sdj-10149

Assessment of Clinical Attachment Level in Anxious Patients

Azhin K. Khwakaram* , Harem Jaafar Hama Rashed*

*Periodontics Department, College of Dentistry, University of Sulaimani, Sulaimani, Iraq.

Submitted: April 3, 2022, Accepted: May 27, 2022, Published: June 1, 2022.

DOI: https://doi.org/10.17656/sdj.10149

Objective: This study aimed to assess the clinical attachment level in anxious patients with periodontitis using the Hamilton Anxiety Scale Rate.  

Methods: The study was conducted at the University of Sulaimani, and Shorsh Dental Center teaching hospital; 100 individuals (50 males and 50 females) were included in the study ranging from (30- 65) years old. The individuals' anxiety level was evaluated using Hamilton Anxiety Scale Rate (HAM-A), and the WHO probe measured the clinical attachment level (CAL). The collected data were analyzed using the Chi square test and Spearman correlation, and p≤0.05 was significant.      

Results: Among 100 individuals that participated in the study,38% had mild anxiety, and the remaining (21,12,18 and 11) % had moderate, severe, very severe, and no anxiety, respectively. In these groups, the majority of participants had stage II periodontitis, followed by stage I, none periodontitis, stage III, and stage IV periodontitis, respectively. There’s no significant difference in CAL between genders (P=0.81). But there were significant differences in anxiety between genders (P=0.028), and there was no significant association between anxiety and CAL (P= 0.803).  

Conclusions: In the present study, the severity of anxiety was stronger in males than in females. Anxiety didn't cause CAL.                                                                                     

Keywords:  Periodontist, Clinical attachment level, Anxiety, Hamilton anxiety rate scale.                       

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References:

1. Racic M, Todorovic R, Ivkovic N, Masic S, Joksimovic B, Kulic M. Self-perceived stress in relation to anxiety, depression and health-related quality of life among health professions students: A cross-sectional study from Bosnia and Herzegovina. Zdr Varst. 2017;56(4):251-9.

2. Crocq MA. The history of generalized anxiety disorder as a diagnostic category. Dialogues Clin Neurosci. 2017;19(2):107-16.

3. Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P T. 2013;38(1):30-44.

4. Darveau RP. Periodontitis: a polymicrobial disruption of host homeostasis. Nat Rev Microbiol. 2010;8(7):481-90.

5. Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2016;15(1):30-44.

6. Velsko IM, Chukkapalli SS, Rivera MF, Lee JY, Chen H, Zheng D, et al. Active invasion of oral and aortic tissues by Porphyromonas gingivalis in mice causally links periodontitis and atherosclerosis. PloS one. 2014;9(5):e97811.

7. Pace CC, McCullough GH. The association between oral microorganisms and aspiration pneumonia in the institutionalized elderly: review and recommendations. Dysphagia. 2010;25(4):307-22.

8. Fitzpatrick SG, Katz J. The association between periodontal disease and cancer: a review of the literature. J Dent. 2010;38(2):83-95.

9. Aragão WAB, Souza-Monteiro de D, Frazão DR, Né YG de S, Ferreira R de O, Rivera LFS, et al. Is there any association between chronic periodontitis and anxiety in adults? A systematic review. Front Psychiatry. 2021;12(8):710606.

10. López R, Ramírez V, Marró P, Baelum V. Psychosocial distress and periodontitis in adolescents. Oral Health Prev Dent. 2012;10(3):211-8.

11. Kesim S, Unalan D, Esen C, Ozturk A. The relationship between periodontal disease severity and state-trait anxiety level. J Pak Med. 2012;62(12):1304-8.

12. Tymkiw KD, Thunell DH, Johnson GK, Joly S, Burnell KK, Cavanaugh JE, et al. Influence of smoking on gingival crevicular fluid cytokines in severe chronic periodontitis. J Clin Periodontol. 2011;38(3):219-28.

13. Kolawole KA, Oziegbe EO, Bamise CT. Oral hygiene measures and the periodontal status of school children. Int J Dent Hyg. 2011;9(2):143–8.

14. Mckenna G, Burke FM. Age-related oral changes. Dent Update. 2010;37(8):519-23.

15. Tanwir F, Altamash M, Gustafsson A. Effect of diabetes on periodontal status of a population with poor oral health. Acta Odontol Scand. 2009;67(3):129-33.

16. Hamilton M. The assessment of anxiety states by rating. Br J Clin Psychol. 1959;32(1):50-5.

17. Thompson E. Hamilton rating scale for anxiety (HAM-A). Occup. 2015;65(7):601.

18. Nayak SU, Nayak DG, Uppoor AS, Pai KK. Evaluation of cortisol levels in gingival crevicular fluid and saliva in anxious and non-anxious patients with chronic periodontitis. J Dent Res. 2013;10(4):474-81.

19. Babay N, Alshehri F, al Rowis R. Majors highlights of the new 2017 classification of periodontal and peri-implant diseases and conditions. Saudi Dent J. 2019;31(3):303-5.

20. Könönen E, Gursoy M, Gursoy UK. Periodontitis: A multifaceted disease of tooth-supporting tissues. J Clin Med. 2019;8(8):11-35.

21. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011;45(8):1027-35. 

22. Ioannidou E. The sex and gender intersection in chronic periodontitis. Public Health Front. 2017;4(5):189.

23. Peeran SW, Kumar NPG, Abdelkader F, Azaruk A, Alsaid FM, Abdalla KA, et al. Association between mental well-being, depression, and periodontal attachment level among young adults of the postwar Sebha city, Libya: A pilot study. J Nat Sci Biol Med. 2014;5(2):308-12.

24. Shrestha S, Sharma S, Sapkota N, Giri DK, Baral D. Association between anxiety and depression with chronic periodontitis. JCMS-Nepal. 2017;13(2):268-74.

25. Aragão WAB, Souza-Monteiro de D, Frazão DR, Né YG de S, Ferreira R de O, Rivera LFS, et al. Is there any association between chronic periodontitis and anxiety in adults? A systematic review. Front Psychiatry. 2021;12:710606.

26. Buechley RW, Drake RM, Breslow L. Relationship of amount of cigarette smoking to coronary heart disease mortality rates in men. Circulation. 1958;18(6):1085-90.

27. Karmakar S, Prakash S. Clinical attachment level: An usung hero in periodontal diagnosis. Int j adv res. 2019;7(4):106-11.

Abstract