Salivary Cortisol as a Stress Monitor During Third Molar Surgery (original) (raw)
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The British journal of oral & maxillofacial surgery, 2015
We measured changes in the salivary concentrations of cortisol as an index of stress, and to find out if patients were stressed during routine intra-alveolar dental extractions. A total of 126 patients (63 experimental and 63 controls) matched for age and sex with a mean (SD) age of 26 (5) years (range 18-40) were recruited. Samples of saliva from patients whose glands had not been stimulated were collected twice from the study group (30minutes before, and 10minutes after, the procedure) and once from the control subjects. All samples were collected between 10.00 and 14.00hours to standardise the method and control for the diurnal variation of cortisol. There was a slight but not significant increase in the mean salivary concentration of cortisol between the preoperative samples (mean (SD) 12.3 (1.5)ng/ml and the postoperative samples 12.8 (2.3)ng/ml in the study group) and the control 8.7 (1.0)ng/ml. However, there was no difference between the sexes. The study highlights a simple ...
UNIVERSITY JOURNAL OF DENTAL SCIENCES
Aims and objective: Anxiety ,fear and pain assessment is essential in day to day Dental practice .The present study evaluated the stress related salivary cortisols levels induced during scaling,tooth preparation and surgical flap elevation in Periodontally compromised subjects Methodology: The salivary cortisol level were assessed in 80 patients ,out of which 40 patients were healthy patient who do not require any Dental treatment and 40 patients who underwent Scaling , tooth preparation and surgical flap elevation in Periodontally compromised subjects The groups divided were as follows . Group 1: control group with no treatment and just the saliva sample was taken. Group 2; The patients underwent scaling Group 3; The patients underwent tooth preparation for fixed prosthesis Group 4; The patients underwent surgical flap elevation in Periodontally compromised situation .The salivary cortisol levels were assessed using Salivary Cortisol Enzyme Immunoassay Kit. Results: The sal...
Estimation of salivary cortisol among subjects undergoing dental extraction
Journal of clinical and experimental dentistry, 2018
Dental procedures can be stressful and studies have shown that salivary cortisol is elevated during such procedures. Our study aimed to evaluate saliva cortisol levels among the subjects who underwent dental extractions and to compare it with that of the controls. The secondary objective of the study was to evaluate any correlation between salivary cortisol and hemodynamic parameters. We conducted this clinical study among subjects, who were indicated for dental extraction. Saliva samples from the subjects in the study group were collected before and after (10 mins) the dental extraction. Hemodynamic parameters like heart rate, systolic (SBP) and diastolic blood pressure (DBP) and oxygen saturation (Sp O2) were measured 10 minutes prior to the dental extraction and after completion of the extraction by a single trained examiner. Salivary cortisol was estimated by solid phase enzyme-linked immunosorbent assay (ELISA). A total of 31 subjects in the study group and 24 subjects in contr...
Nigerian Journal of Clinical Practice, 2015
Background and Objective: A postextraction comparative (cohort) study was carried out to determine whether the number of teeth extracted has an effect on salivary cortisol and by extension on stress. Subjects and Methods: Sixty-three consecutive patients comprising 27 males (42.9%) and 36 females (57.1%) with a male: female ratio of 1:1.3, divided into two groups of A and B with a mean age of 25.8 ± 4.9 years, and age range of 18-37 years took part in the study. Fifty (79.4%) of them in group A (22 males and 28 females) each had a tooth extracted while 13 (20.6%) in group B (5 males and 8 females) had two teeth removed. One ml of resting saliva was collected from each patient 10 minutes after the procedure and analyzed for cortisol. All extractions and sample collections were done between 10 am and 2 pm to standardize the study and control for the diurnal variation of cortisol. Statistical analysis of the generated data was performed by using Student's t-test on SPSS version 17.0. The level of significance was set at 0.05 with P < 0.05 regarded significant. Result: The result showed mean salivary cortisol level of 12.914 ± 2.4684 ng/ml for group A and 12.108 ± 1.7192 ng/ml for group B though not statistically significant (P > 0.05). Females had more extractions in the two groups when compared with males. Male gender had a statistical significance difference (P < 0.05). Conclusion: This study shows that the number of teeth extracted did not have effect on mean salivary cortisol, as a result two teeth extraction does not impart more stress to the patient when compared with one, and as such no additional adjuvant stress relieving measures are needed in two teeth extractions.
Salivary Cortisol Measurement as a Test for Dental Anxiety Before Tooth Extraction
Dental and Medical Problems, 2015
Dental procedures are a source of anxiety for many people. Most patients consider dental appointments unpleasant [1]. Dental anxiety is considered to be a natural reaction of the body, and its origin is multifactorial. Fear of pain which the patient may experience in the dental office is a major cause of anxiety. Other factors that may cause anxiety are noise and vibration of dental drills, the appearance of dental instruments, bad taste and odor of drugs, immobilization in dental chair, and lack of information about the treatment. Anxiety or fear associated with dental procedures is a source of patient's oral problems and it makes it difficult for the physician to perform surgery [2, 3].
Salivary cortisol as a peripheral biomarker of stress in surgical patients
Journal of Medical Biochemistry, 2023
Background: Surgical stress and pain result in activation of hypothalamus-pituitary-adrenal axis. The aim of this study was to establish the effects of postoperative pain and various modalities of analgesic administration on salivary and serum cortisol levels, as well as to establish the validity of salivary cortisol as a stress indicator in surgical patients. Methods: A randomized controlled trial involved 60 patients scheduled for elective abdominal aortic aneurysm surgery. Patients were randomly divided into two groups depending on the model of postoperative analgesia. The first group (MI-morphine intermittently) included patients given morphine doses 0.1 mg/kg/6h s.c. intermittently. The second group (MPCA-morphine patient-controlled analgesia) included patients who received morphine via the PCA system-intravenous administration of morphine adjusted to a dose of 1 mg per shot and a lockout interval of 6 minutes. Results: The intensity of pain did not significantly vary until the hour 10 post-surgery. However, in the period from hour 10 to hour 18 post-surgery, higher intensity of pain was reported in group MPCA (P < 0.05). Hemodynamic instability was more prevalent in the MI group (40.0% vs 6.7%, P = 0.0048). Serum cortisol levels were almost identical in both groups (MI 509.4 nmol/L vs MPCA 511.0 nmol/L, P = 0.1473). Higher values of salivary cortisol were recorded Kratak sadr`aj Uvod: Hirur{ki stres i bol su uzrok aktivacije hipotalamusno-hipofizno-nadbubre`ne osovine. Cilj ove studije bio je da se utvrdi uticaj postoperativnog bola i razli~itih vidova administracije analgetika na vrednosti kortizola u serumu i salivi, kao i da se utvrdi da li je salivarni kortizol dobar pokazatelj stresa kod hirur{kih pacijenata. Metode: Randomizovana kontrolisana studija koja je ukljuila 60 pacijenata primljenih za elektivnu operaciju aneurizme abdominalne aorte. Pacijenti su metodom slu~ajnog izbora podeljeni u dve grupe u zavisnosti od modela postoperativne analgezije. Prvu grupu (MI-intermitentna primena morfina) su ~inili pacijenti koji su dobijali morfin intermitentno u dozi od 0.1 mg/kg/6h s.c. U drugoj grupi (MPCA-analgezija morfinom kontrolisana od strane pacijenta) su bili pacijenti koji su dobijali morfin takozvanom PCA metodom-intravenska primena morfina 1 pritisak/1 mg, interval 6 minuta. Rezultati: Intenzitet bola se nije zna~ajno razlikovao do desetog sata nakon operacije. Me|utim, u periodu od desetog do osamnaestog sata nakon operacije bol je bio izra`eniji u MPCA grupi (P < 0.05). Hemodinamska nestabilnost je bila zastupljenija u grupi MI (40.0% vs 6.7%, P = 0.0048). Serumski kortizol bio je gotovo identi~an po grupama (MI 509.4 nmol/L vs MPCA 511.0 nmol/L, P = 0.1473). Salivarni kortizol je bio vi{i u grupi MPCA ali raz
Salivary Cortisol Changes in Children During Dental Extractions
Journal of Evolution of Medical and Dental sciences, 2014
Dental environment may be a source of stress for young children. Such stressful conditions may provoke fear and anxiety in children. Therefore stress factor is high in children visiting dentists and this stress may increase or decrease in the subsequent visits that follow dependent upon to what they are exposed to, during these visits especially high anxiety provoking procedures like dental extractions. Cortisol, called also "stress hormone" participates in organism's response to stress situations and enters into complex interactions with the hormonal and immune system of a man. The salivary cortisol levels were investigated in 60 children who were divided into study and control groups respectively. The control group was not subjected to any treatment except for collection of saliva. Children belonging to the study group were subjected to dental extraction as indicated and were performed in three scheduled appointments. Saliva samples were collected from all the children during all the appointments. Salivary cortisol levels were evaluated using the ELISA kit supplied by Salimetrics. The results indicated that the salivary cortisol levels increased in the study group when compared to the control groups and within the study group the salivary cortisol levels in the second appointment were on a higher level when compared to the first and third appointments.
International journal of clinical pediatric dentistry
The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction. The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children. The values of cortisol and alpha-amylase showed a significant increase postextraction. Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children. Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This ca...
Salivary cortisol-marker of stress response to different dental treatment
Romanian journal of internal medicine = Revue roumaine de médecine interne, 2006
The measurement of salivary cortisol provides a stress-free, non-invasive collection procedure, which reflects the changes in the hormone plasma levels. The aims of the present study were to determine the level of stress displayed by healthy patients who underwent different types of routine dental treatment procedures and to detect a possible correlation between cortisol and oxidative stress in periodontal disease. 36 subjects took part in this study. Patients received routine dental procedures or underwent oral surgery. The physiologic stress response was determined using salivary cortisol assessment. Total antioxidant capacity of saliva and uric acid was also measured. Salivary cortisol assessment was made in whole saliva by an ELISA extraction-free technique using a Serozyme Cortisol kit (ADALTIS, Italy) for serum and urine and adapted to saliva. Method's sensibility for saliva is 0.55 ng/mL. Uric acid was measured by uricase using a kit from Diamedix and the total antioxidan...
Dental anxiety and salivary cortisol levels before urgent dental care
Journal of Oral Science, 2009
Dental anxiety is still prevalent, despite advances in treatment, and affects the utilization of health care services. The purpose of this cross-sectional study was to determine if patients with different degrees of dental anxiety and pain undergoing emergency dental care have different stress reactions as measured by salivary cortisol. Seventy three patients completed the modified dental anxiety scale (MDAS), and described any previous dental traumatic experience. Their socio-demographic characteristics were also recorded. They also rated pain intensity on a 100 mm visual analogue scale (VAS). A saliva sample was collected before the procedure, and analyzed by enzyme immunoassay. Thirty patients were dentally anxious and forty one complained of pain. In this sample, dental anxiety was not related to gender, age, educational level and family income; however, a previous traumatic event was related to dental anxiety. There was no association between salivary cortisol concentrations and gender or dental anxiety. Patients with pain showed higher cortisol levels. When gathering patient information, the dentist should note patients' negative dental experiences in order to provide more effective, less traumatic treatment.