Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An  in vivo  Study

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Abstract

Aim

The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction.

Materials and methods

The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children.

Results

The values of cortisol and alpha-amylase showed a significant increase postextraction.

Conclusion

Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children.

Clinical significance

Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This can aid in better cooperation of the child during treatment as well as helps in internal motivation toward future dental treatment.

How to cite this article: Chaturvedi Y, Chaturvedy S, Marwah N, Chaturvedi S, Agarwal S, Agarwal N. Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An in vivo Study. Int J Clin Pediatr Dent 2018; 11(3):214-218.

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Most cited references 19

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The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis.

R M Sapolsky, L Krey, B S McEwen (1986)

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Asymmetry between salivary cortisol and alpha-amylase reactivity to stress: relation to aggressive behavior in adolescents.

Douglas Granger, Elana Gordis, P C Trickett … (2006)

This study used a multiple physiological systems measurement approach to test the hypothesis that asymmetry between the major components of the psychobiology of stress is associated with atypical behavior in youth [Bauer, A.M., Quas, J.A., Boyce, W.T., 2002. Associations between physiological reactivity and children's behavior: advantages of a multisystem approach. J. Dev. Behav. Pediatr. 23, 102-113]. Adolescents (N=67; ages 10-14; 52% male) provided 2 saliva samples before, and 4 samples after, a modified Trier Social Stress Test (TSST; Kirschbaum, C., Pirke, K., Hellhammer, D.H., 1993. The "Trier Social Stress Test": a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 28, 76-81). Samples were assayed for cortisol (C) and alpha-amylase (A-A), a surrogate marker of sympathetic nervous system (SNS) activity. Parents/guardians and adolescents reported on adolescents' aggressive behavior. Both salivary A-A and C increased in response to the TSST, with a peak response for A-A immediately post-TSST and for C 10 min post-TSST. A-A and C stress reactivity were estimated using area under the curve (AUC). Asymmetrical C and A-A reactivity accounted for 7% of the variance in parent-reported adolescent aggression. At lower levels of A-A reactivity, lower C reactivity corresponded to higher aggression ratings, but at high A-A reactivity levels, C reactivity was not related to aggression. These results support the hypothesis of Bauer et al. and underscore the importance of a multiple systems measurement approach in biosocial models of adolescent aggression.

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Salivary alpha-amylase as a measure of endogenous adrenergic activity.

M Hudgens, R Chatterton, K Vogelsong … (1996)

This investigation was designed to evaluate the production rates and concentrations of salivary alpha-amylase as a measure of adrenergic activity under several conditions of stress in human subjects. Saliva and blood samples were simultaneously collected from men at four 15 min intervals both before and after regimens for exercise, a written examination, or a rest period. The regressions of salivary alpha-amylase on plasma norepinephrine (NE) concentrations were significant for both exercise (P < 0.001) and examination (P < 0.01) protocols. Aerobic exercise induced a 3-fold mean increase in alpha-amylase; both NE and epinephrine (EP) increased approximately 5-fold over control levels. Levels of alpha-amylase and NE returned to control levels within 30-45 min after exercise, but EP remained elevated by approximately 2-fold during the remaining hour of observation. During the written examination, alpha-amylase and NE, but not EP, concentrations increased in parallel. In further studies the effects of exercise and exposure to heat and cold on the relationship of salivary alpha-amylase to heart rate and body temperature were investigated. Greater intensities of exercise were associated with greater increases in alpha-amylase concentrations. During heat exposure in a sauna (66 degrees C for 40 min) amylase, heart rate and body temperature all increased progressively. However, during exposure to cold (4 degrees C for 40 min) amylase increased rapidly, though heart rate and body temperature remained unchanged. Salivary cortisol concentrations were unchanged during exposure to heat or cold. We conclude that salivary alpha-amylase concentrations are predictive of plasma catecholamine levels, particularly NE, under a variety of stressful conditions, and may be a more direct and simple end point of catecholamine activity than are changes in heart rate.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Clin Pediatr Dent

Journal ID (iso-abbrev): Int J Clin Pediatr Dent

Journal ID (publisher-id): IJCPD

Title: International Journal of Clinical Pediatric Dentistry

Publisher: Jaypee Brothers Medical Publishers

ISSN (Print): 0974-7052

ISSN (Electronic): 0975-1904

Publication date (Print): May-Jun 2018

Publication date (Electronic): 01 June 2018

Volume: 11

Issue: 3

Pages: 214-218

Affiliations

[1 ]Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India

[2 ]Reader, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India

[3 ]Professor and Head, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India

[4 ]Reader, Department of Orthodontics and Dentofacial Orthopedics Government Dental College, Jaipur, Rajasthan, India

[5 ]Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India

[6 ]Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India

Author notes

Corresponding Author: Yogita Chaturvedi, Postgraduate Student, Department of Pedodontics and Preventive Dentistry Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan India, Phone: +9101412349517, e-mail: yogita.chat@gmail.com

Article

DOI: 10.5005/jp-journals-10005-1514

PMC ID: 6102441

PubMed ID: 30131644

SO-VID: 455b594c-f003-435d-a29d-8aff3e1fa147

License:

This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/

Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An in vivo Study

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Abstract

Aim

Materials and methods

Results

Conclusion

Clinical significance

Related collections

Stress signalling in stem cells

Most cited references 19

The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis.

Asymmetry between salivary cortisol and alpha-amylase reactivity to stress: relation to aggressive behavior in adolescents.

Salivary alpha-amylase as a measure of endogenous adrenergic activity.

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