CODS Journal of Dentistry

Register      Login

VOLUME 12 , ISSUE 1 ( January-June, 2020 ) > List of Articles


Salivary Cortisol: A Biomarker for Stress Indicator in Children

S Prathibha Rani, C Amrutha, A Anantharaj, P Praveen, R Sudhir

Keywords : Anxiety scales, Children, Dental anxiety, Oral cavity, Salivary cortisol, State-trait anxiety score

Citation Information : Rani SP, Amrutha C, Anantharaj A, Praveen P, Sudhir R. Salivary Cortisol: A Biomarker for Stress Indicator in Children. CODS J Dent 2020; 12 (1):7-10.

DOI: 10.5005/jp-journals-10063-0064

License: CC BY-NC 4.0

Published Online: 05-04-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Aim and objective: To assess the child\'s anxiety level for various dental procedures using a standard questionnaire and by measuring the salivary cortisol level. Study design: Cross-sectional study. Materials and methods: A sample of 24 healthy children (8–10 years) visiting the Department of Pedodontics and Preventive Dentistry, DAPM RV Dental College, Bengaluru were selected. They were divided into three groups: group I—eight children having their first dental visit, group II—eight children requiring oral prophylaxis after their first visit, group III—eight children requiring extraction of 1 or 2 teeth after their first visit. Levels of dental anxiety were assessed in children using the State-Trait Anxiety Inventory for Children State (STAIC-S) before and after the treatment. Salivary cortisol was assessed in children before and after the treatment using the ELISA test. Statistical analysis used: Student paired t-test was used to compare the mean anxiety score and cortisol levels between pre- and post-time intervals for different procedures within the child group. Results: In children, the mean anxiety score was reduced after the treatment. There was a proportionate decrease in the mean anxiety level among children irrespective of the procedure. Also, there was a reduction in the cortisol level from pre- to post-procedure among children. Conclusion: Assessment of cortisol level in children could be a significant factor that can be used as one of the physiological parameters for various dental procedures.

PDF Share
  1. Ter Horst G, De Wit CA. Review of behavioural research in dentistry 1987-1992: dental anxiety, dentist-patient relationship, compliance and dental attendance. Int Dent J 1993;43(3 Suppl 1): 265–278.
  2. Karibe H, Aoyagi-Naka K, Koda A. Maternal anxiety and child fear during dental procedures: a preliminary study. J Dent Child (Chic) 2014;81(2):72–77.
  3. Seltzer MM, Greenberg JS, Hong J, et al. Maternal cortisol levels and behavior problems in adolescents and adults with ASD. J Autism Dev Disord 2010;40(4):457–469. DOI: 10.1007/s10803-009- 0887-0.
  4. Nilsson S, Buchholz M, Thunberg G. Assessing children's anxiety using the modified short state-trait anxiety inventory and talking mats: a pilot study. Nurs Res Pract 2012;2012:932570. DOI: 10.1155/2012/932570.
  5. Patil SJ, Shah PP, Patil JA, et al. Assessment of the changes in the stress-related salivary cortisol levels to the various dental procedures in children. J Indian Soc Pedod Prev Dent 2015;33(2):94–99. DOI: 10.4103/0970-4388.155116.
  6. Papay JP, Costello RJ, Hedl JJ, et al. Effects of trait and state anxiety on the performance of elementary school children in traditional and individualized multiage classrooms. J Educ Psychol 1975;67(6):840–846. DOI: 10.1037/0022-0663.67.6.840.
  7. Kirschbaum C, Hellhammer DH. Salivary cortisol. In: Fink G, ed. Encyclopedia of stress, vol. 3, San Diego, CA: Academic Press; 2000. pp. 379–384.
  8. Miller CS, Dembo JB, Falace DA, et al. Salivary cortisol response to dental treatment of varying stress. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endodontol 1995;79(4):436–441.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.