Evaluation of cortisol concentrations in saliva as a measure of stress in patients having routine dental extractions

We measured changes in the salivary concentrations of cortisol as an index of stress, and to find out if patients were stressed during routine intra-alveolar dental extractions. A total of 126 patients (63 experimental and 63 controls) matched for age and sex with a mean (SD) age of 26 (5) years (range 18–40) were recruited. Samples of saliva from patients whose glands had not been stimulated were collected twice from the study group (30 minutes before, and 10 minutes after, the procedure) and once from the control subjects. All samples were collected between 10.00 and 14.00 hours to standardise the method and control for the diurnal variation of cortisol. There was a slight but not significant increase in the mean salivary concentration of cortisol between the preoperative samples (mean (SD) 12.3 (1.5) ng/ml and the postoperative samples 12.8 (2.3) ng/ml in the study group) and the control 8.7 (1.0) ng/ml. However, there was no difference between the sexes. The study highlights a simple but effective way of evaluating stress in patients having intra-alveolar dental extraction, and emphasises the invaluable role of salivary cortisol in the evaluation of stress (particularly in our environment).