Evaluation of Dental Anxiety in Children by Estimating the Salivary Cortisol Levels before and after Dental Procedures

Abstract

Aim: Dental procedures in general range from simple examination to complex stressful procedures like extractions. This can cause varied levels of anxiety in children based on the severity and duration of the procedure. This study was designed with the aim to assess changes in salivary cortisol levels due to the various dental procedures carried out in children.
 Materials and Methods: The sample consisted of a total of 30 children of the 5-9 age group whose parents consented to examination and further treatment. Children who had been given a Frankl score of positive (+) or definitely positive (++) upon initial examination were only included in the study. Children with negative (-) and definitely negative (--) Frankl scores, any history of systemic diseases, on corticosteroid therapy, having fever, or medically compromised were excluded from the study. Unstimulated saliva was collected before and after the procedure and was analysed using ELISA. The data collected was statistically analysed and assessed for significance.
 Results: Out of the 30 children 17 were boys and 13 were girls and the difference was statistically insignificant. There was no significant difference in age between the genders (P = 0.12). Paired t - test was done to analyse the intra group data and ANOVA test was done to compare between the groups. Compared to the three procedures restorative was least stressful whereas extractions were most stressful and this result was statistically significant. 
 Conclusions: Within the limitations of this study, we can conclude that salivary cortisol is a good indicator of acute stress. Extraction procedures seem to be the most stressful of all the procedures.