Evaluation of Salivary Alpha Amylase as a Biomarker for Dental Anxiety

Background: The anxiety of dental conditions is very common. Salivary alpha amylase (SAA) enzyme, as a non-invasive biomarker, is considered in assessing dental anxiety. Objectives: The present study aimed at investigating the relationship between salivary alpha amylase level and dental anxiety before and after dental restoration. Methods: In this longitudinal study, which was performed in Babol dental faculty during 2015 and 2016, a total of 99 patients (50 females and 49 males) were selected using simple sampling method. To measure anxiety, the patients completed modified dental anxiety scale (MDAS) and demographic questionnaire. Unstimulated whole saliva was collected 3 times: at the day of dental examination in a stress-free condition; immediately before dental restoration; and 15 minutes after dental restoration. Salivary alpha amylase activity was measured by the Caraway starch-iodine modified method. SPSS 20 software and t test, chi square, Pearson correlation, and ANOVA repeated measurement were used for data analysis. Results: Levels of salivary alpha amylase increased before dental restoration and reduced after dental restoration (P value < 0.001). The alpha amylase level before dental restoration significantly correlated with modified dental anxiety scale (P value < 0.001). Levels of alpha amylase did not show any significant relationship with any of the variables, such as age, gender, level of education, and dental traumatic experience (P value > 0.05). Conclusions: Salivary alpha amylase can be used as a reliable objective tool for measuring anxiety of dental treatment.