Supportive periodontal therapy: individual patients' perception of various professional interventions

Evidence on psychophysiological responses such as heart rate (HR) and electrodermal response (EDR) during long-term supportive periodontal therapy (SPT) is limited. This observational cross-sectional pilot study aimed to explore associations between patient-related factors and physiological stress markers during routine SPT visits, focusing on adherence-related variables.

A sample of n = 75 patients was examined in a questionnaire-based, cross-sectional survey, indicating sufficient adherence to SPT of ≥ 2 years (a maximum deviation ± 6 months between SPT intervals) at a specialized department for periodontology. At the preliminary last SPT visit, in addition to dental parameters, we assessed socio-demographic, treatment-related (critical attitudes/complaints), psychological variables-such as dental fear, oral health-related quality of life, dental anticipatory trauma symptoms, childhood traumata, depression, and personality functioning-and vital parameters such as HR and EDR. The primary endpoint was the difference in HR and EDR across predefined procedural clusters reflecting varying invasiveness (three clusters: non-invasive (n-iC), minimally invasive (m-iC), and invasive (iC). Analyses were performed using non-parametric tests and exploratory correlation analyses.

The mean (standard deviation) of HR differed significantly across intervention clusters (n-iC/m-iC/iC: 73.06[11.96]/67.66[9.60]/69.46[10.00] bpm; p ≤ 0.001), while EDR revealed no significant differences (n-iC/m-iC/iC: 69.64[156.65]/61.72[172.20]/75.10[154.07] µS; p ≥ 0.075). EDR negatively correlated with the number of teeth m-iC-interventions (r = -0.423; p = 0.003). Moreover, EDR and HR were significantly related to certain variables such as long-term medication and number of general diseases (p < 0.001). Significant correlations included a positive association between Oral Health Impact Profile scores and dental anxiety (r = 0.233; p = 0.040) and a negative correlation with the total number of teeth (r = -0.378; p < 0.001).

Socio-demographic and treatment-related factors were intertwined with patient and dental parameters in SPT and appeared to influence adherence. HR varied across clusters, but no clear link between vital signs and psychological stress could be established.

The clinical trial was prospectively registered in the DRKS-German Clinical Trials Register ( https://www.drks.de ) with the registration-ID DRKS00031969 (06/05/2023).