Evaluation of stress in final-year Saudi dental students using salivary cortisol as a biomarker

The aims of this study were to identify the perceived sources of stress in final-year dental students studying in a private dental school in Riyadh, Saudi Arabia, using a modified dental environmental stress (DES) scale and to correlate these findings, at various times in the semester, with the level of acute stress measured with salivary cortisol as a biomarker. A total of forty final-year students were administered a modified DES questionnaire consisting of twenty-five questions to determine the perceived causes of stress. Salivary cortisol levels during the first week of the semester, the final week of clinical training, and one hour before the final didactic examination were assessed. Baseline cortisol levels were significantly lower than the cortisol levels in the clinic, and both these values were significantly lower than the salivary cortisol levels before the examination (p<0.001). Comparison of cortisol levels to the perceived sources of stress and demographic data collected showed that certain discrepancies may exist between the perceived and actual stress felt by dental students at different times in the academic semester.