Page 15 - MDJ Volume 47 Number 2 ( Jul-Dec 2024)

Original Article

Effect of Local Anaesthesia Immediately before Dental

Treatment on the Relationship between Dental Anxiety and
Salivary Cortisol Levels in Patients with ICDAS-II Score 5

Lesions

Ugur Erdemir , Ezgi Erden Kayalıdere , Ahmed Alshawi , Zeynep Günes Ozunal , Sevda Ozel Yildiz , Esra Yildiz 1
1
2
3
4
1
1 Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey, Department of Restorative Dentistry, Faculty of Dentistry, Istanbul Kent
2
University, Istanbul, Turkey, Department of Medical Pharmacology, Faculty of Medicine, Atlas University, Istanbul, Turkey, Department of Biostatistics, Faculty of
3
4
Medicine, Istanbul University, Istanbul, Turkey
Abstract
Background: Dental anxiety is a psychological and physical state of fear in patients experiencing stress over dental procedures. Aim:
This cross-sectional study aimed to investigate the effects of local anaesthesia administered immediately before dental treatment on
the association between dental anxiety and salivary cortisol levels in patients with International Caries Detection and Assessment
System (ICDAS) score 5 lesions. Materials and Methods: A total of 95 patients aged between 16 and 45 years who had a caries lesion
with an ICDAS-II score of at least 5 were examined at Istanbul University, Faculty of Dentistry, Department of Restorative Dentistry.
At the beginning of operative procedures and just before the administration of anaesthesia, the Modified Dental Anxiety Scale was
used to measure patients’ dental anxiety, and enzyme-linked immunosorbent assay kits were used to assess patients’ unstimulated
salivary cortisol levels. The data were statistically analysed using the Mann–Whitney U test and Spearman correlation analysis P <
0.05. Results: The mean values between male and female patients for dental anxiety scores were statistically significant, 9.07 ± 3.07
and 12.42 ± 4.33, respectively (P < 0.05). However, salivary cortisol levels did not exhibit statistical significance; the mean values were
4.49 ± 2.31 and 3.95 ± 2.39, respectively (P > 0.05). There were significant correlations between age and salivary cortisol levels in
female patients (P < 0.05), but there were no significant correlations for any of the parameters in male patients (P > 0.05). Conclusions:
Within the limits of this study, patient gender had an influence on the extent of dental anxiety, and a significant correlation was found
between age and salivary cortisol levels in female patients.

Keywords: Dental anaesthesia, dental anxiety, ICDAS, Modified Dental Anxiety Scale, salivary cortisol level

IntroductIon of needles and instruments, the characteristic smell
Dental anxiety is a psychological and physical state of a dental clinic and the sounds and vibrations of
[5]
instruments can also trigger anxiety. Studies on the
of fear in patients who experience stress before dental
procedures, which may partially or completely prevent
a person from receiving dental treatment. [1,2] According Address for correspondence: Prof. Ugur Erdemir,
to Thomson et al., exogenous factors are the main Department of Restorative Dentistry, Faculty of Dentistry,
[3]
cause of dental anxiety, although endogenous factors Istanbul University, 34134 Istanbul, Turkey.
can also contribute to this condition. Exogenous factors E-mail: [email protected]
arise from patients’ previous negative experiences with This is an open access journal, and articles are distributed under the terms of the
dental treatment, from hearing about others’ negative Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
experiences or from other information channels. others to remix, tweak, and build upon the work non-commercially, as long as
[4]
In addition, sensory triggers such as the appearance appropriate credit is given and the new creations are licensed under the identical terms.
For reprints contact: [email protected]
Access this article online
Quick Response Code: How to cite this article: Erdemir U, Erden Kayalıdere E, Alshawi A,
Website: Günes Ozunal Z, Ozel Yildiz S, Yildiz E. Effect of local anaesthesia
https://journals.lww.com/mdj immediately before dental treatment on the relationship between
dental anxiety and salivary cortisol levels in patients with ICDAS-II
score 5 lesions. Malaysian Dent J 2024;47:41-6.
DOI:
10.4103/MDJ.MDJ_7_24 Received: 19-Jul-2024 Revised: 10-Sep-2024
Accepted: 06-Nov-2024 Published: 30-Dec-2024

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