Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2015, vol. 52, nr 4, October-December, p. 408–414

doi: 10.17219/dmp/59574

Publication type: original article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Salivary Cortisol Measurement as a Test for Dental Anxiety Before Tooth Extraction

Ocena stężenia kortyzolu w ślinie dla oceny stresu pacjenta przed zabiegiem ekstrakcji zęba

Joanna Jakiel1,B,C,D, Anna Szyszkowska1,A,E,F, Joanna M. Szczerba-Gwóźdź1,B,C, Michał Mełges1,A,B,C,D, Mansur Rahnama2,E

1 Department of Oral Surgery, Medical University of Lublin, Lublin, Poland

2 Department of Oral Surgery Medical University of Lublin, Lublin, Poland

Abstract

Background. Dental procedures are a source of anxiety, which is why most patients consider dental treatment unpleasant. Cortisol is a steroid hormone with wide effects on metabolism. Increased cortisol concentration is observed in stressful situations.
Objectives. The aim of the study was to evaluate the level of anxiety before tooth extraction, both in patients’ subjective opinion as well as in cortisol concentration in patients’ saliva before the procedure.
Material and Methods. Saliva for the examination of cortisol concentration was gathered from 44 patients (21 males and 23 females) before tooth extraction. The control group consisted of 31 persons between the ages of 18 and 64 (11 males and 20 females). The Corah’s Dental Anxiety Scale (CDAS) was used to estimate dental fear. Cortisol concentration was determined by means of electrochemiluminescence (ECLIA).
Results. The average cortisol concentration in patients’ saliva before tooth extraction was 0.50 ± 0.23 μg/dL which is within the 0.04 μg/dL – 1.23 μg/dL range. The average cortisol level in saliva in the control group was 0.18 ± 0.10 μg/dL. The difference in cortisol concentration between both groups was statistically significant. Statistical analysis of cortisol concentration in different age groups showed no significant correlation between the concentration of cortisol and age. No statistically significant difference in cortisol concentration before tooth extraction in women and men was noticed. The concentration of cortisol in men had more often extreme values, which is different from the results obtained in women. The highest concentration of salivary cortisol was found in the group declaring low level of anxiety by CDAS. However, there was no statistically significant correlation between salivary cortisol and level of anxiety measured by CDAS.
Conclusion. Increased salivary cortisol concentration showed patients’ anxiety before tooth extraction. The level of anxiety declared by patients before tooth extraction did not show any significant correlation with salivary cortisol concentration.

Key words

cortisol, saliva, dental anxiety

Słowa kluczowe

kortyzol, ślina, lęk dentystyczny

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