Clinical Oral Investigations

, Volume 22, Issue 6, pp 2373–2380 | Cite as

Quantitative evaluation of dental anxiety indicators in the serum and saliva samples of children treated under general anesthesia

  • Sinem Yıldırım
  • Meltem Bakkal
  • Huri Bulut
  • Sahabettin Selek
Original Article



Dental anxiety level has been previously associated with oral health status. Since general anesthesia (GA) allows dental treatments to be performed in anxious children with a high number of caries, we aimed to evaluate the dental anxiety levels of these children before and after dental treatments performed under GA.

Materials and methods

Thirty-eight children with high anxiety aged between 35 and 72 months who required multiple dental treatments to be performed under GA were included in the study. Frankl’s Behavior Rating Scale, sitting patterns, Facial Image Scale, and Children’s Fear Survey Schedule-Dental Subscale (completed by the children’s parents) were recorded before and after the dental treatments performed under GA. Pre-treatment and post-treatment biochemical parameters, including cortisol, alpha-amylase, and chromogranin A levels, in saliva and serum samples were also evaluated.


The psychometric scales showed a statistically significant reduction in the post-treatment dental anxiety levels of the children compared with the pre-treatment anxiety levels. Additionally, the biochemical parameters measured in the serum and whole saliva samples showed a decrease after treatments performed under GA.


Our study results suggest that performing dental treatments under GA can reduce the dental anxiety levels of children with a high number of caries.


Saliva Dental anxiety General anesthesia Children 


Funding information

This study was funded by the Bezmialem Vakif University Scientific Research Committee with a protocol number 3.2016/5.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article reports a study that involved human participants. All the procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric DentistryFaculty of Dentistry, Bezmialem Vakif UniversityIstanbulTurkey
  2. 2.Department of Medical BiochemistryBezmialem Vakif University School of MedicineIstanbulTurkey

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