International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 5 ( May, 2024 ) > List of Articles

ORIGINAL RESEARCH

Quantification of Salivary Chromogranin A Levels during Routine Dental Procedures in Children: An In Vivo Study

Khevna M Vora, Preetam P Shah, Krishna V Patil, Sanket S Kunte, Chetana M Jagtap, Rucha N Davalbhakta

Keywords : Dental stress and anxiety, Desensitization, Local anesthesia, Salivary chromogranin A, Sequential visits

Citation Information : Vora KM, Shah PP, Patil KV, Kunte SS, Jagtap CM, Davalbhakta RN. Quantification of Salivary Chromogranin A Levels during Routine Dental Procedures in Children: An In Vivo Study. Int J Clin Pediatr Dent 2024; 17 (5):585-590.

DOI: 10.5005/jp-journals-10005-2853

License: CC BY-NC 4.0

Published Online: 22-08-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Routine dental procedures frequently involve invasive treatment, multiple injections, and the use of sharp, high-speed cutting instruments, and treatment is often extended over several visits, which are said to be stress-provoking events. Salivary chromogranin A (CgA) is a biomarker that can help clinicians evaluate and quantify the stress experienced by a child during these procedures. Aim: To quantify the changes in salivary CgA levels in children before, during, and after routine dental procedures for multiple appointments. Materials and methods: Eight children, aged 6–8 years, visiting a clinic for the first time and requiring one class I restorative treatment and another treatment involving the use of local anesthesia were included in the study. Unstimulated salivary samples were collected from them during three visits—outpatient department (OPD), before, during, and after restorative treatment at the second visit, and before, during, and after treatment using local anesthesia in the third visit. The salivary samples were centrifuged, stored, and analyzed for CgA. Results: Salivary CgA levels showed a nonsignificant increase from 2.56 to 3.21 pmol/mg protein during the restorative treatment, followed by a nonsignificant reduction after cessation of the treatment. Whereas, salivary CgA levels before the use of local anesthesia were 1.88 pmol/mg protein, which showed a nonsignificant increase to 2.24 pmol/mg protein after its administration and progressed further to 3.27 pmol/mg protein even after the cessation of the treatment. Conclusion: The use of an airotor can cause an increase in stress levels in children, and local anesthesia administration is a more stress-provoking stimulus than an airotor. Multiple visits allow desensitization, which reduces stress and anxiety. Also, salivary CgA can be used as a reliable stress indicator in children.


HTML PDF Share
  1. Folayan MO, Idehen EE, Ojo OO. The modulating effect of culture on the expression of dental anxiety in children: a literature review. Int J Paediatr Dent 2004;14(4):241–245. DOI: 10.1111/j.1365-263X.2004.00563.x
  2. Lee T, Shimizu T, Iijima M, et al. Evaluation of psychosomatic stress in children by measuring salivary chromogranin A. Acta Paediatr 2006;95(8):935–939. DOI: 10.1080/08035250500538940
  3. Lihala R, Jayaram P, Chatterjee A, et al. Effect of non-surgical periodontal therapy on stress and salivary chromogranin-A levels: a clinico-biochemical study. Indian J Dent Res 2019;30(2):213–218. DOI: 10.4103/ijdr.IJDR_273_17
  4. Kanno T, Asada N, Yanase H, et al. Salivary secretion of highly concentrated chromogranin A in response to noradrenaline and acetylcholine in isolated and perfused rat submandibular glands. Exp Physiol 1999;84(6):1073–1083.
  5. Chojnowska S, Ptaszyńska-Sarosiek I, Kępka A, et al. Salivary biomarkers of stress, anxiety and depression. J Clin Med 2021;10(3):517. DOI: 10.3390/jcm10030517
  6. Versloot J, Veerkamp JS, Hoogstraten J. Assessment of pain by the child, dentist, and independent observers. Pediatric Dent 2004;26(5):445–449.
  7. Nutter DP, Goddousi S, Soltani S, et al. The pain assessment practices of pediatric dentists. J Cal Dent Assoc 2019;47(11):719–727. DOI: 10.1080/19424396.2019.12220850
  8. Yon MJY, Chen KJ, Gao SS, et al. An introduction to assessing dental fear and anxiety in children. Healthcare (Basel) 2020;8(2):86. DOI: 10.3390/healthcare8020086
  9. Strimbu K, Tavel JA. What are biomarkers? Curr Opin HIV AIDS 2010;5:463–466. DOI: 10.1097/COH.0b013e32833ed177
  10. KS S, R Y, Purani MP. Diagnostic potential of saliva as a biomarker in early childhood caries: a review. Int J Appl Dent Sci 2019;5(2):341–347.
  11. Soo-Quee Koh D, Choon-Huat Koh G. The use of salivary biomarkers in occupational and environmental medicine. Occup Environ Med 2007;64(3):202–210. DOI: 10.1136/oem.2006.026567
  12. Gomes HS, Anabuki AA, Viana KA, et al. Assessment of child's dental anxiety/fear and stress during dental treatment: a systematic review by CEDACORE. Braz Oral Res 2022;36:e067. DOI: 10.1590/1807-3107bor-2022.vol36.0067
  13. Giacomello G, Scholten A, Parr MK. Current methods for stress marker detection in saliva. J Pharmaceut Biomed Anal 2020;191:113604. DOI: 10.1016/j.jpba.2020.113604
  14. Karaca S, Sirinoglu Capan B. The effect of sequential dental visits on dental anxiety levels of paediatric patients. Eur J Paediatr Dent 2023;24(4):277–280. DOI: 10.23804/ejpd.2023.1848
  15. de Menezes Abreu DM, Leal SC, Mulder J, et al. Patterns of dental anxiety in children after sequential dental visits. Eur Arch Paediatr Dent 2011;12(6):298–302. DOI: 10.1007/BF03262827
  16. Joshi S, Sandhu M, Dhindsa A, et al. A study of variables affecting child fear on successive dental office visits. J South Asian Assoc Pediatr Dent 2021;4(2):79–85. DOI: 10.5005/jp-journals-10077-3045
  17. Yamada T, Ebisu S, Kuwano S. A questionnaire survey on the effect of the sound of dental drills on the feeling of patients in dental clinics. J Acoust Sci Tech 2006;27(5):305–308. DOI: 10.1250/ast.27.305
  18. Howitt JW, Stricker G. Sequential changes in response to dental procedures. J Dent Res 1970;49(5):1074–1077. DOI: 10.1177/00220345700490051201
  19. Mobin T, Khan TZ, Mobin A, et al. Evaluating dental fear and anxiety in pediatric patients visiting a private and a public dental hospital in Lahore, Pakistan. Cureus 2023;15(2):e35243. DOI: 10.7759/cureus.35243
  20. Venham LL, Gaulin-Kremer E, Munster E, et al. Interval rating scales for children's dental anxiety and uncooperative behavior. Pediatr Dent 1980;2(3):195–202.
  21. Meechan JG. Pain control in local analgesia. Eur Arch Paediatr Dent 2009;10(2):71–76. DOI: 10.1007/BF03321603
  22. Pezzini Soares J, Cardoso M, Bolan M. Demystifying behaviour and dental anxiety in schoolchildren during endodontic treatment for primary teeth—controlled clinical trial. Int J Paediatr Dent 2019;29(3):249–256. DOI: 10.1111/ipd.12468
  23. Sikligar S, Bargale S, Dave B, et al. Effect of local anesthesia on anxiety, blood pressure and pulse rate in 6–10 years old children during dental treatment- an in vivo study. J Adv Med Dent Sci Res 2020;8(4):52–56. DOI: 10.21276/jamdsr
  24. Ummat A, Dey S, Nayak AP, et al. Association between dental fear and anxiety and behavior amongst children during their dental visit. Biomed Pharmacol J 2019;12(2). DOI: 10.13005/bpj/1716
  25. Vanhee T, Mourali S, Bottenberg P, et al. Stimuli involved in dental anxiety: what are patients afraid of? A descriptive study. Int J Paediatr Dent 2020;30(3):276–285. DOI: 10.1111/ipd.12595
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.