الفهرس 
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Abstract
Dental stress and anxiety of children toward dentists is still prevalent,
despite advances in treatment, several studies have used changes in salivary
parameters as an indicator of stress, anxiety and fear.
Saliva is a blood mirror especially in children, since saliva sampling is easy.
Very few studies have been conducted to assess the relationship between
stresses during dental treatment in children
Especially when dealing with children, it is important to predict child’s
behavior in dental treatment because there is evidence that dental fear acquired
in childhood may persist to influence adult behavior.
Aim of the study: The aim of the study was to measure and compare the
changes in the stress related parameters (salivary cortisol levels and salivary
rate) in relation to the various dental procedures in children.
Material and method:-
A 40 apparently healthy children aged from 4-12 years of both sexes were
included in the study. The selected children were divided into two groups
according to age, group A consisted of 20 children aged from (4-6 years) and
group B consisted of 20 children aged from (9-12 years). For all children saliva
samples were collected for measuring salivary cortisol level and salivary flow
rate.
Salivary cortisol level was measured by ELISA kit in two appointments:
- In the first appointment the children and parents were explained about the
procedure and the first salivary sample was collected before anesthesia then
after anesthesia the second salivary sample was collected.
- In the second appointment the third salivary sample was collected before
any dental procedures and then after pulpotomy operation the fourth salivary
sample was collected.
Summery & Conclusion
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Salivary flow rate was measured by dividing the collected volume of saliva
(3 ml) on the time needed for collection (stopwatch) of each salivary sample
collected.
The child behavior was assessed by using of Frankl Behavior Rating Scale
(FBRS) in the first and second visits.
The marital status of parents and the characteristics of parent-child
relationship were recorded in the first visit.
Results:-
- Results showed there was an increase in the mean of cortisol level
after anaethesia, while there was a decrease in the mean of cortisol
level at the end of second visit and there was an increase in the mean
of cortisol level as soon as the child sits on the dental chair at second
visit, while there was a decrease in the mean of cortisol level at the
end of second visit.
- There was a statistically significant inverse (negative) correlation
between Cortisol level and salivary flow rate.
- In group A there was an improvement in the child attitude from first
visit to second visit, but in group B There was an increase in
definitely negative attitude from first visit to the second visit.
- There was no statistically significant difference between parental
influences in the two groups.
- There was an improvement in parent’s attitude in both groups.
Summery & Conclusion
69
Conclusion :-
1- Our results indicated that monitoring the salivary cortisol level is valuable,
easy, noninvasive and sensitive marker of the response to latent stress and
anxiety caused by dental treatment.
2- An increase in Cortisol level is associated with a decrease in salivary flow
rate and vice versa.
3- Evaluation of a salivary cortisol level is helpful in behavior modulation in
children..