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Gastrointestinal distress and dysbiosis have been associated with several chronic inflammatory diseases yet have rarely been investigated with respect to oral inflammation. Given the implications of gastrointestinal distress on extraintestinal inflammation, this study aimed to evaluate the potential role of such distress as a mediator between psychological stress and periodontal disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Utilizing a cross\u2010sectional, nationwide sample of 828 adults in the USA generated via Amazon Mechanical Turk, we evaluated data collected from a series of validated self\u2010report psychosocial questionnaires on stress, gut\u2010specific anxiety around current gastrointestinal distress and periodontal disease, including periodontal disease subscales targeted at physiological and functional factors. Structural equation modelling was used to determine total, direct and indirect effects, while controlling for covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Psychological stress was associated with gastrointestinal distress (<jats:italic>\u00df<\/jats:italic>\u2009=\u2009.34) and self\u2010reported periodontal disease (<jats:italic>\u00df<\/jats:italic>\u2009=\u2009.43). Gastrointestinal distress also was associated with self\u2010reported periodontal disease (<jats:italic>\u00df<\/jats:italic>\u2009=\u2009.10). Gastrointestinal distress likewise mediated the relation between psychological stress and periodontal disease (<jats:italic>\u00df<\/jats:italic>\u2009=\u2009.03, <jats:italic>p<\/jats:italic>\u2009=\u2009.015). Given the multifactorial nature of periodontal disease(s), similar results were demonstrated using the subscales of the periodontal self\u2010report measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Associations exist between psychological stress and overall reports of periodontal disease as well as more specific physiological and functional components. Additionally, this study provided preliminary data supporting the potential mechanistic role that gastrointestinal distress plays in connecting the gut\u2013brain and the gut\u2013gum pathways.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.12889","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T03:24:06Z","timestamp":1689045846000},"page":"1250-1257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gastrointestinal distress as a potential mediator between stress and periodontal inflammation"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-5877","authenticated-orcid":false,"given":"Casey D.","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Developmental Sciences, School of Dentistry Marquette University  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-4717","authenticated-orcid":false,"given":"Brenda","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine Boston University  Boston Massachusetts USA"},{"name":"Department of Epidemiology, School of Public Health Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-4629","authenticated-orcid":false,"given":"Raul I.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-5102","authenticated-orcid":false,"given":"Maureen M.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Mucosal Immunology and Biology Research Center, Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2134-0261","authenticated-orcid":false,"given":"Alessio","family":"Fasano","sequence":"additional","affiliation":[{"name":"Mucosal Immunology and Biology Research Center, Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-8455","authenticated-orcid":false,"given":"Daniel W.","family":"McNeil","sequence":"additional","affiliation":[{"name":"Department of Community Dentistry and Behavioral Science, College of Dentistry University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.140520"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-55484-8.00015-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18-0006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.02498"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.2002.290408.x"},{"issue":"3","key":"e_1_2_9_7_1","first-page":"241","article-title":"Psychological perspectives on the pathogenesis of periodontal disease","volume":"44","author":"Dumitrescu AL","year":"2006","journal-title":"Rom J Intern Med"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2012.00457.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1999.70.7.711"},{"issue":"3","key":"e_1_2_9_10_1","first-page":"69","article-title":"The influence of psychological stress on periodontal disease","volume":"48","author":"Hildebrand HC","year":"2000","journal-title":"J West Soc Periodontol Periodontal Abstr"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2006.00282.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12036"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1998.3.1.288"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-6748.123585"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12427"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00230.2018"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.620124"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.7551\/mitpress\/11291.001.0001"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.12490"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2020322118"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/21688370.2016.1251384"},{"key":"e_1_2_9_22_1","unstructured":"National Cancer Institute.Mouth.2021. 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