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Masters Thesis | Child Dental Health | India | Volume 13 Issue 10, October 2024 | Popularity: 5.9 / 10

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Dental Fear in Children with Cleft Lip and Palate and their Correlation to Salivary Cortisol Levels

Dr. Savitha Sathyaprasad, Dr. P Sharvari Aithal

Abstract: Aim: To assess the level of dental fear in children with cleft lip and palate, to compare it with that of a normal group and to correlate the level of fear with the salivary cortisol levels in both the groups. Materials and Methods: This study was conducted on 60 children of age group 4-10 years selected from Mahaveer Jain Hospital, Bangalore. 30 children in the study group were children with cleft lip and palate and 30 normal children age and sex matched, visiting the dental wing of the same hospital for routine dental procedures were selected as the control group. On arrival to the clinic the children were asked to rinse mouth and pre-treatment salivary samples are collected. The Children's Fear Survey Schedule Dental Subscale (CFSS-DS) was selected for the study to psychometrically analyze the fear status of the children consisting of 15 questions, related to various aspects of dental treatment. The children were then subjected to a stressor to measure rise in cortisol levels, in the post stress application period. After impression making the post treatment salivary sample were collected. This procedure was carried out similarly for the study and the control group. Assessment of the fear levels were correlated with the difference in salivary cortisol levels (whether it is high, low or same) in both the groups. The difference in salivary cortisol levels both pre and post treatment are also compared between both the groups. Then comparative assessments of both the groups were made. Results: The present study showed that the fear survey conducted using the child's fear survey schedule dental subscale among the children showed that only 11.7%were very much fearful about the procedure. 62% of the population in the control group shows a not fearful group, 23% of the control group shows a moderately fearful group and 12% of the group represents a fearful population. The mean values of the CPSS scores in the study group was 27.57 and that of the normal group was 25.73. The mean values of the CFSS scores was almost similar in both the groups and the difference between the two means were statistically insignificant with p = 0.18 obtained using independent t test. The fear scores of the two groups were in the same range indicating same psychometric scores for both the groups. The mean values of the cortisol values pre and post treatments showed decimal changes with no significant value rise between the pre and post values. The mean value of preoperative cortisol values in the study group is 0.165 plus/minus 0.12 and that in the normal group is 0.191 plus/minus 0.07 difference in these values is not very high indicating the pre-treatment cortisol levels do not show a statistically significant difference between the two groups (p = 0.343) . The mean value of preoperative cortisol values in the study group is 0.2377 plus/minus 0.26 and that in the normal group is 0.201 plus/minus 0.22 The difference in these values is not very high indicating the pre-treatment cortisol levels do not show a statistically significant difference between the two groups(p-0.56). The difference between the two groups in age fear scores, pre and post cortisol values was calculated using the paired t test. Unpaired t test was used to calculate the difference in mean score between groups. On analysis for the pre operational cortisol values between the two groups do not show any statistical difference between the study and the control groups (p value 0.3). The post operational cortisol values between the two groups do not show any statistical difference between the study and the control groups (p value-0.5). The mean values of the normal group was found to be 0.2010+21786 and that of the CLP group was found to be 0.237725974. Pearson correlation used to calculate correlation of cortisol level and CFSS score. Present study shows that there was a weak negative correlation between cortisol pre-operative level and CFSS score (-0.118) and this was statistically insignificant at 5% significance level (p=0.368) and there was a weak positive correlation between cortisol post-operative level and CFSS score (r=0.151) and this was statistically insignificant at 5% significance level (p=0.250). Conclusion: The results of the study concluded that the fear ratings showed a comparatively not fearful group of children both in the study and the control group. The study group showed fear scale similar to that of the control group concluding that the CLP children did not show an increased response of fear. In the study group there was no considerable rise either in the preoperative or post-operative samples which showed that the previous experiences in hospitals and various treatments did not have a potentially high negative influence on them but infact could make them desensitized to the anxiety provoking stimulus in the dental operatory and could gear them to bear more of such situations like normal people or even better. The post-operative values comparatively higher in the study group showed that this group of children also had procedural anxiety rather than a preoperational anxiety which could probably indicate any influence of the previous experiences. In the present study the psychometric results matched the biometric parameters reassuring its validity and reliability.

Keywords: Cleft lip and palate, Dental fear, Stress, CFSS-DS, Salivary cortisol

Edition: Volume 13 Issue 10, October 2024

Pages: 412 - 419

DOI: https://www.doi.org/10.21275/SR241003150004

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