Association between anxiety, obesity and periodontal disease in smokers and non-smokers: A cross-sectional study

Background. Psychological stress is known to be a relevant risk factor for many inflammatory conditions, including periodontal disease. A few studies have probed the relationship between obesity and periodontal disease. Therefore this crosssectional study was aimed to examine the relationship between psychological stress and obesity and periodontal disease in smokers and nonsmokers. Methods. The participants included 90 patients, equally divided into three groups of nonsmokers and periodontally healthy, nonsmokers and smokers with untreated moderatetosevere chronic periodontitis. Socioeconomic data, psychosocial measurements, physical parameters and clinical findings of PPD, CAL, PI and GI were recorded. Results. The clinical parameters were assessed for three groups in three different anxiety levels of mild, moderate and severe. Intragroup comparison of PPD and CAL in the three anxiety levels showed increased periodontal destruction with an increase in anxiety levels, the results being statistically highly significant for PPD differences in smokers (P <0.0001). The mean differences in PPD and CAL in severe anxiety levels between smokers and nonsmokers were 0.68 mm and 0.70 mm and both the findings were statistically significant. The mean PPD and CAL in smoker and nonsmoker groups in obese patients was higher as compared to nonobese patients and the differences were highly significant (P<0.001). Conclusion. The results of our study indicated a positive and strong correlation between anxiety, obesity and periodontal disease in smokers and nonsmokers. Smoking appears to further attenuate this association.