Evaluation Of Stress Levels Of Pediatric Dentist Performing Dental Treatment In The Operating Room

April 14, 2026 updated by: Merve Kepezkaya, TC Erciyes University

Evaluation Of Stress Levels Of A Group Of Pediatric Dentist During Laryngeal Mask, Deep Sedation And General Anesthesia Procedures

This study will measure the stress levels of pediatric dentists performing dental treatments under deep sedation and general anesthesia. Stress levels will be compared during sedation and general anesthesia procedures performed using three different methods. Salivary alpha-amylase and salivary cortisol levels will be measured to assess stress.

Study Overview

Status

Completed

Conditions

Stress

Detailed Description

The aim of this study is to determine the stress levels of pediatric dentists during dental treatment procedures using different airway devices (nasal mask, laryngeal mask (LMA), intubation tube) in the operating room environment and to examine the changes according to the methods.

Three female dentists with at least 10 years of experience, systemically healthy, and similar age, height, and weight, working at the Pediatric Dentistry Clinic of Erciyes University Faculty of Dentistry participated in this study. Each dentist treated 42 patients, 14 each, using nasal mask, laryngeal mask and general anesthesia methods. A total of 126 patients were treated in the operating room. Vital signs (systolic blood pressure, diastolic blood pressure, pulse, oxygen saturation) were measured three times by physicians, 10 minutes before starting the treatment, 25 minutes after the treatment, and 10 minutes after the treatment ended, and saliva samples were taken.

All measurements were made between 9:00 and 12:00 a.m. salivary cortisol was measured by electrochemiluminescence (ECLIA) method using the Roche Cortisol II kit and the Roche Cobas e 801 analyzer. Salivary alpha amylase was measured by colorimetric enzyme test using Roche Cobas c 701 analyzer. Physicians' stress was assessed using VAS (Visual Analog Scale), one of the psychogenic methods.

Study Type

Observational

Enrollment (Actual)

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Turkey (Türkiye)
- Melikgazi
  - Kayseri, Melikgazi, Turkey (Türkiye), 38039
    - Erciyes University Faculty of Dentistry, Department of Pediatric Dentistry

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The participants were selected from female pediatric dentists working at the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University.

Description

Inclusion Criteria:

Body mass index (BMI) of 25 kg/m² and less
Systemically healthy
Without a diagnosed stress-anxiety disorder or depression
Having worked with pediatric patients in an operating room environment for at least 10 years.
Responding to chronic occupational stress questions similar to the Dentist Job Stress Questionnaire (DJS).
Female pediatric dentist

Exclusion Criteria:

pregnant women
breastfeeding mothers

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Deep sedation with nasal mask Three pediatric dentists each treated 14 patients under deep sedation with a nasal mask. The dentists' stress levels were measured throughout the treatments.
Deep sedation with laryngeal mask Three pediatric dentists each treated 14 patients under deep sedation using a laryngeal mask. The dentists' stress levels were measured throughout the treatments.
general anesthesia Three pediatric dentists each treated 14 patients under general anesthesia. The dentists' stress levels were measured throughout the treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
salivary alpha amylase Time Frame: Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.	Alpha amylase levels were measured in saliva samples taken from pediatric dentists.	Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.
salivary cortisol Time Frame: Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.	Cortisol levels were measured in saliva samples taken from pediatric dentists.	Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.
systolic and diastolic blood pressure Time Frame: Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.	Systolic and diastolic blood pressure was measured in pediatric dentists.	Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.
pulse Time Frame: Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.	The pulse of pediatric dentists was taken.	Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.
oxygen saturation Time Frame: Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.	Oxygen saturation was measured in pediatric dentists.	Measurements were taken three times: 10 minutes before each treatment, 25 minutes after treatment begins, and 10 minutes after the treatment.
Visual Analog Scale (VAS) score Time Frame: Each physician conducted an evaluation at the end of each treatment session.	Physicians used the Visual Analog Scale to indicate stress levels after each treatment.This scale is scored from 0 to 10. A score of 0 means "no stress". A score of 10 describes the "maximum stress" level. Higher scores on this scale indicate increasing stress levels.	Each physician conducted an evaluation at the end of each treatment session.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

TC Erciyes University

Investigators

Study Director: Esra Kızılcı, Erciyes Üniversitesi Diş Hekimliği Fakültesi

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Hellhammer DH, Wust S, Kudielka BM. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009 Feb;34(2):163-171. doi: 10.1016/j.psyneuen.2008.10.026. Epub 2008 Dec 18.
Lesage FX, Berjot S. Validity of occupational stress assessment using a visual analogue scale. Occupational medicine (Oxford, England). 2011;61(6):434-6.
Nater UM, Rohleder N. Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system: current state of research. Psychoneuroendocrinology. 2009;34(4):486-96.
Lovallo WR, Buchanan TW. Stress hormones in psychophysiological research: emotional, behavioral, and cognitive implications. 2017.
Özmert S. Derin Sedasyon Altında Dental Tedavi Uygulanan Çocuklarda Anestezik Yaklaşımın Değerlendirilmesi. Turkish Journal of Pediatric Disease. 2019;13(1):30-5.
Meadows JL, Shah S, Burg MM, Pfau S, Soufer R. Cardiovascular Imaging of Biology and Emotion: Considerations Toward a New Paradigm. Circulation Cardiovascular imaging. 2020;13(8):e011054.
Giacomello G, Scholten A, Parr MK. Current methods for stress marker detection in saliva. Journal of pharmaceutical and biomedical analysis. 2020;191:113604.
Chojnowska S, Ptaszyńska-Sarosiek I, Kępka A, Knaś M, Waszkiewicz N. Salivary Biomarkers of Stress, Anxiety and Depression. Journal of clinical medicine. 2021;10(3).
Song KW, Kim HK. Job stress and its related factors among Korean dentists: An online survey study. International dental journal. 2019;69(6):436-44.
Kızılcı E, Kızılay F, Mahyaddinova T, Muhtaroğlu S, Kolçakoğlu K. Stress levels of a group of dentists while providing dental care under clinical, deep sedation, and general anesthesia. Clinical oral investigations. 2023;27(7):3601-9.
Anabuki AA, Corrêa-Faria P, Batista AC, Costa LR. Paediatric dentists' stress during dental care for children under sedation: a cross-sectional study. European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry. 2021;22(2):301-6.
Humphris G. A review of burnout in dentists. Dental update. 1998;25(9):392-6.
Dewa CS, Lin E, Kooehoorn M, Goldner E. Association of chronic work stress, psychiatric disorders, and chronic physical conditions with disability among workers. Psychiatric services (Washington, DC). 2007;58(5):652-8.
Davidovich E, Pessov Y, Baniel A, Ram D. Levels of Stress among General Practitioners, Students and Specialists In Pediatric Dentistry during Dental Treatment. The Journal of clinical pediatric dentistry. 2015;39(5):419-22.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 15, 2024

Primary Completion (Actual)

February 15, 2025

Study Completion (Actual)

May 1, 2025

Study Registration Dates

First Submitted

December 18, 2025

First Submitted That Met QC Criteria

April 14, 2026

First Posted (Actual)

April 21, 2026

Study Record Updates

Last Update Posted (Actual)