Correlation between Salivary Cortisol Levels and Stress in Patients with Missing Anterior Teeth by Using Patient’s Saliva as a Diagnostic Tool

A BSTRACT Context: Missing anterior teeth can have negative impacts on an individual’s quality of life. The loss of teeth, particularly the anterior teeth, can also result in changes to facial appearance, leading to self-consciousness and stress. Aims: The aim of this study was to assess and compare the salivary cortisol level in subjects with anterior missing teeth and posttreatment with fixed dental prosthesis (FDP), thereby assessing the amount of stress undergone by the subject during the phase of their anterior missing teeth and its replacement with the prosthesis. Settings and Design: An in vivo observational study was conducted on patients who were seeking for the replacement of anterior missing teeth in the department of prosthodontics. Subjects and Methods: A total of 41 subjects aged 20–40 years were selected based on the inclusion and exclusion criteria. 5 ml of saliva sample (sample A) was collected 1 day before the treatment was initiated and 5 ml (sample B) was collected 1 h after the cementation of the fixed prosthesis. Collected samples were stored under −20°C until the day of cortisol evaluation. The estimation was done using enzyme-linked immunosorbent assay kit which is considered to be a gold standard for the analysis of human cortisol. Statistical Analysis Used: The values obtained were recorded and subjected to statistical analysis using software G*power. Results: The study revealed a significant decrease in the cortisol level in posttreatment (2.21 μg/dl) compared to pretreatment group (2.43 μg/dl) with the significance of ( P < 0.001), indicating that there is a decrease in the stress level in subjects after the treatment with the fixed prosthesis. Conclusions: The study revealed a significant association between salivary cortisol level and stress, after the patients received treatment with the fixed partial denture prosthesis in the anterior missing teeth region. The patients eventually were found to be more confident about their appearance, speech, and presentation. Thus, positive psychological well-being results in decrease of salivary cortisol levels.