Stress of caregiving may lead to dental ills
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While providing care for others, many caregivers seem to forget about their own well-being, including their oral health, new study findings suggest.
“Our results indicate that caregiving is associated with elevated plaque and gingivitis levels, thus indicating that this demanding task, usually associated with increasing stress, is a significant risk factor of poor oral hygiene,” the researchers write in the Journal of Periodontology.
Caretakers “need some time to take care of themselves,” study co-author Dr. Fernando N. Hugo, of the State University of Campinas in Sao Paulo, Brazil, told Reuters Health.
It has long been established that chronic stress, depression and levels of the stress hormone cortisol are associated with a person’s risk of illness and death from various conditions. Little research has looked at the role of these factors in oral health, however.
To investigate, Hugo and his colleagues studied 230 men and women, aged 50 to 86 years, who were either caregivers of patients with dementia or members of social activities groups. The researchers assessed the study participants’ level of stress and depression symptoms and analyzed the levels of cortisol in their saliva.
They found that being a caregiver was associated with poorer oral health, including a four-fold greater likelihood of having elevated plaque levels and more than double the risk of gingivitis, in comparison to non-caregivers, Hugo and his team report.
Stress was also associated with both elevated plaque levels and gingivitis, whereas high levels of cortisol were associated with elevated levels of plaque, but not gingivitis, the report indicates.
The reason for the association between caregiving and poorer oral health may be related to caregivers’ “disinterest in performing oral hygiene,” rather than any immune system-related changes, according to Hugo. In a previous study, he and his colleagues had found changes in caregiver’s immune status played a role in caregivers’ higher rates of periodontitis.
“We believe that this represents an interesting and new finding because the relationship between caretaking and oral disease may be mediated not only by changes in immune response, but also by changes in the oral hygiene/care by the caretakers,” he told Reuters Health.
Dr. Kenneth Krebs, president of the American Academy of Periodontology commented on the good news of Hugo’s study: that stress in and of itself does not necessarily lead to dental disease.
“The findings show that if people take care of their mouth during stressful times they could reduce the amount of plaque, hence the amount of gingivitis,” Krebs told Reuters Health.
In practice, Krebs said, he and his colleagues have found that people who are able to maintain good oral hygiene, despite the stress due to the death of a loved one, for example, have less plaque and gingivitis than those who neglect their oral health during such stressful times.
Also, he noted, elevated plaque levels and gingivitis can be caused by “anything that changes behavior in someone,” and are not solely due to stress. Even a vacation, which is typically a low stress time, can lead to increased plaque if a person does not maintain good dental habits, he said.
SOURCE: Journal of Periodontology, June 2006.
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