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High levels of financial stress and poor coping abilities increase twofold the likelihood of developing periodontal (gum) disease, according to a study in the Journal of Periodontology. After accounting for other risk factors – such as age, gender, smoking, poor dental care and diabetes – those who reported high levels of financial strain and poor coping behaviors had higher levels of attachment loss and dental bone loss (signs of periodontal disease) than those with low levels of financial strain.

"Financial strain is a long-term, constant pressure," said Dr. Robert Genco, chair of the Oral Biology Department at The State University of New York at Buffalo, who carried out the studies with the periodontal
research group at Buffalo and behavioral scientist Dr. Lisa Tedesco of
the University of Michigan. "Our studies indicate that this
ever-present stress and a lack of adequate coping skills could lead to
altered habits, such as reduced oral hygiene or teeth grinding, as well as salivary changes and a weakening of the body's ability to fight infection."

However, people who dealt with their financial strain in an active and practical way (problem-focused) rather than with avoidance techniques (emotion-focused) had no more risk of severe periodontal
disease than those without money problems.

The good news is that many of the risk factors for periodontal disease, such as poor oral hygiene and infrequent professional care, can be controlled with minimal personal time and financial resources. Eliminating periodontal disease also eliminates a risk factor for heart disease, respiratory disease, and diabetes complications, it is especially important for people to do what they can to protect their oral health.

Genco and his colleagues are following more than 1,400 people between the ages of 25 and 74 in the ongoing study, which is one of the first to examine the relationship of periodontal disease to stress, distress
and coping in a large population.

Psychological tests were given to identify and weigh the causes of stress (children, spouse, financial strain, single life and work stress) in participants' daily lives and to measure the ability to cope
with stress. To measure financial strain, study participants answered
nine questions, including:

• At the present time, are you able to afford a home that is large enough?
• Do you have difficulty in meeting monthly payments of your family bills?
• How often is it that you don't have enough money to afford the kind of food, clothing, medical care, or leisure activities you and your family need or want?

Further studies are needed to help establish the time course of stress in respect to the onset and progression of periodontal disease and the mechanisms that explain the association. Intervention studies also are needed to determine the extent to which controlling stress
will influence periodontal disease and its treatment.