Association between depression and periodontitis: a systematic review and meta‐analysis

Aim The aim of this systematic review and meta‐analysis was to assess the scientific evidence on the association between depression and periodontitis. Methods An electronic search was conducted in three databases until October 2015 ( PROSPERO ‐ CRD 42014006451). Hand searches and grey literature were also included. Search retrieved 423 potentially studies. Two independent reviewers selected the studies, extracted data and assessed risk bias through a modified version of Newcastle–Ottawa scale. Meta‐analysis was performed for the presence/absence of periodontitis (dichotomic). Summary effect measures and odds ratio ( OR ) 95% CI were calculated. Results After selecting the studies, 15 were included in the systematic review (eight cross‐sectional, six case–control and one cohort study). Six studies reported that depression was associated with periodontitis, whereas nine studies did not. The majority of studies had low risk of bias by methodological quality assessment. Meta‐analysis of seven cross‐sectional studies showed no significant association between depression and periodontitis ( OR  = 1.03, 95% CI  = 0.75–1.41). Conclusion Findings from the present systematic review showed a great heterogeneity among the studies and the summary effect measure of the meta‐analysis cannot affirm an association between depression and periodontitis. Future studies with different designs in distinct populations should be conducted to investigate this association.