Xu Shuyu, Zhang Xuehan, Gong Ruonan, Huang Xuanzhi, Zhang Min
Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Implantology, Stomatological Hospital and Dental School, Tongji University, Shanghai, People's Republic of China.
J Inflamm Res. 2025 Jun 25;18:8317-8329. doi: 10.2147/JIR.S530138. eCollection 2025.
Periodontitis is a prevalent chronic inflammatory disease, with growing evidence suggesting a link to psychological factors such as stress and anxiety. University students, who frequently experience elevated psychological stress, may be particularly susceptible to periodontal issues. This study aimed to examine the relationship between stress levels, anxiety status, and periodontitis in university students, and to assess the potential influence of psychological factors on periodontal health.
The study sample comprised 240 university students. Participants were categorized post hoc according to their periodontal status and psychological assessment scores. Periodontal health was evaluated using the Community Periodontal Index (CPI), while stress and anxiety levels were measured with the Perceived Stress Scale-14 (PSS-14) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Statistical analyses included chi-square tests and multivariable logistic regression models to examine associations between psychological factors and periodontitis, adjusting for potential confounding variables.
Among the participants (mean age: 21.70 ± 3.16 years), 43.3% were diagnosed with periodontitis. The mean age was 21.78 ± 3.32 years in the non-periodontitis group and 21.24 ± 2.06 years in the periodontitis group. Anxiety was prevalent: 33.8% had no anxiety, 30.8% had mild, 22.1% had moderate, and 13.3% had severe anxiety. Reported stress levels were 35.0% normal, 48.8% high, and 16.3% very high. Anxiety levels were significantly associated with an increased risk of periodontitis ( < 0.001). After adjusting for a range of potential confounders, including but not limited to gender, age, education level, smoking, and oral hygiene practices, individuals with mild, moderate, and severe anxiety had 8.391 (95% CI: 2.776-25.362), 11.423 (95% CI: 3.116-41.872), and 46.196 (95% CI: 10.414-204.921) times higher odds of developing periodontitis, respectively, compared to those without anxiety. In contrast, stress levels were not significantly associated with periodontitis after adjustment ( > 0.05).
Anxiety was significantly associated with periodontitis in university students, highlighting the importance of addressing anxiety as part of periodontal disease prevention and management strategies in this population.
牙周炎是一种常见的慢性炎症性疾病，越来越多的证据表明其与压力和焦虑等心理因素有关。经常经历心理压力升高的大学生可能特别容易出现牙周问题。本研究旨在探讨大学生压力水平、焦虑状态与牙周炎之间的关系，并评估心理因素对牙周健康的潜在影响。
研究样本包括240名大学生。根据参与者的牙周状况和心理评估得分进行事后分类。使用社区牙周指数（CPI）评估牙周健康，同时分别用感知压力量表-14（PSS-14）和广泛性焦虑障碍量表-7（GAD-7）测量压力和焦虑水平。统计分析包括卡方检验和多变量逻辑回归模型，以检验心理因素与牙周炎之间的关联，并对潜在的混杂变量进行调整。
在参与者中（平均年龄：21.70±3.16岁），43.3%被诊断为牙周炎。非牙周炎组的平均年龄为21.78±3.32岁，牙周炎组为21.24±2.06岁。焦虑普遍存在：33.8%无焦虑，30.8%有轻度焦虑，22.1%有中度焦虑，13.3%有重度焦虑。报告的压力水平为35.0%正常，48.8%高，16.3%非常高。焦虑水平与牙周炎风险增加显著相关（<0.001）。在调整一系列潜在混杂因素后，包括但不限于性别、年龄、教育水平、吸烟和口腔卫生习惯，与无焦虑者相比，轻度、中度和重度焦虑者患牙周炎的几率分别高出8.391倍（95%置信区间：2.776-25.362）、11.423倍（95%置信区间：3.116-41.872）和46.196倍（95%置信区间：10.414-204.921）。相比之下，调整后压力水平与牙周炎无显著关联（>0.05）。
焦虑与大学生牙周炎显著相关，这凸显了在该人群中将解决焦虑作为牙周疾病预防和管理策略一部分的重要性。
