Anxiety, gingival inflammation and periodontal disease in non-smokers and smokers -: an epidemiological study

Objectives: The aim of the present study was to investigate the influence of anxiety, measured by one single question, on gingival inflammation and periodontal disease in non-smokers and smokers. Material and Methods: The participants were 144 subjects with untreated periodontal disease 30-40 years of age, and 26 healthy controls, 30-40 years of age. All subjects were clinically examined and answered an uncomplicated question regarding anxiety in every day life, as well as smoking habits. The periodontitis subjects were divided into; an aggressive periodontitis (AP)-group and a chronic periodontitis (CP)-group. Fisher's exact probability t-test, analysis of variance (ANOVA), Mann-Whitney U-test and analysis of covariance (ANOVA) were used as statistical methods. Results: Anxious subjects had a significantly higher gingival index than non-anxious subjects, when controlling for smoking (p < 0.01). The healthy anxious non-smokers had an average score of GI 1.6 (+/- 0.4 SD) compared with 1.2 (+/- 0.4 SD), p < 0.05 for the non-anxious non-smokers. Anxious smokers with periodontits (AP-/CP-group) had significantly more sites with pockets >= 5 mm, compared with non-anxious smokers, (p < 0.05). Conclusions: The results of the present study, suggest that self-reported anxiety was associated with an adverse affect on the gingiva. Anxiety seemed to be associated with increased severity of periodontal disease in smokers.