Abstract
Dental anxiety (DA) and hair cortisol concentrations (HCC) are associated with psychological symptoms and vary during pregnancy. We aimed to examine the association between HCC and DA at two points of pregnancy. Participants were pregnant mothers (n = 533) drawn from the FinnBrain Birth Cohort Study donating a hair sample at gestational week (gwk) 24 (n = 442) and/or at delivery (n = 176) and completed questionnaires on DA. Two groups, HCC1 and HCC2, treated as separate in the analyses, were formed according to the hair sample donation time i.e., gwk24 and delivery. 85 subjects were included in both groups. MDAS, EPDS, and SCL-90 were used to measure DA, depressive and anxiety symptoms, respectively, at gwk14 for the HCC1 group and gwk34 for the HCC2 group. The association between DA and HCC was studied with a binary logistic regression model, adjusted for anxiety and depressive symptoms, age, BMI, and smoking status. Individuals with high DA had lower HCC levels at gwk24 (OR = 0.548; 95% CI = 0.35–0.86; p = 0.009), but the association was not statistically significant at the delivery (OR = 0.611; 95% CI = 0.28–1.33; p = 0.216). The independent association between HCC and DA in pregnant women suggests that long-term cortisol levels could play a role in the endogenous etiology of DA. Further studies are however, needed.
Highlights
Dental anxiety is a prevalent problem that often leads to avoidance or symptom-driven use of dental care, especially among those with high dental anxiety [1,2,3]
Dental anxiety has been associated with several psychological disorders and symptoms, such as phobias, depression, and general anxiety [8,9,10,11,12,13,14,15,16,17,18,19,20], supporting the common constitutional vulnerability and endogenous etiology
This supports the endogenous etiology of dental anxiety
Summary
Dental anxiety is a prevalent problem that often leads to avoidance or symptom-driven use of dental care, especially among those with high dental anxiety [1,2,3]. Besides exogenous sources (such as direct and indirect experiences), dental anxiety can originate from endogenous sources [6]. These internal etiological factors have been referred as a ‘constitutional vulnerability to (dental) anxiety disorders’ [7]. Of the two aspects of dental anxiety, anticipatory dental anxiety has shown a stronger association with anxiety and depression than treatmentrelated dental anxiety [20,21]. This supports the endogenous etiology of dental anxiety
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