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Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis

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Abstract

Objectives

The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis.

Materials and methods

This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay.

Results

The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups.

Conclusions

Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual’s response to it. However, further studies are necessary to substantiate these early findings.

Clinical relevance

Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.

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Notes

  1. Hu-Friedy Co., Chicago, IL

  2. Periopaper, Oraflow Inc., Amitville, NY

  3. E-Bioscience, Biomedical Research Center, San Diego, CA

  4. DRG Salivary Cortisol, DRG International, Inc., NJ

  5. IBM SPSS Statistics 19, SPSS Inc., Somers, NY

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Acknowledgements

This study was supported by the Gaziosmanpasa University Scientific Research Projects Office, Tokat, Turkey with the project number 2015/130. The authors are grateful to Gaziosmanpasa University Scientific Research Projects Office for their substantial support.

Funding

The work was supported by the Gaziosmanpasa University Scientific Research Projects Office, Tokat, Turkey with the project number 2015/130.

Author information

Authors and Affiliations

  1. Department of Periodontology, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey

    Fatma Ucan Yarkac

  2. Department of Periodontology, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey

    Ozge Gokturk

  3. Department of Biostatistics, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey

    Osman Demir

Authors
  1. Fatma Ucan Yarkac
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  2. Ozge Gokturk
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  3. Osman Demir
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Corresponding author

Correspondence to Ozge Gokturk.

Ethics declarations

The study protocol was approved by the Ethical Committee, Faculty of Dentistry, Gaziosmanpasa University.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yarkac, F.U., Gokturk, O. & Demir, O. Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis. Clin Oral Invest 25, 1677–1684 (2021). https://doi.org/10.1007/s00784-018-2569-9

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  • DOI: https://doi.org/10.1007/s00784-018-2569-9

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