Key Points
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Salivary cortisol assays are useful in assessing the stress response within a population of surgical patients.
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There is no evidence that having wisdom teeth removed under general anaesthesia is less stressful than under local anaesthesia.
Abstract
Objective To investigate salivary cortisol levels in patients undergoing third molar removal under local and general anaesthesia.
Design Random sampling of two independent groups.
Methods Samples of saliva were collected from patients prior to and after surgery for the removal of impacted wisdom teeth. The samples were analysed to assess cortisol levels. Patients were also asked to complete a Hospital Anxiety and Depression questionnaire on the day of surgery.
Results Patients receiving treatment under local anaesthesia showed lower levels of stress response than those having treatment under general anaesthesia on the actual day of surgery did (Fig. 1). No other significant differences were noted.
Mean +l S.D. salivary cortisol concentrations (nmol/L) pre-, post- and on the day of surgery in subjects undergoing extraction of wisdom teeth under either general anaesthetic (GA; n = 27) or local anaesthetic (LA; n = 27).
Conclusion Local anaesthesia is the preferred mode of pain control for patients who express no strong preference for type of anaesthetic.
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Coulthard, P. A study of stress levels amongst patients undergoing third molar extraction by local and general anaesthesia. Br Dent J 191, 508 (2001). https://doi.org/10.1038/sj.bdj.4801218
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DOI: https://doi.org/10.1038/sj.bdj.4801218
