​A new study suggests that psycho-social factors, such as depression, stress, emotional vulnerability and Type A personality are associated with more severe periodontal injuries.

This, its authors suggest, indicates the need for psychological evaluation and support for patients presenting with aggressive or chronic periodontitis (gum disease).

Previous studies suggesting a link between periodontitis and psychosocial factors presented very mixed results, making it difficult to identify the interaction between specific psychological characteristics and severe gum disease.

Lead author Dr Sébastien Jungo, DDS, Department of Periodontology at Paris Descartes University, said: 'Our aim was to explore the association between clinical variables in patients suffering from aggressive (AP) or chronic periodontitis (CP) and some psychological traits, especially depression, stress, Type A Behaviour Pattern (TABP) and Locus of Control (LOC). We hoped to identify patients at risk for more severe periodontal disease.'

The study included 79 patients with periodontitis who attended the Periodontology Clinic of the Descartes University Hospital in Paris, France. 'Our patients completed some short questionnaires to help us determine certain psychological traits. They also underwent periodontal examinations where we measured probing pocket depth (PPD) and clinical attachment loss (CAL),' explained Dr Jungo.

Commenting on the results, Dr Jungo said: 'After controlling for age, tobacco consumption and the form of periodontitis, we found that a clinical attachment loss of over 5mm was associated with "emotional vulnerability" for all patients, and with stress and Type A personality in patients presenting aggressive periodontitis.'

Regarding the possible causes for the association between severe periodontal injuries and psychological traits, Dr Jungo said that more research was needed: 'This is a small study but it is representative of what periodontists see in their clinics. In the future there is a need for wider interventional studies, as well as research into inflammatory markers in addition to psychological assessment.

'At this stage we can say that the psychological evaluation of patients presenting with particularly aggressive periodontal disease is important. For patients presenting Type A personality, depression, perceived stress or emotional vulnerability, the oral healthcare team should recommend psychosocial support,' concluded Dr Jungo.