Association of stress, salivary cortisol level, and periodontitis among the inmates of a central prison in Kerala

Abstract

Background: The aim of this cross‑sectional study was to evaluate the association between stress,
salivary cortisol, and periodontitis among the inmates of the central prison.
Materials and Methods: Seventy inmates were grouped depending on their pocket depth into
Group A (pocket depth >4 mm and <6 mm), Group B (at least four sites with pocket depth ≥6 mm),
and Group C (pocket depth ≤3 mm). The clinical parameters such as the oral hygiene index‑simplified,
gingival index, pocket depth, and the clinical attachment levels (CALs) were recorded. Stress was
measured using the Depression, Anxiety, and Stress Scale along with prison time served. Saliva
samples were collected, and cortisol levels were determined using electrochemiluminescence
assay. Chi‑square test was used for finding the association between the clinical parameters. The
correlation between clinical parameters, stress, salivary cortisol levels, and time served was done
using Pearson’s rank correlation coefficient.
Results: The CALs, the stress score and the salivary cortisol levels were significantly higher in
Group B (P < 0.001). Pearson’s correlation showed a positive correlation between stress, cortisol
level, and pocket depth. A positive correlation which was statistically significant was obtained
between salivary cortisol level and prison time served by the inmates.
Conclusion: Within the limits of this study, it can be concluded that there is a positive relation
between stress and periodontal disease. The study suggests that salivary cortisol level can be used
as a marker to assess stress.
Key Words: Cortisol, periodontitis, stress