Assessment of dental anxiety by physiological measurement (salivary cortisol) and psychological measurement (dental anxiety scale) in children


Dental anxiety is considered one of the most common sources of fear and anxiety that cause activation of adrenal gland to increase secretion of cortisol hormone. The aims of the present study are: measurement of the level of dental anxiety by physiological measurement (cortisol level in saliva) and psychological measurement (dental anxiety scale (DAS); evaluation of the stress response during several stages of dental treatment; assessment of the effects of dental anxiety on the oral health status of the child; and evaluation of factors that could affect dental anxiety in the children. The studied group included 85 children, aged between 9-13 years, 39 female, 46 male, selected from patients attended to the Dental Preventive Health Center in Al-Kadhimiya City, accompanied by the mother. Interviewing with each child's mother were conducted including a questionnaire about different variables affect dental anxiety, then another interviewing with each child including (DAS). Then saliva samples were collected from the children at the waiting room. All children received dental treatment according to their chief complaint, except 15 children, they received amalgam restoration under local anesthesia and saliva samples were collected from them during different stages of the treatment:1. After anesthetic injection, 2. After cavity drilling, 3. At the end of the treatment.The control group included 30 children, from them saliva samples had been collected in their school away from dental fear. A highly significant difference in the level of salivary cortisol was found between control and studied group and a significant correlation was observed between DAS scores and salivary cortisol level at the waiting room which indicates that both of these two methods are valid and can be used as a tool for the assessment of dental anxiety. Anesthetic injection was associated with a higher increase in the level of salivary cortisol. Patients reported high scores in DAS, have less filled, more decayed surfaces and more plaque accumulation than those who reported low scores in the scale. It is found that anesthetic injection, and pain associated with dental treatment is the most common sources and reasons for dental anxiety, so the dentist must decrease or eliminate any procedure that provoke anxiety and fear because of its effect on later perception of the child to the dentistry in general.