Stress in elective dental treatment: epinephrine, norepinephrine, the VAS, and CDAS in four different procedures

This study focuses on progressive stress during defined, elective dental treatments, expressed in VAS, CDAS, and catecholamine excretion in urine. Fourteen male patients had avoided dental treatment for years; all were classified as ASA risk score I. The different dental sessions were: first visit after many years; check-up (nonpainful and nontraumatic); drilling and restoring under local anesthetics; drilling and restoring without local anesthesia; and extractions. Urine collection was performed directly before and after the sessions to measure epinephrine and norepinephrine concentrations. Anticipation stress was registered in the VAS, CDAS, and epinephrine excretion. Progressive stress was reflected in epinephrine increase, which discriminated between the different elective dental treatments.