Salivary catecholamine assay for assessing anxiety in pediatric dental patients

For the behavioral management of pediatric dental patients, it is important to estimate the degree of anxiety during dental treatment. The purpose of this study was to investigate salivary catecholamine levels in children undergoing dental treatment and to assess the degree of anxiety at each dental procedure. The salivary norepinephrine (NE) level was not influenced by a subcutaneous injection of 50 micrograms of NE in 6 adult volunteers, suggesting a poor diffusive effect of plasma NE into the salivary gland. The salivary NE and epinephrine (E) were measured in 8 children between the ages of 3 and 7 years who underwent restorative dental procedures. Salivary NE significantly increased when the children lay on a dental chair and subsequently received infiltration anesthesia. The salivary E level did not show a significant change throughout the study. After the treatment, salivary NE returned to the pretreatment level. These findings suggest that the increase in salivary NE before infiltration anesthesia reflects enhanced peripheral NE release as a result of stress-induced sympathetic responses and that salivary NE assay is useful for the assessment of dental anxiety in children.