Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis

Objectives The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis. Materials and methods This study included 30 non-pregnant women (mean age 27.93 +/- 6.61 years) and 30 pregnant women (mean age 28.93 +/- 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay. Results The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 +/- 9.82 pg per site and 8.08 +/- 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups. Conclusions Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings.