Exploring the Correlation Between Psychological Stress, Anxiety, and Periodontitis Among University Students: A Cross-Sectional Investigation

Shuyu Xu, Xuehan Zhang, Ruonan Gong, Xuanzhi Huang, Min Zhang Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology & Department of Implantology, Stomatological Hospital and Dental School, Tongji University, Shanghai, People’s Republic of ChinaCorrespondence: Min Zhang, Email [email protected]: Periodontitis is a prevalent chronic inflammatory disease, with growing evidence suggesting a link to psychological factors such as stress and anxiety. University students, who frequently experience elevated psychological stress, may be particularly susceptible to periodontal issues. This study aimed to examine the relationship between stress levels, anxiety status, and periodontitis in university students, and to assess the potential influence of psychological factors on periodontal health.Methods: The study sample comprised 240 university students. Participants were categorized post hoc according to their periodontal status and psychological assessment scores. Periodontal health was evaluated using the Community Periodontal Index (CPI), while stress and anxiety levels were measured with the Perceived Stress Scale-14 (PSS-14) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Statistical analyses included chi-square tests and multivariable logistic regression models to examine associations between psychological factors and periodontitis, adjusting for potential confounding variables.Results: Among the participants (mean age: 21.70 ± 3.16 years), 43.3% were diagnosed with periodontitis. The mean age was 21.78 ± 3.32 years in the non-periodontitis group and 21.24 ± 2.06 years in the periodontitis group. Anxiety was prevalent: 33.8% had no anxiety, 30.8% had mild, 22.1% had moderate, and 13.3% had severe anxiety. Reported stress levels were 35.0% normal, 48.8% high, and 16.3% very high. Anxiety levels were significantly associated with an increased risk of periodontitis (P 0.05).Conclusion: Anxiety was significantly associated with periodontitis in university students, highlighting the importance of addressing anxiety as part of periodontal disease prevention and management strategies in this population.Keywords: periodontitis, anxiety, stress, university students, oral health