Salivary cortisol and anxiety in recurrent aphthous stomatitis

Abstract

Anxiety and salivary cortisol were measured in two groups of patients with recurrent aphthous ulceration. One group of patients had persistent aphthae (Group 1) and the others had been relieved of their aphthae following correction of detected haematinic deficiency states (Group 2). Anxiety was measured using the Hospital Anxiety and Depression scale and radioimmunoassay of salivary cortisol. There was a statistically significant increased proportion of borderline or clinically anxious patients in Group 1 compared to Group 2 (P < 0.05). Median salivary cortisol levels also showed a statistically significant elevation in Group 1 (P < 0.01). It is concluded that stress may play a role in the aetiology of recurrent aphthous stomatitis, particularly in patients who have an underlying anxiety trait.

Increased Anxiety Level and High Salivary and Serum Cortisol Concentrations in Patients with Recurrent Aphthous Stomatitis

“…Nevertheless, many patients make an association between RAS and what they term stress. It has been reported that previous studies have focused on individuals who in retrospect were more likely to have had trait anxiety as a basis for their perceived stress (McCartan et al 1996). Trait anxiety is nearly equivalent to stress and can be measured, although the biochemical response to both may differ.…”

“…A previous study investigated the possible association between anxiety, as measured by Hospital Anxiety and Depression scale (HAD), and salivary cortisol in patients with RAS, concluding that stress may play a role in the etiology of RAS (McCartan et al 1996).…”

“…Our study used for the evaluation of anxiety the Spielberger's STAI , a more sensitive method, which measures both trait anxiety as a general aspect of personality (STAI-T) and state anxiety as a response to a specific situation (STAI-S), whereas McCartan et al (1996) used the HAD scale, which was designed to assess only trait anxiety in the recent past. In our study the study groups were carefully selected by excluding patients with hematological deficiency states (such as iron deficiency and vitamin B12 deficiency), whereas in McCartan's study one study group was composed of patients with detected hematological deficiencies.…”

“…Furthermore, it has been reported the association between stress and anxiety and saliva cortisol levels (Vedhara et al 2003). A previous study investigated the possible association between anxiety, as measured by Hospital Anxiety and Depression scale (HAD), and salivary cortisol in patients with RAS, concluding that stress may play a role in the aetiology of RAS (McCartan et al 1996).…”

Recurrent aphthous stomatitis

“…Some changes in salivary composition, such as pH, that affect the local properties of saliva and a stress-induced rise in salivary cortisol have been correlated with RAS 17,18 . Although direct association of salivary gland dysfunction with RAS has not been demonstrated 19 , patients with a combination of RAS and xerostomia may experience increased symptoms due to the increased oral dryness.…”