Stress, relaxation and saliva: a follow-up study involving clinical endodontic patients

Dentally induced stress and relaxation-induced anxiety reduction recently have been correlated with salivary changes in private patients treated by a solo endodontist. Hypnosis was shown to be more effective than local anesthesia in anxiety reduction. Dental students and clinic patients were employed in this study in an attempt to replicate the previous findings. One additional salivary variable (pH) was examined. Twenty-nine endodontic clinic patients were treated, each by a different dental student. The patients completed dental anxiety questionnaires and had salivary samples taken prior to, and at the conclusion of, their initial endodontic treatments. Pain and anxiety were managed using local anesthesia, hypnosis, or nitrous oxide-oxygen, either alone or in combination. There were significant anxiety-reduction changes by the conclusion of the visits (p less than 0.001) as measured by increased salivary volume, increased salivary translucency, reduced salivary protein, increased salivary pH and reduced questionnaire-determined anxiety level. Hypnosis and nitrous oxide-oxygen were significantly more effective (p less than 0.05) than local anesthesia in anxiety reduction as measured by salivary changes and questionnaires. It can be concluded that saliva is an easily obtained fluid that can be used to determine levels of stress and relaxation.