Psychological Assessment of Patients With Apical Periodontitis and Caries: A Case-Control Study.

AIM: To assess the association between apical periodontitis (AP) and subclinical symptoms of anxiety, depression and disordered eating. METHODOLOGY: A total of 120 individuals were included in this case-control study. Sixty subjects were assigned to case (AP+) and 60 to control group (AP-). The periapical and dental status were assessed using radiographic images (OPT, periapical radiographs) and dental examination. The DMFT index (decayed, missing and filled teeth) and the periapical index (PAI) scores were recorded. All subjects were interviewed to compile medical history data, anxiety (Hamilton A), depression (Hamilton D) and eating disorder (EAT-26) questionnaires. Inferential and both simple and multiple logistic regression analyses were performed. RESULTS: Significant associations were observed between AP and higher scores on HAM-A, HAM-D and EAT-26. The regression model showed that higher PAI scores were significantly associated with increased odds of anxiety, depression and disordered eating. A PAI score of 3 showed increased odds of anxiety (OR = 5.57, p = 0.004) and depression (OR = 3.65, p = 0.025). A PAI score of 4 showed even greater odds for anxiety (OR = 8.68, p = 0.001), depression (OR = 14.07, p = 0.001) and disordered eating (OR = 3.98, p = 0.032). Participants with more than one periapical lesion were 3.56 times more likely to report higher levels of anxiety (p = 0.007), 3.59 times more likely to experience elevated depression (p = 0.018) and 3.08 times more likely to exhibit disordered eating behaviours (p = 0.028). Additionally, higher DMFT scores were associated with an increased likelihood of higher HAM-A scores (OR = 1.18, p = 0.001). CONCLUSIONS: The study results show a statistically significant higher prevalence of mood disorders and mental health-related conditions including anxiety, depression and eating disorders in patients with AP. Longitudinal studies are needed to determine the nature of the observed association. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06589076.