Salivary Alpha Amylase, Dental Anxiety, and Extraction Pain: A Pilot Study

The primary intention of this study was to determine whether salivary alpha-amylase (sAA) factors or the Dental Anxiety Scale (DAS) was a better predictor of dental extraction pain. This study followed a cross-sectional design and included a convenience sample (n = 23) recruited from an outpatient oral surgery clinic. While waiting for their scheduled appointments, consenting patients completed both basic demographic/medical history questionnaires and Corah's DAS as well as submitted sublingual saliva samples. After their extractions, patients marked visual analog scales (VAS) to indicate the intensity of their intraoperative discomfort. Results of this study confirm that there is a relationship between a patient's dental anxiety and intraoperative extraction pain (r[21] = .47, P = .02). This study did not find that preoperative sAA factors (concentration and output rate) were related to either VAS extraction pain or DAS score. A strong positive relationship was observed between the concentration of sAA and the rate of sAA output (r[21] = .81, P < .001). Based on the results of our study, we conclude that dental anxiety has a moderate but significant correlation with intraoperative dental pain. Factors of sAA do not appear to be predictive of this experience. Therefore, simply assessing an anxious patient may be the best indication of that patient's extraction pain.