Aim: To objectively evaluate stress levels of orthodontic patients by measuring saliva cortisol levels and to compare them to pain levels described subjectively by patients using VAS.
Materials and Methods:Four patients (2 males &2 females, mean age 14.75y±3.77) underwent orthodontic flexible archwire. Unstimulated whole saliva secretion was obtained using the spitting method during 7 time points (10-15 minutes prior to treatment, 1, 2, 24, 48 hours, and 1, 2 weeks after treatment). At each time point a questionnaire and ratings with VAS were filled out. Thereafter, samples were kept at -180 C until laboratory procedures. After thawing, mixing and centrifuging 10 min at 2000g, salivary cortisol measurements were measured in duplicates using Cortisol LIA ELISA kit.
Results: The table describes mean±SD of salivary cortisol concentrations and and the VAS±SD score from 4 patients following placement of initial archwire.
Analysis/time T0 T+1hr T+2hrs T+24hrs T+48hrs T+1w T+2w
Mean salivary 5.98 6.74 5.63 5.78 4.6 5.19 4.58
cortisol±SD ±1.52 ±2.08 ±2.39 ±2.12 ±2.44 ±0.96 ±5.45
(ìg/dL)
3.0 4.0 3.5 0.5 0.0 0.0
Mean VAS±SD 0.0 ±2.58 ±3.27 ±2.52 ±1.0
Conclusions: These preliminary results indicate an elevation in levels salivary cortisol after 1 hour of initial archwire placement with gradually decreases over time. Interestingly, VAS scores at the different time points show a delayed response compared to cortisol levels. More subjects' measurements are required to conclude if the pattern presented here is accurate.