Influence of dental extraction on patient’s stress and anxiety levels by assessing the salivary cortisol concentration at different time points during the extraction procedure

Abstract

The aim of our study was to analyze the stress and anxiety in patients undergoing
routine dental extraction, by the assessment of cortisol in saliva, which can be
considered as one of the major hormones that is released during stressful events.
After obtaining the ethical approval and the patients were consented for their role
in this study, we examined 26 patients (13 males, and 13 females).The age ranged
from 29-42 with mean age of 36.2. We collected three salivary samples from each
patient after asking him to chew on a cotton roll to stimulate salivary secretion. The
first sample was obtained 10 minutes prior to local anesthetic injection, the second
sample collected 6-8 minutes after the local anesthetic injection, and third sample
acquired 10-15 minutes post-extraction. The samples were assessed and analyzed
using ELISA immunoassay (competitive inhibition enzyme immunoassay technique).
Statistical analysis was performed using SPSS statistical software (version
19).ANOVA and t-test were applied to obtain the significance and correlation
between the examined samples.
Significant difference was shown among the three samples (P-Value =0.002).
The mean value in the third sample (post-extraction salivary sample) was
considerably high when compared to the other samples (Mean ± SD = 0.184± 0.184,
0.307 ± 0.121 and 0.357 ± 0.141) respectively, which positively correlates with the
patient’s level of stress. Cortisol concentration in μg/dl in percentages between each
sample and the percentages, 50%, were0.105 μg/dl, 0.295 μg/dl and 0.410 μg/dl, (75
%) were0.348 μg/dl, 0.410 μg/dl and 0.443 μg/dl and (90%), 0.443 μg/dl, 0.468 μg/dl
and 0.518 μg/dl.
Our study revealed that salivary cortisol is within its highest levels after extraction
in 15 minutes.