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Depressive Symptoms Favor Abundant Growth of Salivary Lactobacilli

From the Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu (S.S.A., T.K.S.), and Oral and Maxillofacial Department, Oulu University Hospital (M.L.E.K.), Oulu, Finland.

Address reprint requests to: Sirpa S. Anttila, DDS, Institute of Dentistry, University of Oulu, Aapistie 3, FIN-90220 Oulu, Finland.

OBJECTIVE: The purpose was to study the growth of lactobacilli in subjects with depressive symptoms in the total 55-year-old population of Oulu (a medium-sized town in Finland); 780 people participated.

METHODS: The dental examination included measurements of salivary lactobacillus growth with the Dentocult-LB method; measurements of salivary flow rate, pH, and buffering capacity; and assessment of oral health status. Depressive symptoms were determined with the Zung Self-Rating Depression Scale (ZSDS). Participants were also asked about their health, medication, smoking, and dietary habits.

RESULTS: The prevalence of high lactobacillus counts (100,000 CFU/ml) was 22% among women and 31% among men (p = .02). Thirty-seven percent of the subjects with a high rate of depressive symptoms (ZSDS score of 40) and 23% of those with an ZSDS score of 39 had high counts of lactobacilli (p = .003). A logistic regression analysis with improvement of goodness of fit was made to confirm the relation between abundant lactobacilli and a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with abundant lactobacillus growth.

CONCLUSIONS: The association between high lactobacillus counts and depressive symptoms suggests that depressed subjects are at risk of having caries and possibly other dental diseases that should be recognized in the treatment of these patients.

Key Words: salivary lactobacilli • dental health • depressive symptoms

Abbreviations: BMDP = biomedical data program; DSM-III =Diagnostic and Statistical Manual of Mental Disorders,third edition; Ig = immunoglobulin; PLR = procedure oflogistic regression; ZSDS = Zung Self-Rating Depression Scale.

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