Salivary cortisol: Biomarker for stress during routine dental extractions - A prospective comparative study

Dental procedures, including routine extractions, can induce psychological stress and activate the hypothalamic-pituitary-adrenal axis (HPAA), leading to increased cortisol levels. Therefore, it is of interest to evaluate salivary cortisol as a biomarker of stress in 15 healthy male patients aged 30-50 years undergoing simple extraction of single-rooted teeth. Saliva samples were collected 30 minutes before and 30 minutes after the procedure between 10:00 AM and 2:00 PM to minimize diurnal variation and cortisol levels were estimated using enzyme-linked immunosorbent assay. The mean salivary cortisol level increased significantly from 19.27 ± 10.27 ng/mL before extraction to 51.27 ± 10.75 ng/mL after extraction (paired t-test, p < 0.001). Thus, we show that salivary cortisol is a reliable non-invasive biomarker for assessing acute stress associated with routine dental extractions.