Evaluation of salivary cortisol changes and psychological profiles in patients with recurrent aphthous stomatitis

Abstract

Background and Objective:Some studies suggest that psychological condition and stress can play role in the development of recurrent aphthous stomatitis (RAS). The purpose of this study was to evaluate salivary cortisol changes and psychological conditions in patients with RAS.Materials and Methods:Twenty-seven patients (13 males and 14 females, mean age of 32.8 (±10.2) years) with minor RAS and 27 age- and sex-matched controls without RAS participated in this study. The concentration of cortisol (nanomole/L) was measured in samples of unstimulated saliva from patients and controls two times; once during the presence of active lesions and once again when the lesions had healed by immunologic assay. The Hospital Anxiety and Depression Scale was employed to determine psychological condition. Visual analog scale for pain severity was recorded for patients with active lesions episode. Data were analyzed by the SPSS software (version 18.0) using paired and unpaired t-tests and Pearson correlation coefficient.Results:Salivary cortisol level was lower in patients during active lesions (12.4 ± 5.1) and healing (10.5 ± 3.9) episodes compared to the controls (13.1 ± 3.6) (P = 0.583, P = 0.015; respectively). There was no significant difference in salivary cortisol between active lesions and healing episodes (P = 0.943). Anxiety and depression represented no significant differences between active lesions and healing episodes (P > 0.05). Anxiety and depression levels in patients were significantly higher than in controls (P < 0.05). Pain severity in active lesions was not significantly correlated to salivary cortisol level, and anxiety or depression scores (P > 0.05).Conclusion:The findings showed that occurrence of RAS was associated with anxiety and depression but not with alterations of salivary cortisol level.

Prevalence of Psychosomatic Disorders Among Dental Students with Recurrent Aphthous Stomatitis. A Cross-Sectional Study.

“…In this study, more than half of the respondents were anxious, 58.2%. This nding is consistent with papers published locally and abroad [17][18][19][20][21][22][23][24] . The highest rates of anxiety disorder among patients with RAS was reported by Ajmal et.al.…”

“…Articles on the same subject have discussed stressful events in various forms. [21][22][23][24][25][26][27][28] The highest incidence of stress among patients with RAS was recorded by Ajmal et.al. 16 They reported that 90% of patients with RAS were exposed to stress.…”

Comparison of salivary epidermal growth factor in patients with recurrent aphthous stomatitis, smokers, and healthy individuals

“…In fact, RAS is a cellular immune response in which T lymphocytes, cytokines, and tumor necrosis cause epithelial cell death and ulcer. [1213] Natural healing of ulcers and oral lesions is the result of a complex interaction among various types of cells at the ulcer area and their ability in producing a series of growth factors and responses. These factors regulate growth, cell migration and proliferation, extracellular matrix production, enzymatic activity, and higher growth factor production.…”

Reccurent aphthous stomatitis

“…Prema novijim studijima psihološki stres djeluje kao trigger ili modificirajući čimbenik za razvoj lezija kod pacijenata sklonim RAS-u 11,20,21 . U prilog tome govore i povećane razine salivarnog kortizola kod oboljelih 20,22,23 , iako novije studije navode da se stres, anksioznost i depresija mogu povezati s pojavom RAS-a bez značajne promjene nivoa kortizola 24,25 . S druge strane, neka istraživanja, uspoređujući stupanj psihološkog stresa u akutnoj fazi i fazi remisije RAS-a, zaključuju da nema povezanosti između psihološ-kog stresa i RAS-a 26,27 .…”