Background: Various oral stimuli that are perceived by the brain as stressful can trigger patterns of neurological activity which then directly influence immune and endocrine response. Objective: To analyze the psycho-neuro-endocrine-immunological interactions involved in oral diseases and conditions. Data sources: Web of Science, PubMed, Google Scholar were databases researched for peer review articles in indexed journals. Study selection: A literature search limited to peer-reviewed articles in indexed journals published before January 2019 was performed using specific keywords. 107 articles were selected. Data extraction: The aspects related to psycho-neuro-immune interactions relevant for dental practitioners were synthesized and presented in the form of narrative review. Oral diseases and conditions in which psychological factors act through neurological, endocrine and immunological mechanisms are discussed. The following clinical entities were included: periodontitis, oral lichen planus, recurrent aphthous stomatitis, temporomandibular disorders, herpes labialis, burning mouth syndrome, and atypical odontalgia. Additionally, the role of psycho-neuro-immunological factors on bacterial adherence and oral microbiome is briefly discussed. Data synthesis: Various oral diseases and conditions of multifactorial etiology can be influenced by psycho-neuro-immunological interactions. In daily practice, clinicians should be aware of the interplay between mental and general health and consider addressing psychological disturbances as a supplement for conventional treatment modalities. Recognizing these interactions should help to better understand the relationship between mental and physical health.
Authors: Matej Par, Zrinka Tarle
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