Salivary cortisol-marker of stress response to different dental treatment

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 antioxidant capacity (TAC) using the spectrophotometric assay, also called "Trolox equivalent antioxidant capacity" (TEAC). This method is an adaptation of the ABTS assay.

Cortisol levels are influenced by the duration and types of treatment and anesthesia. The results indicate that saliva of healthy individuals is significantly more effective than that of patients with periodontal diseases in scavenging a wide variety of generated free radicals.

Within the limits of this study, there is a relationship between salivary cortisol levels, time and intensity of various dental treatment procedures. Periodontal diseases are associated with oxidative stress and a defect in the total antioxidant activity of saliva.