Evaluation of Salivary cortisol in patients undergoing oral surgery

During the dental treatment, anxiety and stress, when not controlled, can lead to complications in clinical practice. Objective: The aim of this study was to evaluate the influence of stress on the hypothalamic-pituitary-adrenal (HPA) by using the dosage of salivary cortisol in 26 patients undergoing surgical procedures. Methods: The samples of saliva (5 mL) were taken at 8am during a preoperative session (7 days before surgery) and during the day of surgery. Using three scales of anxiety (Corah, Faces, Visual Analogue Scale - VAS), the volunteers” anxiety was evaluated at the beginning of each session. The samples were tested using the ELISA Kit Cortisol - Salivary EIA Direct and taken to an ELISA reader at 450nm for the analysis of salivary cortisol (ng/mL). The data were analyzed by linear curve shape to obtain the results. Statistical analysis was performed using the Wilcoxon test for the anxiety scales and the Fisher exact test for assay of cortisol. Results: The salivary levels of cortisol presented difference when the evaluated periods (average 16.81 during the surgical procedure and 26.69 in the preoperative session). Nevertheless, the difference was not statistically meaningful (p = 0.3061). The anxiety scales used did not show statistically significant differences in the two periods (p = 0.7830). Conclusion: It was concluded that even in the sample with low anxiety levels for both tested periods as shown by the used scales, the anxiety has influence on the HPA axis under stressful procedures such as dental surgery.