Assessment of Neuroendocrine Stress Biomarkers Induced by Diverse Dental Interventions: An In Vivo Comparative Study

Abstract

Objective: Managing anxiety, fear and pain are critical components of any dental procedure. The current study quantitatively assessed the variations in salivary cortisol levels associated with stress triggered by three common dental treatments, such as teeth whitening, veneer preparation, and dental implant placement.

Aim: This In Vivo study aimed to assess and comparatively evaluate the variations in salivary cortisol levels associated with stress across patients undergoing teeth whitening, veneer preparation for fixed prostheses, and dental implant placement.

Methods: The levels of salivary cortisol were assessed in 80 individuals, comprising 40 healthy individuals (control) and 40 patients who underwent treatment (teeth whitening, veneer preparation, or dental implants). The patients were divided into four groups. To determine concentrations of cortisol in saliva, an Enzyme Immunoassay Kit was utilised in accordance with the manufacturer's protocol.

Saliva samples from each group underwent cortisol analysis via a validated Enzyme Immunoassay procedure calibrated specifically for salivary hormone quantification.

Results: The data revealed a stepwise reduction in salivary cortisol from Group 4 — which showed hormone levels — through Group 2 and Group 3, to Group 1, which showed minimal cortisol activity, implying that procedural invasiveness is a key determinant of the magnitude of stress in dental patients.

Conclusion: Patients who underwent implant placement showed the highest physiological stress response among all the procedures administered in the current study. Even a non-invasive procedure like teeth whitening showed a measurable elevation in the levels of cortisol, highlighting the necessity of assessing anxiety on a routine basis and management across all types of dental treatments.