Psychosocial factors in periodontal disease and tooth wear

This thesis investigates some putative relationships between relevant psychosocial fectors (PSFs) and two types of dental disorder, namely, inflammatory periodontal diseases and tooth wear. The first study investigated possible associations between a number of PSFs and adult onset rapidly progressive periodontitis (RPP). It was shown that there was a significant relationship between the combined PSFs and the three periodontal diagnoses of RPP, routine chronic adult periodontitis (RCAP) and no significant periodontal destruction (control group). The RPP group presented significantly more depression and loneliness than the RCAP and control groups. The second study investigated whether a number of PSFs could predict dental plaque levels in a group of patients with two forms of chronic periodontitis (CP): RPP and RCAP. Because gender, smoking and education have been associated with neglect of oral hygiene, their role as predictors of plaque was also examined. In addition, this study investigated whether RPP and RCAP patients differ significantly on plaque and smoking, before their periodontal treatment. It was found that the PSFs were not significant predictors of plaque, and that only gender contributed significantly to the prediction of plaque. Females had significantly less plaque than males, and the RPP and RCAP patients did not differ significantly on plaque. However, RPP patients smoked significantly more than RCAP patients, and there was a marginally significant correlation between depression and smoking. The third study investigated putative associations between a number of PSFs and tooth wear with a significant component of attrition. The results suggested that attrition-tooth-wear patients differed significantly fi-om controls only on trait anxiety. Overall, it was concluded that the PSFs are not equally associated with different forms of CP, they may be of importance to periodontal destruction via a mechanism other than neglect of oral hygiene, and trait anxiety might worsen attrition. Suggestions were made for further research