Periodontal disease and emotional disorders: A meta‐analysis

• Published in: Journal of clinical periodontology Vol. 48; no. 2; pp. 180 - 204
• Main Authors: Zheng, De‐Xiu, Kang, Xiao‐Ning, Wang, Yi‐Xi, Huang, Yi‐Na, Pang, Chun‐Feng, Chen, Yu‐Xuan, Kuang, Zhi‐Li, Peng, Yun
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.02.2021
• Subjects: Aged; Anxiety; Anxiety - complications; Anxiety - epidemiology; Cross-Sectional Studies; depression; Depression - complications; Depression - epidemiology; Emotional disorders; Emotions; Gum disease; Humans; Information processing; Mental depression; Meta-analysis; Observational studies; observational study; periodontal disease; Periodontal diseases; Periodontal Diseases - complications; Periodontal Diseases - epidemiology; Prospective Studies; systematic review; anxiety; depression; systematic review; periodontal disease; observational study
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.13395

Objective The objective of this study was to evaluate the relationship of periodontal disease with depression and anxiety via a systematic review and meta‐analysis. Method We systematically searched the EMBASE, PubMed, Web of Science, PsycINFO, and SinoMed databases (until August 4, 2019) with language restricted to English and Chinese. Case–control, cross‐sectional, and cohort studies that calculated the risk ratio (RR), odds ratio (OR)/prevalence OR (POR), and hazard ratio (HR) of depression/anxiety with periodontal disease or the OR/POR/RR/HR of periodontal disease caused by depression/anxiety were included. Observational studies that reported the depression/anxiety scale score of patients with periodontal disease and healthy periodontal subjects aged ≥14 years were also included. We used the standard format to extract the following information from each included study: author/s, survey year, study design, age of participants, periodontal disease definition, depression/anxiety measurement, and summary of results. The Newcastle–Ottawa scale was used to ascertain the quality of the included citations. Results After screening, 40 studies were included. A meta‐analysis of the case–control studies showed that periodontal disease was positively associated with depression (OR = 1.70, 95% confidence interval [CI]  = 1.01–2.83). A meta‐analysis of 12 studies showed that periodontal disease was significantly correlated with anxiety (OR = 1.36, 95% CI = 1.11–1.66). A meta‐analysis of 18 studies showed that subjects with periodontal disease had higher depression scale score (standardized mean difference [SMD] = 1.05, 95% CI = 0.68–1.41) and anxiety scale score (SMD = 0.70, 95% CI = 0.44–0.96). Conclusion Periodontal disease is associated with emotional disorders. However, the high degree of heterogeneity among studies should be considered. More high‐quality prospective studies are required to confirm the relationship.