Salivary cortisol: a marker of anxiety in response to different dental treatment procedures: A cross sectional study

Abstract

Aim: To evaluate and compare the levels of salivary cortisol prior to, during, and after different forms of dental treatment. Materials and Methods: An in-vivo cross-sectional study was designed to study saliva samples from a group of 70 subjects who reported to the Dental Outpatient Department for the estimation of salivary cortisol. The subjects were grouped into seven treatment groups and the sample size was estimated to be 10 per group (at 80% power and 5% α-error) based on the results from a previous study done by Carmen Benjamins, HenkAsscheman, and Albert H. B. Schuurs. All subjects were administered the Modified Dental Anxiety Scale. Unstimulated saliva was collected prior to, during, and at the end of the treatment procedure and assessed for salivary cortisol concentration by ELISA. Chi-square test was used to check for association between the independent variables and the mean salivary cortisol levels. ANOVA was used to estimate the variation in salivary cortisol levels across the three time periods in each of the treatment groups. Results: The mean salivary cortisol concentrations were highest in the prophylaxis group (12.16 ± 4.00) followed by extraction (9.77 ± 3.92) and the endodontics group (8.69 ± 7.81). ANOVA revealed that there was statistical significance for the mean cortisol levels across the time intervals in the examination, prophylaxis, and extraction group alone. Conclusion: The study reported maximum mean cortisol levels in the prophylaxis and extraction group. Also, maximum association between the time factor and cortisol concentrations was observed in the examination, extraction, and prophylaxis groups.