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

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.