Investigation Of Influencing Factors Of Dental Anxiety In Orthodontic Patients And Study Of Salivary Cortisol And SAA Expressio

Objective: To investigate the prevalence of dental anxiety in orthodontic patients,to explore the factors affecting the MDAS score and the prevalence of dental anxiety in orthodontic patients,and to study the expression levels of salivary cortisol and SAA in the saliva of orthodontic patients with dental anxiety group and without dental anxiety group.Methods: A questionnaire survey was conducted on 236 orthodontic patients who attended the Department of Orthodontics of the Affiliated Stomatology Hospital of Hunan University of Chinese Medicine from July 2021 to March 2023 using the general questionnaire and MDAS,and the factors affecting the MDAS score of orthodontic patients and the prevalence of dental anxiety disorders were analyzed.The saliva of40 orthodontic patients from January to March 2023,including 24 patients without dental anxiety and 16 patients with dental anxiety,were collected at 8-10 a.m.,and salivary cortisol and SAA concentrations were determined by enzyme-linked immunosorbent method,and the expression differences of salivary cortisol and SAA were compared between the two groups.Results: Among the 236 orthodontic patients,122 patients suffered from dental anxiety,with a prevalence rate of 51.69%.There were significant differences in the prevalence of dental anxiety disorder and MDAS scores in the four factor groups of age,number of orthodontic visits,total number of visits,and orthodontic correction(P < 0.05).There was a statistically significant difference in MDAS scores between orthodontic patients with and without a history of tooth extraction(P < 0.05),while the prevalence of dental anxiety disorder was not statistically significant(P > 0.05).There were no significant differences in the incidence of dental anxiety and MDAS scores between the six treatment groups: gender,history of fillings,history of dental cleaning,history of surgery,history of implant and restorative treatment,and history of treatment(P > 0.05).There was a significant difference in MDAS scores between the age groups of adolescent orthodontics patients at first oral visit(P < 0.05),while there was no difference in MDAS scores in adult orthodontic patients(P > 0.05).Logistic regression analysis showed that the number of orthodontic visits was inversely correlated with the prevalence of dental anxiety(regression coefficient-0.687,P < 0.05,OR=0.503).The level of salivary cortisol was higher in the dental anxiety group(4.74±1.39ng/ml)than in the group without dental anxiety(3.16±1.42ng/ml),and the difference was statistically significant(P <0.05),and the difference in SAA expression was not statistically significant(P> 0.05).Conclusion: 1.Adult orthodontic patients are more anxious than adolescent orthodontic patients.2.The number of orthodontic visits increased,and the incidence of dental anxiety and MDAS score decreased.3.Orthodontic patients with dental anxiety have higher expression levels of salivary cortisol than orthodontic patients without dental anxiety.4.There was no difference in SAA expression in orthodontic patients with dental anxiety and orthodontic patients without dental anxiety,and it could not be used as a biomarker for evaluating dental anxiety.