Abstract
BackgroundThe purpose of this study was to assess the salivary cortisol and salivary alpha-amylase levels in children aged between 6 and 9 years, 3 months and 1 year after the successful completion of dental treatment through either pharmacological or non-pharmacological behavior management techniques.MethodsA total of 1567 patients aged between 6 and 9 years who had completed dental treatment were screened. A total of 703 patients who were caries free at the end of 3 months were classified based on Frankl behavior score and administered the Arabic version of the Children’s Fear Survey Schedule- Dental Subscale (CFSS-DS) and accordingly allocated to one of three groups; (Phobic Patients, Anxious Patients, Control Group). A total of 183 patients met the inclusion criteria and were followed up for 1 year. A total of 151 patients completed the study. Patients’ heart rate on recall, salivary cortisol and salivary amylase were compared between the groups.ResultsThe results of the study showed that amylase and cortisol levels had a significant association with the level of dental fear. The phobic patients had the highest levels of salivary amylase and salivary cortisol levels with no significant associations observed with either heart rate or extent of dental treatment. Control and anxious patients had significantly lower amylase levels when compared to phobic patients. There was no significant difference between the salivary cortisol levels of anxious and phobic patients. These findings were replicated on 1-year recall.ConclusionsWithin the limitations of this study we can conclude that salivary amylase is an indicator of of acute stress that can differentiate between anxiety and dental fear; while salivary cortisol appears to be a marker of long-term stress that lacks the sensitivity to differentiate between the two.
Highlights
The purpose of this study was to assess the salivary cortisol and salivary alpha-amylase levels in children aged between 6 and 9 years, 3 months and 1 year after the successful completion of dental treatment through either pharmacological or non-pharmacological behavior management techniques
Specific phobia is defined by the Diagnostic and Statistical Manual for mental disorders (DSM- V) as being fearful or anxious about, or avoidant of, circumscribed objects or situations [4]
The aim of this study was to evaluate salivary cortisol and alpha amylase levels in patients who are not afraid of the dentist, patients who have overcome their fear of the dentist through behavior management and patients who cannot be managed by non-pharmacological behavior management
Summary
The purpose of this study was to assess the salivary cortisol and salivary alpha-amylase levels in children aged between 6 and 9 years, 3 months and 1 year after the successful completion of dental treatment through either pharmacological or non-pharmacological behavior management techniques. The study of fear remains, to a large extent, based on subjective analyses and questionnaires. Specific phobia is defined by the Diagnostic and Statistical Manual for mental disorders (DSM- V) as being fearful or anxious about, or avoidant of, circumscribed objects or situations [4]. There have been attempts made to study the development of dental phobia and the change in phobic behavior according to the age of the child [6,7,8]. Researchers agree that there is a strong relationship between dental fear and the normal cognitive and psychological development of individuals [9, 10]. Children aged between 6 and 9 years have begun the process of cognitive development and exhibit both anxiety and phobia. Behavioral scientists have used this age group previously for the analysis of phobias and behavioral problems [11, 12]
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