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Comparison of Anxiety Levels with Salivary Cortisol Levels in Patients Undergoing Endodontic and Restorative
Alev Ercan1, Tufan Ozasir2, Birgul Ozasir2
1Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey, alevercan@baskent.edu.tr.
Abstract:
Objectives: This clinical within-subjects study aimed to compare patients' stress levels at the beginning and end of endodontic treatment (ET) and restorative treatment (RT) and to examine whether a correlation exists between dental anxiety levels, as measured by anxiety assessment tests, and cortisol levels obtained from saliva.
Subjects And Methods:
Forty-four patients who required ET and RT on a maxillary premolar were selected. They were asked to complete the Corah's Dental Anxiety Scale (CDAS) before and after each treatment phase. Saliva samples were collected and analysed to determine their salivary cortisol levels using validated liquid chromatography-tandem mass spectrometry. Intragroup comparisons of the CDAS scores and salivary cortisol levels were conducted using the Wilcoxon signed-rank test, while intergroup comparisons were performed using the Mann-Whitney U test. Correlations were assessed using Spearman's method.
Results:
Statistically significant reductions were observed in the CDAS scores and cortisol levels during treatment. Specifically, the CDAS scores significantly decreased from the pre-ET phase to the post-ET phase (p = 0.004), and from the pre-RT phase to the post-RT phase (p < 0.001). Additionally, the salivary cortisol levels after the post-RT phase were significantly lower than in both the pre-RT and pre-ET phases (p < 0.001).
Conclusion:
Although the patients reported higher anxiety levels before ET than RT, the absence of a control condition and the time gap between the sessions limited the interpretation of these findings and prevented definitive causal conclusions. No statistically significant correlation was found between the CDAS scores and the cortisol levels.
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