The influence of the psychosocial stress on oral health status in the conditions of being in Ukraine during the prolonged state of martial law

Abstract

Aim: To study the presence of clinical and biochemical correlations between psycho-emotional stress, level of cortisol and periodontal oral health status of the patients in Ukraine during prolonged martial law. Materials and Methods: The comprehensive clinical and laboratory study covered 49 persons, including 20 patients with Gingivitis (40.8%) and 29 with Periodontitis (59.2%). Biochemical blood test was performed to determine the level of “stress hormone” – cortisol. Patients filled out the questionnaire by the method of V. Zung (low mood-subdepression scale) to determine psycho-emotional state in the conditions of prolonged martial law in Ukraine. Results: The research results showed that in the conditions of martial law in Ukraine, “stabilization” and “improvement” of the process of patients with Gingivitis was established in 50%, with Periodontitis - only in 41.4% of patients. In 54% of patients, a significant deterioration of clinical indices was established, compared to the indicators before the war. In patients with Periodontitis, РВІ index was 1.33 (0.62-1.43) score, which was not statistically significantly different from the initial level (p>0.05). Biochemical blood tests revealed an increased level of the hormone cortisol in 18% of patients. According to the method by V. Zung scale of mental states, the majority of patients (87%) showed low mood and emotional instability within the medium level (range 2 and 3). Correlation was identified, according to the Spearman coefficient (R=0.39, р<0.05), between scale assessments by V.Zung and the blood level of cortisol. Conclusions: Psycho-emotional stress is one of the leading pathogenetic factors in the deterioration of oral health status and the development of periodontal diseases, especially in people in Ukraine during prolonged martial law. Indicators of method by V. Zung scale of mental states and the level of cortisol are optimal markers of the need to correct the psycho-emotional state. For patients with increased levels of stress and fear, it is necessary to create special treatment-prevention schemes, taking into account greater attention to motivation to maintain the health of the oral cavity, as well as more frequent hygiene procedures.