Clinical
InquirySalivary cortisol as a measure of dental anxiety
Section snippets
Background
Nine percent of the child and adolescent population exhibit dental fear/anxiety and dental behavior management problems (DBMP). Most of these children or adolescents are referred to pediatric dental specialists who are trained to manage young patients. Various scales have been used to measure children’s psychological characteristics, but these have been subjective instruments. Interest in an objective measurement such as salivary biomarkers is growing. Stressor stimulus activates the
Methods
A single pediatric dentist performed dental prophylaxis (DP) with a rubber cup and pumice, then did a dental examination in 39 children age 2 to 5 years before a dental sedation appointment. The saliva of each child was sampled upon waking (UW), on arrival at the dental office reception area (RA), and 25 minutes after the dental prophylaxis (DP). These samples were compared using an enzyme immunoassay kit.
Results
The children’s mean decayed-missing-filled tooth (dmft) index was 7.15, and the dental examination lasted a mean of 10.4 minutes. Thirty-six of the 39 children had tooth decay that required restoration, pulp therapy, or extraction. Twenty-six of the children exhibited some protest behavior during the dental examination, but fewer than half of these required restraint by the parents to have the dental examination completed.
The salivary cortisol levels varied throughout the examination. When the
Discussion
DP is considered a nonstressful procedure to introduce children with no history of dental treatment or dental pain to the dental experience. However, this study indicates that prophylaxis with a rubber cup at low speed increases the stress level, as determined by salivary cortisol measurements, of children with DBMP. Stress level was associated with toothache, no previous dental treatment, protest behavior, and protective measures taken by parents during the dental examination.
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Gomes HS, Cieira LAC, Costa PS, et al: Professional dental prophylaxis increases salivary cortisol in children with dental behavioural management problems: A longitudinal study. BMC Oral Health 16:74, 2016
Reprints available from LR Costa, Departamento de Saúde Oral, Faculdade de Odontologia/UFG, Av. Universitária Esquina com 1a Avenida s/n, Setor Universitário, CEP: 74605-220 Goiânia, GO, Brazil; e-mail: [email protected]