Η διακύμανση της α-αμυλάσης στο σάλιο και η συσχέτισή της με το άγχος του παιδιού κατά την οδοντιατρική του αντιμετώπιση

Abstract

Salivary alpha amylase was taken into account as an important physiologicalindicator in psychoneuroendocrinological research focusing on stress. Thepurpose of this study was to examine the effect of dental stress on salivary alphaamylase activity, heart rate, and cooperative behavior in children receivingtreatment using local anesthesia. Before that, the suitability of two samplingdevices that allow saliva collection through absorption to a cotton roll(Salivette®-method) or to small cotton pellets (VectaSpinTM Micro [VSM]-method) were studied. In particular, any loss of sAA activity in relation to thesaliva volume absorbed was examined. Additionally, the sAA activity in restingand stimulated saliva sampled from young adults under no stressful conditionwas examined. VSM collected samples showed a non-volume dependentdecrease of sAA activity of about 25%. Salivette requires large saliva volumes toallow an accurate sAA estimation. With cases of limited saliva access, VSM maybe a suitable sampling device. Significant mean changes were observed in flowrate and sAA activity between resting and stimulated saliva. The final modelconsists of two components, the first revealed a positive correlation between ageand sAA while the second one revealed a negative correlation between theinteraction of age × flow rate in its condition (resting or stimulated saliva), withsAA. Both flow rate and age influence sAA activity. Finally, regarding the mainstudy dental treatment that includes local anesthesia evokes changes in salivaryalpha amylase activity. Under the same conditions, heart rate is a rapid indicatorof stress. Based on sAA activity changes, dentally naïve children who receivelocal anesthesia need at least 3 sessions of dental treatment before their stressreactions decrease. The lack of correlation between cooperation and HR or sAAactivity indicates that manifest cooperative behavior is not a reliable indicator ofthe stress that child is experiencing in the dental situation.