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In addition, life events, environmental factors, and lifestyle affect the onset, progression, and recurrence of mental health disorders. These may all overlap with periodontal and\/or peri\u2010implant disease. Mental health disorders are associated with more severe periodontal disease and, in some cases, poorer healing outcomes to nonsurgical periodontal therapy. They can result in behavior modification, such as poor oral hygiene practices, tobacco smoking, and alcohol abuse, which are also risk factors for periodontal disease and, therefore, may have a contributory effect. Stress has immunomodulatory effects regulating immune cell numbers and function, as well as proinflammatory cytokine production. Stress markers such as cortisol and catecholamines may modulate periodontal bacterial growth and the expression of virulence factors. Stress and some mental health disorders are accompanied by a low\u2010grade chronic inflammation that may be involved in their relationship with periodontal disease and vice versa. Although the gut microbiome interacting with the central nervous system (gut\u2010brain axis) is thought to play a significant role in mental illness, less is understood about the role of the oral microbiome. The evidence for mental health disorders on implant outcomes is lacking, but may mainly be through behaviourial changes. Through lack of compliance withoral hygiene and maintenance visits, peri\u2010implant health can be affected. Increased smoking and risk of periodontal disease may also affect implant outcomes. Selective serotonin reuptake inhibitors have been linked with higher implant failure. They have an anabolic effect on bone, reducing turnover, which could account for the increased loss.<\/jats:p>","DOI":"10.1111\/prd.12452","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T15:04:42Z","timestamp":1659366282000},"page":"106-124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":141,"title":["Mental health and periodontal and peri\u2010implant diseases"],"prefix":"10.1111","volume":"90","author":[{"given":"Jake","family":"Ball","sequence":"first","affiliation":[{"name":"Centre for Rural Dentistry and Oral Health Charles Sturt University  Orange New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6457-5327","authenticated-orcid":false,"given":"Ivan","family":"Darby","sequence":"additional","affiliation":[{"name":"Periodontics, Melbourne Dental School The University of Melbourne  Melbourne Victoria 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