Please read and complete the assignment that is attach on file. No plagiarism or AL!

Topic: Stress 

1. Characteristics of Stress 

a. Stress elicits a physiologic and psychological response, which is one of the body's survival mechanisms 

Broadly, there are two types of stress: acute and chronic. 

1. Acute stress (short-term stress) is beneficial because it physiologically prepares the cardiovascular, musculoskeletal, and neuroendocrine systems to respond to a fight-or-flight situation and is considered an essential adaptive instinct to have for survival. 

2. Chronic stress (long-term stress), however, is maladaptive, because it takes a prolonged toll on the body by impeding the normal physiological regulatory mechanisms, which governs homeostasis. This regulatory mechanism is mediated by cortisol, a steroid hormone produced in the adrenal cortex which is subsequently released to mediate an individual's response to stress. At physiologic levels, cortisol is an essential hormone needed for maintenance of normal blood pressure and heart rate and regulating inflammation. However, excessive levels of cortisol will disrupt the homeostatic balance and lead to elevated blood pressure and excessively rapid heart rate (tachycardia), which could predispose an individual to cardiovascular complications. Further, with respect to the host immune response. elevated levels of cortisol will intensify the natural immunosuppressive effect of this hormone and increase an individual's susceptibility to infection. Figure 14-5 depicts the relationship of chronic stress to systemic conditions and periodontal disease 

Environmental influences, Psychological factors , Major life events, Dally hasseles = Chronic stress + Negaty coping mechanisms =

Increased cortisol production Prolonged stress -> Health impairing behaviors ->

• Suppression of inflammatory response

• Increase in blood glucose levels 

• Altered cytokine levels 

• Increased susceptibility to chronic systemic conditions <- Poor oral hygiene, Cigarette and alcohol consumption , Altered sleep patterns, Poor nutritional Intake

Figure 14-6 Relationship of Chronic Stress to Systemic Conditions and Periodontal Disease. 

b. The potential effects of chronic stress can manifest as anxiety, depression, impaired cognition, or altered 

self-esteem. 

2. Stress as a Risk Factor for Periodontitis 

a. Numerous clinical studies have investigated the correlation between chronic periodontal disease and 

stress, 30-31 

1. A majority of studies included in a recent systematic review showed a positive relationship between stress and periodontal disease?.

2. High financial stress and depression are significant risk factors for periodontal disease after adjusting for age, gender, smoking, diabetes, and periodontal microorganisms. 3.33 

b. Stress-induced behavioral changes may explain the detrimental effect of stress on periodontal health. These behavioral changes include poor self-care, unhealthy dietary habits, increased smoking, in- creased alcohol consumption, and nonadherence to periodontal maintenance regimens 

1. The relationship between stress and neglected self-care was observed in a group of medical students preparing for exams. Exam students reported a reduction in thoroughness of oral hygiene behavior and had higher plaque scores than the control group of students not taking exit The authors of this study conclude that stress may cause individuals to be neglectful in performing their daily self. 

2 Stress-induced eating behaviors such as excessive consumption of refined carbohydrates may increase accumulation of plaque biofilm.

Implications for the Dental Hygienist :

1. Prolonged or intense periods of stress may suppress the immune system, which might tip the hot-microbial interaction in favor of bacteria causing increased attachment loss. Stress also effects how individuals look after themselves and might lead to less effective daily plaque biofilm removal increased tobacco use and poor nutrition.  

2. Managing periodontal health in individuals undergoing significant stress requires recognition of stress as a risk factor for periodontal disease 

3. Informing patients of the potential adverse effects of stress on their general and oral health is the first step to guiding individuals to think about strategies for stress management. In this context, the dental team may need to closely collaborate with the patient's physician and a mental health care expert to achieve optimal treatment outcomes 

4. It may be necessary to recommend shorter intervals between professional care appointments to monitor changes to the patient's compliance and behavior. 

5. The 2021 Oral Health in America Advances and Challenges identifies that one of the challenges to health care delivery in the 21st century is unraveling the complex interrelationship between mental health (such as individuals suffering from chronic stress) and oral health 

6. Patients with mental health issues often have difficulty maintaining a regular oral hygiene regimen of a relationship with an oral health provider. Dental or orofacial pain can worsen depression 

7. As such, the report concludes that one way to overcome this challenge is by encouraging the dental, medical, and other health professionals to work collectively with the patient to integrate oral, medical, behavioral health care in medical settings, dental clinics, community health centers, and nursing homes and in medical, dental, nursing, and dental hygiene programs.