Evaluation of stress, serum and salivary cortisol, and interleukin-1β levels in smokers and non-smokers with chronic periodontitis

Abstract

Background: Existing literature indicates a positive relationship between stress and chronic periodontitis (CP) but there is limited information on the combined influence of stress and smoking on the progression of periodontal disease. So, the objective of this study was to evaluate the effects of stress, salivary and serum, cortisol and interleukin-1β levels in smokers with CP.

Methods: Seventy-five patients equally divided into three groups of healthy controls (Group I), smokers and non-smokers with CP (Group 2 and Group 3) respectively were evaluated for clinical parameters, biochemical parameters of salivary and serum cortisol and IL-1β levels via enzyme linked immunosorbent assay (ELISA). Zung's self-rating depression scale questionnaire was used to determine the stress levels amongst the patients.

Results: Smokers with CP exihibited higher values of probing pocket depth, clinical attachment level, plaque index while lower papillary bleeding index, and gingival index scores as compared to non-smokers with CP. The salivary cortisol and IL-1 β were relatively higher as compared to serum values in Group 2 than Group 3. The Group 2 patients revealed higher depression scores as compared to Group 3 patients. The depression scores positively and significantly correlated with the salivary cortisol in Group 2 patients.

Conclusion: The results indicate that smokers with CP exhibit a significantly higher serum and salivary cortisol, IL-1β, and stress levels and thus they may show an increased risk and periodontal disease severity. Further exploration of relationships between periodontitis and stress is required.

Keywords: chronic periodontitis; cortisol; interleukin-1β; smoking; stress.