Influence of Occupational Stress and Coping Style on Periodontitis among Japanese Workers: A Cross-Sectional Study

An Evaluation of Occupational Stress and Periodontal Status Among Indian Army Male Personnel: A Cross-Sectional Study

BACKGROUND

Oral illnesses are multifactorial and also behavior-related. Stress and habits influence periodontal disease. Based on this premise, assessing the influence of stress on military personnel and understanding its influence on oral and periodontal health becomes imperative.

AIM

The aim of this study was to evaluate the occupational stress and periodontal status among Indian army personnel.

METHODS

A cross-sectional study was carried out among 1000 army personnel divided into four groups of 250 each. Group A had recruits, Group B had trainee officers, Group C personnel were serving in the army below the officer's rank and Group D had officers who were currently serving in the army. Oral Hygiene Index - Simplified (OHI-S), Gingival Bleeding Index (GBI), pocket depth, and clinical loss of attachment (CLOA) were assessed for periodontal status. Stress levels were evaluated using the Modified Occupational Stress Index Questionnaire. Analysis of variance (ANOVA) test was applied to compare OHI-S, GBI, presence of pocket depth, and occupational stress scores, while the Kruskal-Wallis test was used to compare the occupational stress index and CLOA among the study groups.

RESULTS

Significant differences were observed among the four groups in terms of OHI-S (p = 0.001), GBI (p = 0.001), CLOA (p = 0.001), occupational stress scores (p = 0.001), and occupational stress index (p = 0.001). Differences observed among the four groups regarding periodontal disease based on the presence of pockets were weakly significant (p = 0.05). On intergroup comparison, a significant association could not be established between the groups as the p-value was ≥ 0.05. However, a weak association could be established between Groups A and C with a p-value of 0.031. Participants with moderate to high occupational stress showed more risk of developing pockets and CLOAs as compared to those having low stress.

CONCLUSION

The study revealed that the majority of army personnel were suffering from gingival bleeding and periodontal diseases; however, the association between stress level and periodontal diseases in Indian army personnel was less and not significant.

Effect of Occupational Stress on Periodontitis According to the Salivary RANKL Level Among Iraqi Employees

Background

Findings show that periodontitis does not affect all populations; similarly, some individuals present risk conditions such as occupational stress, making them more susceptible to developing periodontitis through unhealthy habits like poor oral hygiene and immune suppression. Periodontitis triggers an inflammatory host immune response; "Receptor Activator Nuclear Factor KB ligand (RANKL)" is the primary regulator of osteoclast differentiation and activity. It was found that osteoclastic bone damage caused by periodontitis depends on the RANKL produced by osteoblastic and periodontal ligament cells.

Objective

This study aimed to assess the effect of occupational stress on employees with periodontitis using salivary RANKL marker.

Material and Methods

A case-control analysis was done at my clinic with 90 male employees aged 30-50. The participants completed self-administered questionnaires and had periodontal exams. Employee occupational stress was estimated using a life events scale questionnaire. Calibrated dentists performed the parameters used in the periodontal assessment after collecting whole unstimulated salivary samples from each employee to measure salivary RANKL using ELISA technique.

Results

The present finding revealed a statistically significant difference among groups in "probing pocket depth, plaque index, bleeding on probing, clinical attachment level, and salivary RANKL level". They were higher in the stressed employees' group, which is not statistically significant.

Conclusion

The findings of this investigation observed that occupational stress increased clinical periodontal parameters and salivary RANKL of periodontitis in employees.

Effects of social support on oral health behavior: Serial multiple-mediator model

OBJECTIVE

This study investigates the serial multiple mediation of job stress and perceived behavioral control (PBC) in the relationship between social support and oral health behavior (OHB).

MATERIALS AND METHODS

This cross-sectional study was conducted in Minhang District, Shanghai, China, between July and November 2021. 559 Employees from 10 community health centers were recruited. A five-part survey was used to collect data on demographic characteristics, social support, job stress, PBC and OHB. Descriptive statistics, independent-sample t-test, Pearson's correlation analysis, ordinary least-squares regression and the bootstrap method were used to analyze data.

RESULTS

Social support was found to impact OHB through three significant mediation pathways: the pathway through job stress (point estimate = 0.033; 95%BC CI [0.004, 0.089]), the pathway through PBC (point estimate = 0.283; 95%BC CI [0.174, 0.416]), and the serial multiple mediating pathway through first job stress and then PBC (point estimate = 0.006; 95%BC CI [0.001, 0.019]).

CONCLUSION

This study indicates that job stress and PBC play a serial multiple-mediator role in the relationship between social support and OHB. To ensure the effectiveness of social support intervention on OHB, workplace managers and employees should strengthen the motivators that could promote the reduction of job stress and the improvement of PBC.

Impact of Stress on Periodontal Health: Literature Revision

Stress is a physiological response of the body to stressful life events but may not be when the individual is persistently exposed to the stress trigger, and it negatively affects certain physiological functions, thus triggering psychosomatic diseases. In literature, chronic stress and inadequate coping strategies are found to mediate the risk and development of periodontitis; mechanisms have therefore been proposed to explain the effects of stress on the periodontium. Since stress is a prevalent problem in modern life and given the importance of maintaining oral health, the present literature review aimed to estimate the association between stress and periodontal disease. The research question adopted is the following: "Are psychological stress and periodontal disease related?" The search was conducted in August 2022 and limited to articles in electronic databases from 2017 to 2022 in English, excluding reviews and literature reviews. From the electronic databases, a total of 532 articles were identified and became 306 after reviews and duplicates were removed. An additional bibliographic search was conducted through the same electronic databases, controlled terms and keywords including only systematic reviews, which were previously excluded. Through the bibliography cited in the systematic reviews, an additional 18 articles were identified, with a new total of 324. As a result of reading the title and abstract of these 324 articles, an additional 295 were excluded. Reading the full text of the remaining 29 studies, 2 articles were excluded due to non-adherence to the eligibility criteria. The remaining 27 results were included in our literature review. It has been suggested in the literature that adverse socioeconomic conditions elicit a stress response, which can trigger periodontal inflammation. Most of the 27 articles included in the study confirm and demonstrate a positive association between psychological stress and periodontal disease. Numerous studies have shown the mechanisms through which chronic stress negatively affects periodontal tissues. Therefore, in the light of the results obtained from this review, it is important that oral health professionals, also for general health purposes, consider stress factors among the risk factors of periodontal disease, its severity and decreased efficacy of treatments. It is therefore advisable to act preventively through the interception of chronic stress.

Impact of COVID-19 Pandemic Perception on Job Stress of Construction Workers

Construction has been regarded as one of the most stressful industries, and the COVID-19 pandemic has deteriorated this situation. This research developed and tested a model of the impact of COVID-19 pandemic perception on job stress of construction workers. Both problem-focused and emotion-focused coping were considered as mediators. Empirical data were collected using a detailed questionnaire from the Chinese construction industry. The results showed that pandemic perception was significantly related to psychological and physical stress. Emotion-focused coping was mainly triggered by pandemic fear and job insecurity, while problem-focused coping was mainly triggered by organizational pandemic response. Furthermore, the effects of pandemic fear and organizational pandemic response on job stress were mediated by problem-focused coping. Finally, the theoretical and practical significance, research limitations, and future research directions of this study are discussed.

Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan

Background

Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss.

Methods

This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status.

Results

Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models.

Conclusion

ERI at work was associated with an increased risk of poor periodontal status.

Work Stressors and Occupational Health of Young Employees: The Moderating Role of Work Adaptability

Work adaptability refers to the work experience, habits, and skills that enable an individual to adapt to current or changing work tasks and situations. It is a coping resource that individuals use to mitigate various types of stress. Adopting the interaction model of work stress, this study investigated 168 young employees in 20 organizations in Zhejiang Province through interview research and a questionnaire survey. The results show that work adaptability has a significant main effect on occupational health. The work adaptability of employees plays a moderating role in the relationship between occupational health and lack of work meaning stress, role conflict stress, interpersonal relationship stress, negative organizational atmosphere stress, and total score of work stressors. Young employees with high work adaptability have worse occupational health under high-level stress situations due to a lack of work meaning. For promoting occupational health in young employees, organizations should have this group of workers complete meaningful jobs or inform them of the importance of their jobs, reduce role conflict, and create a supportive organizational atmosphere. For management, it is imperative to eliminate high-level stress that stems from a lack of work meaning in order to retain young employees with high work adaptability. These findings shed light on how work adaptability helps young employees deal with stress and improve their occupational health. In organizational and self-stress management, it is beneficial to improve employees’ work adaptability continuously as a means of effectively resisting stress and maintaining occupational health.

Possible association between COVID-19 caused stress and periodontal health - a pilot study

Introduction/Objective. Stress is proposed as one of the risk factors linked to periodontal disease. The COVID-19 pandemic has a significant negative impact in population on mental and somatic health. This study aimed to examine the possible association between COVID-19 resultant stress and periodontal health. Methods. An observational pilot study was conducted from March 2020 to October 2021 and included 202 participants. Participants graded their stress level using the Perceived Stress Scale (PSS). Periodontal Disease Index and Clinical Attachment Level were determined. Participants were categorized into following groups: Ia (low stress), IIa (moderate stress), IIIa (high stress) and Ib (healthy parodontium), IIb (mild periodontal disease), IIIb (severe periodontal disease). The cause/effect relationship between stress and health was measured. Results. The results indicated a statistically significant difference between the groups classified according to the stress level concerning values of all the measured parameters. The Poisson regression analysis showed that in both models, crude and adjusted, periodontal health-related covariables were higher in subjects perceiving greater stress (Periodontal Disease Index ? Pradjusted = 1.042, 95% CI [1.030?1.055] and Clinical Attachment Level ? PRadjusted = 1.108, 95% CI [1.094?1.122]). Conslusion. During COVID-19 pandemic increased stress has a negative impact on mental health and may result in the deterioration of the entire oral cavity?s health, including the periodontium.

Work stress and oral conditions: a systematic review of observational studies

OBJECTIVES

Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss.

DESIGN

A systematic review of published observational studies.

DATA SOURCES

A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020.

STUDY SELECTION

Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss.

DATA EXTRACTION

Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality.

CONCLUSIONS

There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.

Interaction between and impact of IL-6 genotype and alpha-tocopherol levels on periodontal condition in aging individuals

BACKGROUND AND OBJECTIVES

Few studies have assessed the possible interaction between and impact of IL-6 variants and serum α-tocopherol levels on periodontal condition in older individuals. Here, we assessed the relationship between IL-6 variants and serum α-tocopherol levels on periodontal condition by considering effect modification.

MATERIAL AND METHODS

Among the study participants, 359 who were 71 years of age underwent a dental examination, biochemical analysis, and interview. After dividing the participants into tertiles based on serum α-tocopherol levels, we conducted Poisson regression analysis to compare the prevalence rate ratio (PRR) for periodontal disease markers with the IL-6 genotype (rs1800796) based on each tertile adjusted by the number of teeth present (offset).

RESULTS

The PRRs of the IL-6 genotype for periodontal condition (probing pocket depth [PPD], clinical attachment level [CAL], and bleeding on probing [BOP]) which were adjusted by the number of teeth present (offset) were 1.17 (P < .001), 1.37 (P < .001), and 1.08 (P = .048), respectively. In addition, a significant association was found between the reciprocal number of PRRs of the IL-6 genotype and three serum α-tocopherol levels. The adjusted PRRs (± standard error) of the IL-6 genotypes for PPD were 0.48 (0.12) for the first group (P < .001), 1.54 (0.04) for the second group (P < .001), and 2.11 (0.03) for the third group (P < .001); similar tendencies were seen for CAL and BOP.

CONCLUSION

The results of this study suggest a potential association between the IL-6 genotype and periodontal condition in relation to serum antioxidant concentrations.