Relationship Between Periodontal Diseases and Mental Health: A Narrative Review

Introduction. Periodontal diseases are prevalent oral diseases affecting the global population. These diseases arise from infections and inflammation of the gums and supporting bones, significantly impacting oral health. The established link between periodontal and systemic diseases underscores their importance as a public health concern. Chronic stress and depression can result in general dysregulation of the immune system, of both cellular and humoral pathways, which may contribute to pathogenic infection and concomitant periodontal tissue destruction. Aim. This work aims to analyze the literature data of scientific research on this topic to assess the pathogenetic mechanisms of the stress response to the condition of periodontal tissues. The evidence is consistent with the hypothesis that stress can modify the host defense and progression of periodontal infections in patients susceptible to periodontitis. Materials and methods. The authors conducted a review of contemporary literature regarding the connection between psycho-emotional stress, periodontal diseases, and mental health. It was utilized 4 databases to find articles published from 2010 to November 2024. Initially, it was identified 1712 records, and after screening and applying specific inclusion and exclusion criteria, 98 articles were selected for full-text review. Ultimately, 56 records were excluded after reading full-text, and the process is visually summarized in a PRISMA flowchart. Results. Periodontal diseases are primarily caused by bacteria in dental plaque, with key pathogens like Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans leading to severe tissue destruction. The disease progresses through a complex interplay between microbial activity and the host's inflammatory response, with dysbiosis contributing to its cyclic nature. Chronic stress is a significant risk factor, creating a bidirectional relationship with periodontal disease and potentially exacerbating its progression. Conclusions. Understanding this bidirectional relationship highlights the importance of comprehensive health approaches integrating periodontal care with mental health support. Improving oral health contributes to better physical outcomes and enhances mental well-being, emphasizing the need for interdisciplinary strategies in patient care. Future studies must clarify the complex interactions of chronic stress in periodontal diseases.