Salivary Cortisol as a Stress Biomarker in Oral Surgical Treatment

Aim of the study is to evaluate the biochemical and psychological characteristic of the stress in the oral-surgical manipulations by investigating the level of the salivary cortisol and using the scale for self-assessment of the Dental Anxiety Scale /DAS/.

 

Material: The study includes two groups of randomly selected volunteers – males and females, corresponding to the inclusion and exclusion criteria. The experimental group includes a total of 54 subjects (21 males and 30 females), at a mean age of 37,24±1,85 years, which were subject of ambulatory oral surgical procedures. The control group consists of 59 people (29 males and 30 females) at a mean age of 37,78±1,41 years. The volunteers are randomly selected by inclusion and exclusion criteria.

 

Methods: The collection of unstimulated saliva was carried out at the same time of the day, in the interval between 10:00-12:00 am, because of the circadian rhythm of the cortisol secretion. The dental anxiety was assessed by the scale of N. Corah-Dental Anxiety Scale /DAS/. The concentration of the salivary cortisol was determined with a electrohemiluminescence method with Elecsys Cortisol Reagent Kit, Roche, Switzerland.

 

Results and discussion: A statistically significant difference in the level of the salivary cortisol and the studied clinical indices between the experimental and the control group was established: cortisol P <0,001 (14,37±1,36 and 5,31±0,51); systolic arterial pressure P<0,01 (128,78±2,71 and 119,94±1,81); diastolic arterial pressure P<0,05 (84,90±1,46 and 80,27±1,17); pulse rate P<0,01 (82,53±1,98 and 74,65±1,27). There was no correlation between the level of the anxiety and the salivary cortisol in the experimental group, but a significate association between the cortisol level, the pulse rate and the diastolic arterial pressure was found.

 

Conclusion: The difference in the level of the cortisol between the groups is a clear evidence of the experienced stress, and this should be keep in mind, especially in patients with accompanied deseases. Our study is the first report in the country regarding the biochemical investigation of the stress from the dental treatment by salivary cortisol and is a precondition for further studies of this problem.