Anxiety and cortisol excretion correlate prior to dental treatment

The aim of this study was to investigate the possible relationship between dental anxiety and cortisol excretion prior to dental treatment. Trait and state dental anxiety of male subjects were determined using the Dental Anxiety Scale (DAS) and a visual analogue scale (VAS), respectively. Urine and stimulated parotid saliva were collected immediately before dental treatment sessions. Cortisol levels were determined by radioimmunoassay. The self-reported trait dental anxiety (=DAS score) showed a significant relation to the urinary cortisol excretion. The salivary cortisol concentration did not correlate with either VAS or DAS score. The data suggest that dental anxiety has a long-term effect on cortisol metabolism of patients. Therefore, measurement of the cortisol concentration in urine, which reflects a longer term response to stress, seems a promising parameter in the investigation of dental anxiety.