Title

Salivary cortisol: Biomarker for stress during routine dental extractions - A prospective comparative study

Authors

S. Sindhuja Devi¹, I. Packiaraj², G.L. Georgeno², Kala Bhagavathy², Antony jebaraj², Reethu Vincely² & B. Sathyapriya Lakshmanan^3,*

Affiliation

¹Department of Oral and Maxillofacial Surgery, Bharath Institute of Higher Education and Research, Tamil Nadu, Chennai, India; ²Department of Oral and Maxillofacial Surgery, Rajas Dental college and Hospital, Kavalkinaru, Tirunelveli, Tamil Nadu, India; ³Department of anatomy, Balaji Dental College and Hospital, Tamil Nadu, India; *Corresponding author

Email

S. Sindhuja Devi - E-mail: dr.sindhujadevi@rajasdentalcollege.edu.in; Phone: +91 9524170007

I. Packiaraj - E-mail: dripackiaraj@gmail.com; Phone: +91 9443173903

G.L. Georgeno - E-mail: georgeno303@gmail.com; Phone: +91 8610146541

Kala Bhagavathy - E-mail: kalabags79@gmail.com; Phone: +91 9443500566

Antony Jebaraj - E-mail: drantonyjebaraj@gmail.com; Phone: +91 9677826099

Reethu Vincely - E-mail: reethuvincely@gmail.com; Phone: +91 8098759445

B. Sathyapriya Lakshmanan - E-mail: sathyapriyas.anatomy@sbdch.bharathuniv.ac.in; Phone: +91 9600033301

Article Type

Research Article

Date

Received April 1, 2026; Revised April 30, 2026; Accepted April 30, 2026, Published April 30, 2026
 

Abstract

Dental procedures, including routine extractions, can induce psychological stress and activate the hypothalamic–pituitary–adrenal axis (HPAA), leading to increased cortisol levels. Therefore, it is of interest to evaluate salivary cortisol as a biomarker of stress in 15 healthy male patients aged 30–50 years undergoing simple extraction of single-rooted teeth. Saliva samples were collected 30 minutes before and 30 minutes after the procedure between 10:00 AM and 2:00 PM to minimize diurnal variation and cortisol levels were estimated using enzyme-linked immunosorbent assay. The mean salivary cortisol level increased significantly from 19.27 ± 10.27 ng/mL before extraction to 51.27 ± 10.75 ng/mL after extraction (paired t-test, p < 0.001). Thus, we show that salivary cortisol is a reliable non-invasive biomarker for assessing acute stress associated with routine dental extractions.

Keywords

Dental anxiety, enzyme-linked immunosorbent assay, hypothalamo-hypophyseal system, hydrocortisone, psychological stress, stress biomarkers

Citation

Devi et al. Bioinformation 22(4): 2560-2564 (2026)

Edited by

Hiroj Bagde

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.