Perceived stress among gravid and its effect on their oral health in Sri Ganganagar, Rajasthan, India


  • Nikita Goyal Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
  • Simarpreet Singh Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
  • Anmol Mathur Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
  • Neha Gupta Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
  • Diljot K. Makkar Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India
  • Vikram P. Aggarwal Department of Public Health Dentistry, Surendera Dental College and Research Institute, Sri Ganganagar, Rajasthan, India



Dental caries, Gravid, Oral health, Stress


Background: The gestation period presents unique stresses that challenges overall psychological adaptation of a women. The present study is designed especially to focus on evaluating the effect of perceived stress on pregnant women and its effect on their oral health.

Methods: A cross-sectional study was conducted among 18-30 years old, pregnant women in the Sri Ganganagar city. Prior to the clinical examination a questionnaire was used in order to collect the information which comprised of three parts and were completed through an interview. The first part comprised of demographics questionnaire, second part included oral hygiene questionnaire and third part was perceived Stress Scale. Descriptive analysis described demographics and socioeconomic characteristics. Multivariate analysis was used to describe the association between stress and various characteristics. Chi-square and Kruskal-wallis test was used to study the association of independent variables with level of stress.

Results: The high stress was reported among those females who were aged > 25 years (46.66%), living in rural areas (73.33%), were employed (57.77%), were in third trimester of pregnancy (96.66%) and had no previous pregnancy experience (67.77%). The mothers in high stress group had high levels of dental diseases when compared to the other two groups (low and moderate stress).

Conclusions: Based on the results, this study emphasizes on the need for a continued effort to improve the mental and oral health status of gravid women so as to reduce the incidences of psychological and physical troubles in this population predicted.


Iranzad I, Bani S, Hasanpour S, Mohammadalizadeh S, Mirghafourvand M. Perceived Social Support and Stress among Pregnant Women at Health Centers of Iran- Tabriz. J Caring Sci. 2014; 3(4): 287-95.

Cornejo C. Oral health status and oral health-related quality of life in pregnant women from socially deprived populations. Acta Odontol Latinoam 2013;26:68-74.

Couto ER, Couto E, Vian B, Gregório Z, Nomura ML, Zaccaria R. Quality of life, depression and anxiety among pregnant women with previous adverse pregnancy outcomes. Sao Paulo Med. J 2009;127(4):185-9.

Repetti RL, Taylor SE, Seeman TE. Risky families: family social environments and the mental and physical health of offspring. Psychol Bull. 2002;128(2):330-60.

Kalra S, Einarson A, Karaskov T, Uum SV, Koren G. The relationship between stress and hair cortisol in healthy pregnant women. Clin Invest Med. 2007;30(2):103-7.

De Weerth C, Buitelaar JK. Physiological stress reactivity in human pregnancy-a review. Neurosci Biobehav Rev. 2005;29:295-312.

Malathi K, Sabale D. Stress and periodontitis: A review. IOSR J Dent Med Sci. 2013;9(4):54-7.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav.1983;24:385-96.

Pitcairn J. A case of disease of the gams (that) occurred during pregnancy. Hosp Rep. 1818;2:309.

Pinard A. Gingivitis in pregnancy. Dent Register. 1877;31:258.

Samant A, Malik CP, Chabar SK, Devi PK. Gingivitis and Periodontal disease in pregnancy. J Clin Periodontal. 1976;47:415-8.

Raber- Durlacher JE, Van steenbergen TJ, Van Der Relden U. Expenmental gingivitis during Pregnancy and postpartum: Clinical endocrinological and microbiological aspects. J Clin Periodontal. 1994;21:549.

Yaghobi S, Haghighati F. Evaluation of the oral health status and needs for periodontal treatment in pregnant women. Avicenna J Dent Res. 2010;2(1):53-8.

Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc. 1964;68:7-13.

Community Periodontal Index. World Health Organization. Oral health surveys: basic methods. 4th ed. Geneva: WHO;1997:36-8.

Klein H, Palmer C, Knutson JW. Studies of dental caries I: dental status and dental needs of elementary school children. Public Health Rep. 1938;53:751-65.

Vijayaselvi R, Beck MM, Abraham A, Kurian S, Regi A, Rebekah G. Risk factors for stress during antenatal period among pregnant women in tertiary care hospital of Southern India. J Clin Diagn Res. 2015;9(10):1-5.

Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Women’s Health. 2003;12(4):373-380.

Glazier RH, Elgar FJ, Goel V, Holzapfel S. Stress, social support, and emotional distress in a community sample of pregnant women. J Psychosom Obstet Gynecol. 2004;25:247-55.

Turner RJ, Frankel BG, Levin DM. Social support: Conceptualization, measurement and implications for mental health. Res Community Ment Health. 1983;3:67-111.

Turner RJ, Lloyd DA. The stress process and the social distribution of depression. J Health Soc Behav. 1999;40:374-404.

Bolton HL, Hughes PM, Turton P, Sedgwick P. Incidence and demographic correlates of depressive symptoms during pregnancy in an inner city London population. J Psychosom Obstet Gynaecol. 1998;19:202.

Srinivasan N, Murthy S, Singh AK, Upadhyay V, Mohan SK, Joshi A. Assessment of burden of depression during pregnancy among pregnant women residing in rural setting of Chennai. J Clin Diagn Res. 2015;9(4):8-12.

Desai S, Waite LJ. Women's employment during pregnancy and after the first birth: occupational characteristics and work commitment. Am Sociol Rev. 1991;56:551-66.

Homer CJ, James SA, Siegel E. Work-related psychosocial stress and risk of preterm, low birthweight delivery. Am J Public Health. 1990;80:173-7.

Peruzzo DC1, Benatti BB, Ambrosano GM, Nogueira-Filho GR, Sallum EA, Casati MZ et al. A systematic review of stress and psychological factors as possible risk factors for periodontal disease. J Periodontol. 2007;78(8):1491-504.

Logrippo MT. The relationship of perceived trust and perceived stress among pregnant women receiving care from a certified nurse midwife: Seton Hall University Dissertations and Theses (ETDs);2013. Available from:

Wang JL. Rural-urban differences in the prevalence of major depression and associated impairment. Soc Psychiatry Psychiatr Epidemiol. 2004;39(1):19-25.

Hillemeier MM, Weisman CS, Chase GA, Dyer AM. Mental health status among rural women of reproductive age: findings from the Central Pennsylvania Women’s Health Study. Am J Public Health. 2008;98(7):1271-9.

Blazer D, George LK, Landerman R, Pennybacker M, Melville ML, Woodbury M, Manton KG et al. Psychiatric disorders. A rural/urban comparison. Arch Gen Psychiatry 1985;42(7):651-6.

Villegas L, McKay K, Dennis CL, Ross LE. Postpartum depression among rural women from developed and developing countries: a systematic review. J Rural Health. 2011;27:278-88.

Jesse DE, Dolbier CL, Blanchard A. Barriers to seeking help and treatment suggestions for prenatal depressive symptoms: focus groups with rural low-income women. Issues Ment Health Nurs. 2008;29(1):3-19.

Hoyt DR, Conger RD, Valde JG, Weihs K. Psychological distress and help seeking in rural America. Am J Community Psychol. 1997;25(4):449-70.

Kerby J. How stressed are rural people? Rural Soc. 1992;2:15-17.

Teixeira C, Figueiredo B, Conde A, Pacheco A, Costa R. Anxiety and depression during pregnancy in women and men. J Affect Disord. 2009;119:142-8.

Sam KSN, Leung WK. A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss. Community Dent Oral Epidemiol. 2006;34:252-66.

Abdollahi F, Rohani S, Sazlina GS. Bio-psycho-socio-demographic and obstetric predictors of postpartum depression in pregnancy: a prospective cohort study. Iran J Psychiatry Behav Sci. 2014;8(2):11-21.






Original Research Articles