Sex steroid levels and stress-related markers in pregnant and non-pregnant women and the effect of periodontal therapy.

BACKGROUND: Periodontal disease during pregnancy can produce adverse events; in the current study stress was investigated as an exacerbating factors of periodontal disease. The aims of this study were to evaluate the possible associations between stress and pregnancy through scanning for gingivitis and to explore the effect of non-surgical periodontal therapy (NPT) on stress-related markers (CgA, AA, ß-endorphin, DHEA, sIgA and NPY) and sex steroid levels (estrogen and progesterone) in pregnant and non-pregnant women. MATERIAL AND METHODS: A total of 87 subjects; 22 pregnant women with gingivitis, 25 periodontally healthy pregnant women; 22 non-pregnant women with gingivitis and 15 periodontally healthy non-pregnant women, participated in this study. Periodontal clinical measures, stress hormones and sex steroid levels were measured at baseline and following the periodontal therapy. RESULTS: While periodontal therapy showed an improvement in salivary CgA, AA, ß-endorphin, DHEA, and sIgA levels (p<0.05) in non-pregnant women with gingivitis; neuropeptide Y levels were found to be unaffected (p>0.05). There were no significant changes in salivary CgA, AA, DHEA, sIgA, and neuropeptide Y levels in pregnant women with gingivitis (p>0.05); however, a decrease in ß-endorphin levels was observed after therapy (p<0.05). Pregnant women with gingivitis had higher gingival crevicular fluid (GCF) ß-endorphin levels in comparison to non-pregnant women with gingivitis. CONCLUSIONS: Gingival inflammation can be a psychosocial stress inducing factor during pregnancy. Furthermore, periodontal therapy may assist in reducing stress-related hormone levels in GCF during pregnancy.

Comparison of two measures to determine the oral health-related quality of life in elders with periodontal disease.

The Oral Health Impact Profile (OHIP) and Geriatric Oral Health Assessment Index (GOHAI) are accepted as comprehensive and widely used tools for assessing oral health-related quality of life (OHQoL). However, OHQoL assessment of elders with periodontal disease has not yet been investigated. OBJECTIVE: To assess the discriminative performance of GOHAI and OHIP-14 and to compare the psychometric properties of the scales in older people with periodontal disease. METHOD: Participants were 155 elderly patients with periodontal disease attending a university periodontal department. Periodontal measures included gingival index, plaque index, probing pocket depth, clinical attachment level, and bleeding on probing. GOHAI and OHIP-14 scales were used to assess OHQoL. In addition, participants completed a checklist of symptoms related to periodontal disease. RESULTS: Using the additive method for scoring, 22 participants (14.2%) had a GOHAI score of 0, indicating no impact from periodontal conditions, while 2 participants (1.3%) had an OHIP-14 score of 0. Over two-thirds of participants (70.96%) reported that their self-rated oral health was poor. CONCLUSIONS: Both OHIP-14 and GOHAI detected the impacts of oral disease in the elderly with periodontal diseases. Despite differences in content and emphasis, these two scales can be considered broadly equivalent. The main difference between them is the percentage of elderly participants scoring 0; the number of participants with a score of 0 for GOHAI is higher than OHIP-14. In this respect the improvements in OHQoL of the elderly items may be more difficult to detect with GOHAI.