口腔疾病防治2026，Vol.34Issue(3)：281-291,11.DOI:10.12016/j.issn.2096-1456.202550193
牙周病与抑郁焦虑双向关联的研究进展
Research progress on the bidirectional association between periodontal disease and depression/anxiety
摘要
Abstract
There are practical and cost-effective opportunities for the prevention and early intervention of periodon-tal disease,a common oral condition.Depression and anxiety represent major global mental health challenges,and they are characterized by high prevalence rates and an elevated suicide risk.Their clinical management is complicated by extended treatment timelines and substantial healthcare costs.Accumulating evidence demonstrates a statistically sig-nificant bidirectional association between periodontal disease and depression/anxiety disorders.However,established clinical pathways integrating these conditions remain lacking.This review presents a comprehensive analysis of current research examining the relationship between periodontal disease and mood disorders,specifically depression and anxi-ety.This study explored the bidirectional mechanisms within the microbiota-oral-brain axis,which includes both peri-odontal disease inducing neuroinflammation through pro-inflammatory factors,such as interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)activating the TLR-4/NF-κB signaling pathway,and depression and anxiety leading to"glucocorticoid resistance"through hypothalamic-pituitary-adrenal(HPA)axis dysregulation,thus causing dual immune dysfunction that exacerbates periodontal tissue destruction,as well as the mechanisms by which biological,psychologi-cal,and social factors contribute to the bidirectional association between periodontal disease and depression/anxiety.We propose implementing bidirectional referral protocols between dental and psychiatric services in clinical practice,incorporating mental health screening tools,such as Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7(GAD-7),for patients with moderate-to-severe periodontal disease,and incorporating periodontal examination into routine assessment during psychiatric services.This multidisciplinary approach aims to break the vicious circle be-tween these conditions and provide clinicians with pragmatic intervention strategies.关键词
牙周病/抑郁症/焦虑症/双向关联/微生物-口腔-大脑轴/生物-心理-社会因素/双向转诊/多学科协作Key words
periodontal disease/depression/anxiety/bidirectional relationship/microbiota-oral-brain axis/biopsychosocial factors/bidirectional referral/multidisciplinary approach分类
医药卫生引用本文复制引用
王俐雯,蔡宇泰,阮亚茹,张凡,余红梅,郜艳晖..牙周病与抑郁焦虑双向关联的研究进展[J].口腔疾病防治,2026,34(3):281-291,11.基金项目
国家自然科学基金(82273742) （82273742）
广东省自然科学基金(2024A1515012603) This study was supported by the grants from the National Natural Science Foundation of China(No.82273742)and the Natural Science Foundation of Guangdong Province(No.2024A1515012603). （2024A1515012603）
