institute of Mental Health. Major Depression: Definitions. Accessed November 11, 2022.

  40. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-38. doi: 10.1146/annurev-publhealth-031912-114409.

  41. Centers for Disease Control and Prevention. Mental Health Conditions: Depression and Anxiety. Accessed November 11, 2022.

  42. National Alliance on Mental Illness (NAMI). Depression: Treatment. Accessed Accessed November 11, 2022.

  43. Lu XT, Zhao YX, Zhang Y, et al. Psychological stress, vascular inflammation and atherogenesis: potential roles of circulating cytokines. J Cardiovasc Pharmacol. 2013 Jul;62(1):6-12. doi: 10.1097/FJC.0b013e3182858fac.

  44. Kaufman J, Charney D. Comorbidity of mood and anxiety disorders. Depress Anxiety 2000; 12(Suppl 1): 69-76. doi: 10.1002/1520-6394(2000)12:1+<69::AID-DA9>3.0.CO;2-K.

  45. Strarr LR, Hammen C, Connolly NP, et al. Does relational dysfunction mediate the association between anxiety disorders and later depression? Test an interpersonal model of comorbidity. Depress Anxiety. 2014 Jan;31(1):77-86. doi: 10.1002/da.22172. Epub 2013 Aug 26.

  46. Wittchen HU, Beesdo K, Bittner A, et al. Depressive episodes—evidence for a causal role of primary anxiety disorders? Eur Psychiatry. 2003 Dec;18(8):384-93. doi: 10.1016/j.eurpsy.2003.10.001.

  47. Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1 and IL-6: a meta-analysis. Psychosom Med. 2009 Feb;71(2):171-86. doi: 10.1097/PSY.0b013e3181907c1b. Epub 2009 Feb 2.

  48. Singh T, Newman AB. Inflamamtory markers in population studies of aging. Ageing Res Rev. 2011 Jul;10(3):319-29. doi: 10.1016/j.arr.2010.11.002. Epub 2010 Dec 8.

  49. Hannestad J, DellaGioia N, Bloch M. The effect of antidepressant medication treatment on serum levels of inflammatory cytokines: a meta-analysis. Neuropsychopharmacology. 2011 Nov;36(12):2452-9. doi: 10.1038/npp.2011.132. Epub 2011 Jul 27.

  50. Marshall EC, Zvolensky MJ, Vujanovic AA, et al. Evaluation of smoking characteristics among community-recruited daily smokers with and without posttraumatic stress disorder and panic psychopathology. J Anxiety Disord. 2008 Oct;22(7):1214-26. doi: 10.1016/j.janxdis.2008.01.003. Epub 2008 Jan 11.

  51. Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patietns in Western Australia: retrospective analysis of population-based registers. BMJ. 2013 May 21;346:f2539. doi: 10.1136/bmj.f2539.

  52. Lawrence D, Kisley S, Pais J. The epidemiology of excess mortality in people with mental illness. Can J Psychiatry. 2010 Dec;55(12):752-60. doi: 10.1177/070674371005501202.

  53. Kisley S, Sawyer E, Siskind D, et al. The oral health of people with anxiety and depressive disorders – a systematic review and meta-analysis. J Affect Disord. 2016 Aug;200:119-32. doi: 10.1016/j.jad.2016.04.040. Epub 2016 Apr 21.

  54. Okoro, Catherine A.; Strine, Tara W.; Eke, Paul I.; Dhingra, Satvinder S.; and Balluz, Lina S., The association between depression and anxiety and use of oral health services and tooth loss. Public Health Resources 2012; 264.

  55. Longley AJ, Doyle PE. Mental illness and the dental patient. J Dent Hyg 2003; 77(3):190-204; quiz 204-6. Erratum in: J Dent Hyg 2004; 78(1): 4.

  56. The Cleveland Clinic Dental Phobia. Accessed November 11, 2022.

  57. Matevosyan NR. Oral health of adults with serious mental illness: A review. Comm Ment Health J. 2009

  58. Lam PD, John DA, Galfalvy H, Kunzel C, Lewis-Fernandez R. Oral Health-Related Quality of Life Among Publicly Insured Mental Health Service Outpatietns with Serious Mental Illness. Psych Services 2019; 70(12): 1101-1109.

  59. Freeman R, Goss S. Stress measures as predictors of periodontal disease--a preliminary communication. Community Dent Oral Epidemiol. 1993 Jun;21(3):176-7. doi: 10.1111/j.1600-0528.1993.tb00748.x.

  60. Gree LW, Tryon WW, Marks B, et al. Periodontal disease as a function of life events stress. J Human Stress. 1986 Spring;12(1):32-6. doi: 10.1080/0097840X.1986.9936764.

  61. Mannem S, Chava VK. The effect of stress on periodontitis: A clinicobiochemical study. J Indian Soc Periodontol. 2012 Jul;16(3):365-9. doi: 10.4103/0972-124X.100912.

  62. Rai B, Kaur J, Anand SC, et al. Salivary stress markers, stress, and periodontits: a pilot study. J Periodontol. 2011 Feb;82(2):287-92. doi: 10.1902/jop.2010.100319. Epub 2010 Aug 19.

  63. Peruzzo DC, Benatti BB, Ambrosano GM, et al. A systematic review of stress and psychological factors as possible risk factors for periodontal disease. J Periodontol. 2007 Aug;78(8):1491-504. doi: 10.1902/jop.2007.060371.

  64. Nasciemento GG, Gastal MT, Leite FRM, et al. Is there an association between depression and periodontitis? A birth cohort study? J Clin Periodontol. 2019 Jan;46(1):31-39. doi: 10.1111/jcpe.13039.

  65. Khambaty T, Steward JC. Associations of depressive and anxiety disorders with periodontal disease prevalence in young adults: analysis of 1999-2004 National Health and Nutrition Examination Survey (NHANES) Data. Ann Behav Med. 2013 Jun;45(3):393-7. doi: 10.1007/s12160-013-9471-0.

  66. Kurushima Y, Bowyer R, Ide M, et al. Genetic and environmental contributions to the association between mood disorder and periodontal disease: A cross-sectional study among female twins in the UK. J Clin Periodontol. 2019 Jan;46(1):40-50. doi: 10.1111/jcpe.13045.

  67. Shannon IL, Kilgore WG, O’Leary TJ. Stress as a predisposing factor in necrotizing ulcertative gingivitis. J Periodontol. 1969 Apr;40(4):240-2. doi: 10.1902/jop.1969.40.4.240.

  68. Sheilds WD. Acute necrotizing ulcerative gingivitis. A study of some of the contributing factors and their validity in an Army population. J Periodontol. 1977 Jun;48(6):346-9. doi: 10.1902/jop.1977.48.6.346.

  69. Maupin CC, Bell WB. The relationship of 17-hydroxycorticosteriod to acute necrotizing ulcerative gingivitis. J Periodontol. 1975 Dec;46(12):721-2. doi: 10.1902/jop.1975.46.12.721.

  70. Davies RM, Smith RG, Porter SR. Destructive forms of periodontal disease in adolescents and young adults. Br Dent J. 1985 Jun 22;158(12):429-36. doi: 10.1038/sj.bdj.4805622.

  71. Page RC, Altman LC, Ebersole JL, et al. Rapidly progressive periodontitis. A distinct clinical condition. J Periodontol. 1983 Apr;54(4):197-209.

  72. Anttila S, Knuuttilla M, Ylostalo P, et al. Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need. Eur J Oral Sci. 2006 Apr;114(2):109-14. doi: 10.1111/j.1600-0722.2006.00334.x.

  73. Kurer JR, Watts TL, Weinman J, et al. Psychological mood of regular dental attenders in relation to oral hygiene behaviour and gingival health. J Clin Periodontol. 1995 Jan;22(1):52-5. doi: 10.1111/j.1600-051x.1995.tb01770.x.

  74. Boyapati L, Wang HL. The role of stress in periodontal disease and wound healing. Periodontol 2000. 2007;44:195-210. doi: 10.1111/j.1600-0757.2007.00211.x.

  75. Anttila SS, Knuuttila ML, Sakki TK. Depressive symptoms favor abundant growth of salivary lactobacilli. Psychosom Med. 1999 Jul-Aug;61(4):508-12. doi: 10.1097/00006842-199907000-00015.

  76. Anttilla SS, Knuuttila ML, Sakki TK. Relationship of depressive symptoms to edentulousness, dental health, and dental health behavior. Acta Odontol Scand. 2001 Dec;59(6):406-12. doi: 10.1080/000163501317153275.

  77. Cademartori MG, Gastal MT, Nascimento GG, Demarco FF, Correa MB. Is depression associated with oral health outcomes in adults and elders? A systematic review and meta-analysis. Clin Oral Invest 2018; 22(8): 2685-2702.

  78. Elter JR, White BA, Gaynes BN, et al. Relationship of clinical depression to periodontal treatment outcome. J Periodontol. 2002 Apr;73(4):441-9. doi: 10.1902/jop.2002.73.4.441.

  79. Kamma JJ, Baehni PC. Five-year maintenance follow-up of early-onset periodontitis patients. J Clin Periodontol. 2003 Jun;30(6):562-72. doi: 10.1034/j.1600-051x.2003.00289.x.

  80. Bhatia A, Sharma RK, Tewari S, et al. Effect of fluoxetine on periodontal statsu in patients with depression: a cross-sectional observational study. J Periodontol. 2015 Aug;86(8):927-35. doi: 10.1902/jop.2015.140706. Epub 2015 Mar 27.

  81. Bhatia A, Sharma RK, Tewari S, et al. Periodontal status in chronic periodontitis depressed patients on desvenlafaxine: An observational study. J Indian Soc Periodontol. 2018 Sep-Oct;22(5):442-446. doi: 10.4103/jisp.jisp_219_18.

  82. Anguiar JCA, Gomes EPP, Fonseca-Silva T, et al. Fluoxetine reduces periodontal disease progression in conditioned fear stress model in rats. J Periodontal Res. 2013 Oct;48(5):632-7. doi: 10.1111/jre.12049. Epub 2013 Feb 21.

  83. Branco-de-Almeida LS, Franco GC, Castro ML, et al. Fluoxetine inhibits inflammatory response and bone loss in a rat model of ligature-induced periodontitis. J Periodontol. 2012 May;83(5):664-71. doi: 10.1902/jop.2011.110370. Epub 2011 Oct 3.

  84. Kroenke K, Strine TW, Spitzer RL, et al. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009 Apr;114(1-3):163-73. doi: 10.1016/j.jad.2008.06.026. Epub 2008 Aug 27.

  85. Villalobos Sancho SM. Effect of antidepressants on inflammatory markers in gingival tissue and serum samples in patients with chronic periodontitis. A Thesis. University of Alabama at Birmingham. Accessed November 11, 2022.

  86. Self Management Resource Center (Open Source). Personal Health Questionnair Depression Scale (PHQ-8). Accessed November 11, 2022.

Additional Resources

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