Biopsychosocial Mechanisms in the Development and Progression of Periodontal Disease

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PROJECT SUMMARY In recognition of the importance of treating whole persons, biopsychosocial approaches have long been championed. The emphasis in health and disease research, however, is in biological abnormalities. Examining diseases from psychological and socio-behavioral perspectives adds unique perspectives in understanding the etiology and course of any given disease. That is, greater understanding is needed in elucidating how and why biopsychosocial factors may precipitate the onset of disease. Periodontal disease continues to be among the most prevalent dental, oral, and craniofacial conditions across the globe. Patients with periodontal disease— especially those from underserved populations—are faced with potentially life-long symptoms that affect their overall health and quality of life. Additional work is needed to characterize the mechanisms that explain biopsychosocial relations contributing to periodontal disease. Thus, work that tackles the multidisciplinary and complex systems nature of periodontal disease is needed to help facilitate future preventative, mitigating, and restorative interventions based on biological, psychological, and socioeconomic mechanisms. During the F99 phase of this proposal, the awardee will continue through dissertation work, to examine a novel psycho- biological mechanism by exploring the role of the protein zonulin (modulator of tissue permeability) in periodontal parameters and its potential ability to explain the relation between psychological stress and periodontal disease. More specifically, the awardee will examine the relation of zonulin, as measured by serum, salivary, and gingival crevicular fluid ELISA, and periodontal disease parameters. Additionally, zonulin will be examined as a potential mediating and moderating factor in the relation between psychological stress and cytokines in periodontal examination participants. It is hypothesized that serum zonulin levels will mediate the relation between reports of psychological stress and various periodontal and inflammatory parameters (e.g., probing depth, attachment loss, IL-6 levels). In the K00 phase, the awardee will work in understanding the upstream socioeconomic (e.g., social networks) and psychological aspects (e.g., stress) of a biopsychosocial approach to understanding periodontal disease. It is hypothesized that people who report social connections with those they perceive to have poor oral health, who engage in risk behaviors (e.g. smoking, sugary diet), and who utilize dental care infrequently, will be more likely to report indicators of periodontal disease. Secondly, it is expected that poor psychological functioning will diminish social network effects. The F99 and K00 phases will utilize the training and mentorship gained as a predoctoral trainee and continuing to surround himself with mentors and in a multidisciplinary environment in his transition to the postdoctoral and early career stages of becoming an independent scholar. Thus, this award will facilitate the ability to identify novel biopsychosocial mechanisms in the development and progression of a complex oral disease through both its research and training plans.