Quantitative evaluation of dental anxiety parameters with serum and saliva samples of children treated under general anesthesia

Depending on the studies which indicate a positive relationship between dental anxiety and increasing demand for dental treatment due to higher number of decays, the present study aims to eliminate the need for dental treatment via single-session general anesthesia (GA) in order to reduce dental anxiety in children. Additionally, the study evaluated the relationship between oxidative stress parameters and physicochemical properties of saliva (such as flow rate, pH, total protein), dental caries, age, and gender. Thirty eight children aged between 2 and 7 were selected for the study, whom required GA because of having multiple dental treatments and high anxiety levels. At the initial examination, Frankl's Behaviour Rating Scale, sitting patterns, Facial Image Scale (FIS) and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) of the children were recorded and compared with the corresponding control scores which were taken after treatment. All patients were also evaluated by salivary and serum cortisol, alpha amylase, chromogranin A, Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS), Nitric Oxide (NO), Glutathione Peroxidase (GPx), and Catalase (CAT) levels. The results of the present study revealed a statistically significant reduction in dental anxiety levels measured by biochemical parameters (cortisol, α-amylase, CgA) after treatment. Statistically siginificant increases in TAC, GPx, flow rate levels were also observed, whereas significant decreases were found in TOS, NO, CAT, OSI and total protein levels. In conclusion dental anxiety of the children were observed with a reduced level after all dental treatments were performed under general anesthesia. Therefore, GA can be suggested as a behaviour management technique for children who have high anxiety levels and high number of dental caries. After all dental treatments were performed, it was shown that serum/saliva TAC levels increased whereas serum/saliva TOS and serum OSI levels had a decrease which indicates the relationship between caries and oxidative stress parameters. Positive correlations observed between the serum and saliva samples supported the idea of that saliva can be an alternative diagnostic liquid instead of serum. Key words: Dental anxiety, Cortisol, Alpha amylase, Chromogranin A, Oxidative stress