People who believe that luck decides their fate may be at greater risk of developing severe gum disease than those who think their actions change their fate.
Researchers studied two types of people: those who had an external locus of control, meaning that they believe that their actions have little effect on what happens to them happens, and those with an internal locus of control, that is, people who believe that their actions can directly affect their lives.
According to the press release, the extrinsic locus was independently associated with more tooth loss, indicating greater severity of periodontitis compared to the intrinsic locus of control.
“The finding that this belief system is associated with oral health should encourage dentists to assess the emotional state of their patients and, if necessary, refer them to a psychologist,” the author of the study said in a press release. Dr. Sebastien Jungo of the University of Paris.
To explore the relationship between locus of control and oral health, the researchers collected data from 79 patients who attended a periodontal consultation at Bretonneau University Hospital in Paris. The average age of the participants was 46 years old and two-thirds of them were women.
The data included lifestyle information such as smoking status and personal information such as income. In addition, patients completed questionnaires to determine their locus of control, stress levels, and depressed mood.
Clinicians recorded the degree of plaque control in each patient and the number of teeth. At a second consultation approximately two weeks later, the severity of gum disease was assessed by bleeding on probing and pocket depth.
Twenty patients had an external locus of control and 59 had an internal locus of control. In the extrinsic locus group, participants lost, on average, three teeth compared to one lost tooth in the intrinsic locus group. In addition, the maximum attachment loss was significantly higher at 9.95 mm in the external loci group compared to the maximum attachment loss of 8.38 mm in the internal loci group.
After adjusting for factors that may have influenced the relationship between locus of control and oral health, the researchers found that extrinsic locus of control was strongly associated with depression score, education level, number of teeth, and maximum attachment loss, with odds ratios of 1.21, 0.6, 0.67 and 1.31, respectively.
For patients who do not believe they have much control over the trajectory of their lives, doctors should ask questions such as “What do you think is causing your disease?” and “How can it be treated?”
According to Jungo, patients' response can be critical to optimizing their treatment adherence.
“The findings suggest that this group may need encouragement to consider periodontitis as a treatable disease, especially if they feel overwhelmed,” he said.