Stress, Immune System & Periodontal Disease

Contents and Outline

1. Stress and Periodontal Disease

  • Introduction
  • Stress and Disease: New Perspectives
    • The Immune System and the Brain Stress and the Immune System
    • Controlling the Immune Response Pinpointing the Problems Taking Control Now

2. Biology of Stress

  • Biochemistry of Stress
  • Allostasis and Stress
  • Stress System-Stress Syndrome
  • Immunologic and Behavioral Homeostasis

3. Stress As a Common Pathway

  • For Chronic Disease
  • Psychoneuroimmunology
  • The Role of Psychological Stress and Other Psychosocial Factors in Bacterial, Viral and Parasitic Infections
  • Gender Responses to Stress
    • “Tend-and-Befriend” v. “Fight-or-Flight”
  • Hypercorticoidism, Osteoporosis, and Major Depression
  • Post-Traumatic Stress Disorder and White Blood Cell Counts
  • Stress and the Distribution of Immune Cells
    • Dynamics and Magnitude of Stress-Induced Changes in Leukocyte Distribution
    • Hormone Dependency and Stress-Induced Alterations in Leukocyte Distribution
    • Stress-Induced Changes in Leukocyte Distribution–Potential Mechanisms
    • Stress-Induced Changes in Leukocyte Distribution–Functional Implications
  • Bidirectional Effect of Stress
  • The Glucocorticoid Hormone Paradox
  • The Stress Spectrum

4. Stress As a Potential Risk Factor in Periodontal Disease

  • Psychosocial Stress and Coping Behaviors in Periodontal Disease
  • Coping Styles
  • Clinical Examination
  • Depression and Bacteroides forsythus
  • Periodontal Disease and Financial Strain
  • Coping Behaviors and Periodontal Disease
  • Salivary Cortisol Levels and Periodontal Disease
  • Stress, Distress and Inadequate Coping
    • Behavioral Changes and Health
  • Mental Stress
  • Social Factors
  • Psychobiology
  • Acute Necrotizing Ulcerative Gingivitis
  • The Role of Psychosocial Disturbances in Periodontal Disease

5. Evidence For The Role of Stress in Periodontal Disease

  • Stress, Disease and Illness: Review of Basic Concepts, Models and Mechanisms
  • Models of the Role of Stress in Periodontal Disease
  • Data Supporting the Role of Stress in Periodontal Disease
  • The Catecholamine Connection
  • Stress-Induced Cytokine Production
  • Cytokine Regulation of the Periodontal Ligament
  • Bacterial Paralysis of Mucosal Defense
  • Immune System and Stress – Wound Healing and Viral Disease
  • Trait Anxiety and Periodontal Disease
    • Chronic Stress and the Bone-Resorptive Cytokine Interleukin-6

6. Summary

  • Stress, Immune System, and Periodontal Disease

Learning Objectives

After completing the course, you’ll be able to:

  1. Define stress, distress, and coping style.
  2. List the three hormones and their associated glands necessary for communication between the brain and immune system.
  3. Define homeostasis.
  4. Define neuroimmunomodulation.
  5. Discuss the impact of acute and protracted stress on the immune system.
  6. Discuss the role of life events in periodontal disease.
  7. Discuss the first and second models proposed by Genco to explain the role of psychosocial stress on periodontal disease.
  8. Discuss the relationship between stress and acute necrotizing ulcerative gingivitis (ANUG).
  9. Discuss the proposed psychoneuroimmunologic link between Bacteroides forsythus, a periodontal pathogen, and adult periodontitis.
  10. Discuss the relationship between hypercorticoidism, osteoporosis, and major depression.
  11. Discuss the impact of stress on the distribution of immune cells.
  12. Discuss the proposed mechanisms of stress-induced changes in leukocyte distribution.
  13. Explain the bidirectional effect of stress.
  14. Discuss the glucocorticoid hormone paradox.
  15. Explain the catecholamine connection.
  16. Discuss how stress induces cytokine production.
  17. Explain how cytokines regulate the periodontal ligament.
  18. Explain how bacteria paralyze oral mucosal defense.
  19. Discuss trait anxiety and periodontal disease.
  20. Discuss the relationship between stress and the bone-resorptive cytokine, interleukin-6.

Learning Objectives To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.