Salivary opiorphin as a potential non-invasive biomarker for dental anxiety

Dental anxiety remains a major challenge in clinical dentistry, often preventing patients from seeking necessary treatment and compromising oral health outcomes. Although psychological scales such as Corah's Dental Anxiety Scale are widely used to assess anxiety, objective biochemical markers could provide valuable complementary information. Opiorphin, an endogenous peptide known for its analgesic and antidepressant-like effects, has recently emerged as a potential biomarker for stress and pain regulation. However, the role of Opiorphin in dental anxiety remains largely unexplored; therefore, to the best of our knowledge, the present investigation represents an initial effort to address this gap in the literature. This study aimed to estimate salivary opiorphin levels in patients undergoing routine dental checkups and examine their correlation with anxiety levels using Corah's Dental Anxiety Scale. Additionally, it sought to evaluate the relationship between salivary opiorphin and the established dental anxiety biomarker, salivary alpha-amylase.

Fifty-six adult participants aged 20-60 years who reported for routine dental checkups without associated pain, systemic illness, or recent analgesic use were enrolled. Corah's Dental Anxiety Scale was used to evaluate anxiety, and unstimulated saliva samples were collected. Opiorphin levels were quantified using a human opiorphin ELISA kit, while salivary alpha-amylase activity was determined using a human AMY1 ELISA kit.

A strong, statistically significant positive correlation was found between anxiety scores and salivary opiorphin levels, whereas no significant relationship was observed with salivary alpha-amylase.

These findings indicate that salivary opiorphin may serve as a novel, non-invasive biomarker for dental anxiety, offering new avenues for early detection and individualized management of anxious patients.