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 undergoingroutine dental extraction, by the assessment of cortisol in saliva, which can beconsidered as one of the major hormones that is released during stressful events.After obtaining the ethical approval and the patients were consented for their rolein this study, we examined 26 patients (13 males, and 13 females).The age rangedfrom 29-42 with mean age of 36.2. We collected three salivary samples from eachpatient after asking him to chew on a cotton roll to stimulate salivary secretion. Thefirst sample was obtained 10 minutes prior to local anesthetic injection, the secondsample collected 6-8 minutes after the local anesthetic injection, and third sampleacquired 10-15 minutes post-extraction. The samples were assessed and analyzedusing ELISA immunoassay (competitive inhibition enzyme immunoassay technique).Statistical analysis was performed using SPSS statistical software (version19).ANOVA and t-test were applied to obtain the significance and correlationbetween 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) wasconsiderably 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 thepatient’s level of stress. Cortisol concentration in μg/dl in percentages between eachsample 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/dland 0.518 μg/dl.Our study revealed that salivary cortisol is within its highest levels after extractionin 15 minutes.