The interplay between stress and periodontal health: A systematic review
Bibliographic record
Abstract
ABSTRACT Periodontal disease, which is chronic in nature, is an inflammatory condition that is affected by the above-mentioned factors of microbes, system, and society. The mounting proof indicates that one of the channels through which psychological stress can worsen periodontal inflammation is through both biological and behavioral mechanisms. This review was conducted to find the relationship between psychological stress and periodontal health, exploring underlying mechanisms, behavioral influences, and treatment outcomes. All the databases, such as PubMed, Scopus, Web of Science, and Google Scholar, were searched for articles published from January 2000 to July 2025. Those studies in which Human studies in assessing stress using validated scales or biomarkers and periodontal parameters such as probing depth or attachment loss were included. Methodological quality was summed up using the Newcastle–Ottawa Scale, Cochrane Risk of Bias Tool, and Assessing the Methodological Quality of Systematic Reviews checklist. Twenty-seven studies met the inclusion criteria. Most a positive association between higher stress and worsened periodontal outcomes. Elevated cortisol, immune dysregulation, and behavioral changes such as poor hygiene and smoking mediated this relationship. Stressed individuals also showed poorer responses to periodontal therapy. The psychological pressure is greatly associated with the development of the gum disease. A combination of mental evaluation and stress handling in periodontal treatment may result in better outcomes. More longitudinal and interventional research is necessary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.033 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.007 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".