Quantification of Salivary Chromogranin A Levels during Routine Dental Procedures in Children: An In Vivo Study

Routine dental procedures frequently involve invasive treatment, multiple injections, and the use of sharp, high-speed cutting instruments, and treatment is often extended over several visits, which are said to be stress-provoking events. Salivary chromogranin A (CgA) is a biomarker that can help clinicians evaluate and quantify the stress experienced by a child during these procedures.

To quantify the changes in salivary CgA levels in children before, during, and after routine dental procedures for multiple appointments.

Eight children, aged 6-8 years, visiting a clinic for the first time and requiring one class I restorative treatment and another treatment involving the use of local anesthesia were included in the study. Unstimulated salivary samples were collected from them during three visits-outpatient department (OPD), before, during, and after restorative treatment at the second visit, and before, during, and after treatment using local anesthesia in the third visit. The salivary samples were centrifuged, stored, and analyzed for CgA.

Salivary CgA levels showed a nonsignificant increase from 2.56 to 3.21 pmol/mg protein during the restorative treatment, followed by a nonsignificant reduction after cessation of the treatment. Whereas, salivary CgA levels before the use of local anesthesia were 1.88 pmol/mg protein, which showed a nonsignificant increase to 2.24 pmol/mg protein after its administration and progressed further to 3.27 pmol/mg protein even after the cessation of the treatment.

The use of an airotor can cause an increase in stress levels in children, and local anesthesia administration is a more stress-provoking stimulus than an airotor. Multiple visits allow desensitization, which reduces stress and anxiety. Also, salivary CgA can be used as a reliable stress indicator in children.

Vora KM, Shah PP, Patil KV, et al. Quantification of Salivary Chromogranin A Levels during Routine Dental Procedures in Children: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(5):585-590.