Download PDF
Methods Inf Med 2011; 50(04): 358-363
DOI: 10.3414/ME10-01-0045
Original Articles
Schattauer GmbH

Relationship between Malocclusion and Heart Rate Variability Indices in Young Adults

A Pilot Study
D. Ekuni
1   Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
N. Takeuchi
1   Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
M. Furuta
1   Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
T. Tomofuji
1   Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
,
M. Morita
1   Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
› Author Affiliations
Further Information

Publication History

received: 09 June 2010

accepted: 03 August 2010

Publication Date:
18 January 2018 (online)

    Permissions and Reprints

Summary

Objectives: Heart rate variability (HRV) has been used to assess sympathetic and parasympathetic modulation of heart rate. Chronic stress relates to reduced HRV. Malocclusion has effects on quality of life, which can lead to chronic stress. Therefore, we hypothesized that malocclusion, as chronic stress, may contribute to reduced HRV. The aim of this study was to investigate the relationship between malocclusion and HRV indices in healthy young adults.

Methods: Thirty-seven non-smoking healthy subjects, aged 22 to 25 years, were examined. Malocclusion was defined by Angle classification. HRV indices included root mean square of successive differences, low frequency (LF), high frequency (HF) and ratio of LF to HF. The effects of malocclusion on quality of life and mental health were assessed using self-reported questionnaires, the condition-specific Oral Impacts on Daily Performances index (CS-OIDP) and the Hopkins Symptoms Checklist (HSCL), respectively.

Results: Significantly lower score of HF and higher heart rate (HR) level and CS-OIDP score were observed in subjects with malocclusion (n = 17) compared to those in the control subjects (n = 20) (P < 0.05). There was a positive correlation between HR and score of “anxiety” in HSCL (P < 0.05).

Conclusions: The data showed an association between malocclusion and lower HRV. Based on our results, orthodontic treatment might contribute not only to improvement of oral esthetic and functional problems but also to improvement of stress and HRV indices.

Keywords

Malocclusion - heart rate variability - oral health-related quality of life - young adult - high frequency
 

  • References

  • 1 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 1996; 93: 1043-1065.
    CrossrefPubMedGoogle Scholar
  • 2 Berntson GG, Bigger Jr JT, Eckberg DL, Grossman P, Kaufmann PG, Malik M, Nagaraja HN, Porges SW, Saul JP, Stone PH, van der Molen MW. Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology 1997; 34: 623-648.
    CrossrefPubMedGoogle Scholar
  • 3 Berntson GG, Lozano DL, Chen YJ. Filter properties of root mean square successive difference (RMSSD) for heart rate. Psychophysiology 2005; 42: 246-252.
    CrossrefPubMedGoogle Scholar
  • 4 Eckberg DL. Sympathovagal balance: a critical appraisal. Circulation 1997; 96: 3224-3232.
    CrossrefPubMedGoogle Scholar
  • 5 Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, Schouten EG. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study Atherosclerosis Risk In Communities. Circulation 2000; 102: 1239-1244.
    CrossrefPubMedGoogle Scholar
  • 6 Stein PK, Rich MW, Rottman JN, Kleiger RE. Stability of index of heart rate variability in patients with congestive heart failure. Am Heart J 1995; 129: 975-981.
    CrossrefPubMedGoogle Scholar
  • 7 Virtanen R, Jula A, Kuusela T, Helenius H, VoipioPulkki LM. Reduced heart rate variability in hyper-tension: associations with lifestyle factors and plasma renin activity. J Hum Hypertens 2003; 17: 171-179.
    CrossrefPubMedGoogle Scholar
  • 8 Urbancic-Rovan V, Meglic B, Stefanovska A, Bern-jak A, Azman-Juvan K, Kocijancic A. Incipient cardiovascular autonomic imbalance revealed by wavelet analysis of heart rate variability in Type 2 diabetic patients. Diabet Med 2007; 24: 18-26.
    CrossrefPubMedGoogle Scholar
  • 9 Kojima M, Hayano J, Fukuta H, Sakata S, Mukai S, Ohte N, Seno H, Toriyama T, Kawahara H, Furukawa TA, Tokudome S. Loss of fractal heart rate dynamics in depressive hemodialysis patients. Psychosom Med 2008; 70: 177-185.
    CrossrefPubMedGoogle Scholar
  • 10 Waldstein SR, Neumann SA, Burns HO, Maier KJ. Role-played interpersonal interaction: ecological validity and cardiovascular reactivity. Ann Behav Med 1998; 20: 302-309.
    CrossrefPubMedGoogle Scholar
  • 11 Schubert C, Lambertz M, Nelesen RA, Bardwell W, Choi JB, Dimsdale JE. Effects of stress on heart rate complexity – a comparison between short-term and chronic stress. Biol Psychol 2009; 80: 325-332.
    CrossrefPubMedGoogle Scholar
  • 12 de Geus EJ, van Doornen LJ, de Visser DC, Orlebeke JF. Existing and training induced differences in aerobic fitness: their relationship to physiological response patterns during different types of stress. Psychophysiology 1990; 27: 457-478.
    CrossrefPubMedGoogle Scholar
  • 13 Boutcher SH, Stocker D. Cardiovascular response of young and older males to mental challenge. J Gerontol B Psychol Sci Soc Sci 1996; 51: 261-267.
    PubMedGoogle Scholar
  • 14 Pagani M, Montano N, Porta A, Malliani A, Abboud FM, Birkett C, Somers VK. Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. Circulation 1997; 95: 1441-1448.
    CrossrefPubMedGoogle Scholar
  • 15 Bonnet MH, Arand DL. Heart rate variability in insomniacs and matched normal sleepers. Psycho-som Med 1998; 60: 610-615.
    CrossrefPubMedGoogle Scholar
  • 16 Zucker TL, Samuelson KW, Muench F, Greenberg MA, Gevirtz RN. The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study. Appl Psychophysiol Biofeedback 2009; 34: 135-143.
    CrossrefPubMedGoogle Scholar
  • 17 Kanters JK, Højgaard MV, Agner E, Holstein-Rathlou NH. Influence of forced respiration on nonlinear dynamics in heart rate variability. Am J Physiol 1997; 272: R1149-R1154.
    PubMedGoogle Scholar
  • 18 Weinberger M, Hiner SL, Tierney WM. In support of hassles as a measure of stress in predicting health outcomes. J Behav Med 1987; 10: 19-31.
    CrossrefPubMedGoogle Scholar
  • 19 Furlan R, Barbic F, Piazza S, Tinelli M, Seghizzi P, Malliani A. Modifications of cardiac autonomic profile associated with a shift schedule of work. Circulation 2000; 102: 1912-1916.
    CrossrefPubMedGoogle Scholar
  • 20 Lucini D, Di Fede G, Parati G, Pagani M. Impact of chronic psychosocial stress on autonomic cardiovascular regulation in otherwise healthy subjects. Hypertension 2005; 46: 1201-1206.
    CrossrefPubMedGoogle Scholar
  • 21 Bernabé E, Sheiham A, de Oliveira CM. Impacts on daily performances attributed to malocclusions by British adolescents. J Oral Rehabil 2009; 36: 26-31.
    CrossrefPubMedGoogle Scholar
  • 22 Tajima M, Kohzuki M, Azuma S, Saeki S, Meguro M, Sugawara J. Difference in quality of life according to the severity of malocclusion in Japanese orthodontic patients. Tohoku J Exp Med 2007; 212: 71-80.
    CrossrefPubMedGoogle Scholar
  • 23 Azuma S, Kohzuki M, Saeki S, Tajima M, Igarashi K, Sugawara J. Beneficial effects of orthodontic treatment on quality of life in patients with malocclusion. Tohoku J Exp Med 2008; 214: 39-50.
    CrossrefPubMedGoogle Scholar
  • 24 Nicodemo D, Pereira MD, Ferreira LM. Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery. Med Oral Patol Oral Cir Bucal 2008; 13: E48-E51.
    PubMedGoogle Scholar
  • 25 Adulyanon S, Sheiham A. Oral Impact on daily performances. In: Slade GD. (ed). Measuring oral health and quality of life. University of North Carolina: Chapel Hill; 1997. pp 151-160.
    Google Scholar
  • 26 Gherunpong S, Sheiham A, Tsakos G. A sociodental approach to assessing children’s oral health needs: integrating an oral health-related quality of life (OHRQoL) measure into oral health service planning. Bull World Health Organ 2006; 84: 36-42.
    PubMedGoogle Scholar
  • 27 Gherunpong S, Tsakos G, Sheiham A. Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP. Community Dent Health 2004; 21: 161-169.
    PubMedGoogle Scholar
  • 28 Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci 1974; 19: 1-15.
    CrossrefPubMedGoogle Scholar
  • 29 Nakano T, Kitamura T. The relation of anger subcomponent of Type A behavior to psychological symptoms in Japanese and international students. Jpn Psychol Res 2001; 43: 50-54.
    CrossrefPubMedGoogle Scholar
  • 30 Petersen RW, Graham G, Quinlivan JA. Psychologic changes after a gynecologic cancer. J Obstet Gynaecol Res 2005; 31: 152-157.
    CrossrefPubMedGoogle Scholar
  • 31 Angle EH. Classification of malocclusion. Dent Cosmos 1899; 41: 350-357.
    PubMedGoogle Scholar
  • 32 Bernabé E, Sheiham A, de Oliveira CM. Condition-specific impacts on quality of life attributed to malocclusion by adolescents with normal occlusion and Class I, II and III malocclusion. Angle Orthod 2008; 78: 977-982.
    CrossrefPubMedGoogle Scholar
  • 33 Camillo CA, Pitta F, Possani HV, Barbosa MV, Marques DS, Cavalheri V, Probst VS, Brunetto AF. Heart rate variability and disease characteristics in patients with COPD. Lung 2008; 186: 393-401.
    CrossrefPubMedGoogle Scholar
  • 34 Song HS, Lehrer PM. The effects of specific respiratory rates on heart rate and heart rate variability. Appl Psychophysiol Biofeedback 2003; 28: 13-23.
    CrossrefPubMedGoogle Scholar
  • 35 Rabbia F, Silke B, Conterno A, Grosso T, De Vito B, Rabbone I, Chiandussi L, Veglio F. Assessment of cardiac autonomic modulation during adolescent obesity. Obes Res 2003; 11: 541-548.
    CrossrefPubMedGoogle Scholar
  • 36 Vaschillo E, Lehrer P, Rishe N, Konstantinov M. Heart rate variability biofeedback as a method for assessing baroreflex function: a preliminary study of resonance in the cardiovascular system. Appl Psychophysiol Biofeedback 2002; 27: 1-27.
    CrossrefPubMedGoogle Scholar
  • 37 Critchley HD, Mathias CJ, Josephs O, O’Doherty J, Zanini S, Dewar BK, Cipolotti L, Shallice T, Dolan RJ. Human cingulate cortex and autonomic control: converging neuroimaging and clinical evidence. Brain 2003; 126: 2139-2152.
    CrossrefPubMedGoogle Scholar
  • 38 Napadow V, Dhond R, Conti G, Makris N, Brown EN, Barbieri R. Brain correlates of autonomic modulation: combining heart rate variability with f MRI. Neuroimage 2008; 42: 169-177.
    CrossrefPubMedGoogle Scholar
  • 39 Ahs F, Sollers 3rd JJ, Furmark T, Fredrikson M, Thayer JF. High-frequency heart rate variability and cortico-striatal activity in men and women with social phobia. Neuroimage 2009; 47: 815-820.
    CrossrefPubMedGoogle Scholar
  • 40 Lambertz M, Vandenhouten R, Grebe R, Langhorst P. Phase transitions in the common brainstem and related systems investigated by nonstationary time series analysis. J Auton Nerv Syst 2000; 78: 141-157.
    CrossrefPubMedGoogle Scholar
  • 41 Takahashi F, Abe A, Isobe Y, Aizawa Y, Hanada N. Assessment of malocclusion of Japanese junior high school pupils aged 12-13 years in Iwate prefecture according to the Dental Aesthetic Index (DAI). Asia Pac J Public Health 1995; 8: 81-84.
    CrossrefPubMedGoogle Scholar
  • 42 Hensel E, Born G, Körber V, Altvater T, Gesch D. Prevalence of defined symptoms of malocclusion among probands enrolled in the Study of Health in Pomerania (SHIP) in the age group from 20 to 49 years. J Orofac Orthop 2003; 64: 157-166.
    CrossrefPubMedGoogle Scholar
  • 43 Helm S, Petersen PE. Individual changes in malocclusion from adolescence to 35 years of age. Acta Odontol Scand 1989; 47: 211-216.
    CrossrefPubMedGoogle Scholar
  • 44 Zhang M, McGrath C, Hägg U. The impact of malocclusion and its treatment on quality of life: a literature review. Int J Paediatr Dent 2006; 16: 381-387.
    CrossrefPubMedGoogle Scholar
  • 45 Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleve Clin J Med 2009; 76: S13-S17.
    CrossrefPubMedGoogle Scholar
  • 46 Greiser KH, Kluttig A, Schumann B, Swenne CA, Kors JA, Kuss O, Haerting J, Schmidt H, Thiery J, Werdan K. Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002-2006. Eur J Epidemiol 2009; 24: 123-142.
    CrossrefPubMedGoogle Scholar
  • 47 Sato N, Miyake S, Akatsu J, Kumashiro M. Power spectral analysis of heart rate variability in healthy young women during the normal menstrual cycle. Psychosom Med 1995; 57: 331-335.
    CrossrefPubMedGoogle Scholar
  • 48 Landén M, Wennerblom B, Tygesen H, Modigh K, Sörvik K, Ysander C, Ekman A, Nissbrandt H, Olsson M, Eriksson E. Heart rate variability in premenstrual dysphoric disorder. Psychoneuroendocrinology 2004; 29: 733-740.
    CrossrefPubMedGoogle Scholar