This study aims to assess the difference in self-perceived stress before and after an academic assessment and its association with the marks scored and to study the association of salivary cortisol, Immunoglobulin A (IgA), and chromogranin A (CgA) with stress levels before and after the assessment. Thirty-one third-year dental undergraduates indicated how stressed they felt on a 5-point rating scale just prior to and immediately after a one-hour written test. Five-minute unstimulated whole saliva samples were also collected at those times to measure salivary cortisol, IgA, and CgA. Students rated significantly higher stress scores before (median [inter quartile range]: 3[1]), compared to after the test (2[2]) (p=0.015). Higher cortisol levels (mean: 6.32 nmol/l) were observed before than after the exam (mean: 5.16 nmol/l) (p=0.015). No significant differences were noted between the pre-and post-test saliva samples for salivary IgA and CgA levels. A negative correlation was seen between post-test stress scores and test marks (Spearman's r = -0.325, p=0.07). Dental students perceived a higher level of stress prior to the test, which declined after that. Pre-test stress scores were associated with raised salivary cortisol, but not IgA or CgA. Students who perceived higher levels of stress after the test generally had poorer results.
Dentists were accurate in their prescriptions of antibiotic prophylaxis for dental procedures, but not for cardiac conditions. It may be helpful to attain a consensus among local cardiologists and dentists to unify the antibiotic prophylaxis prescription practices in Singapore.
To study the perceived sources of stressful events in dental students and the relationship between their self-perceived stress levels and salivary IgA. Undergraduates as well as postgraduates at the Faculty of Dentistry, National University of Singapore were surveyed one month after the new term. A 38-item dental environmental stress (DES) questionnaire, with subscales of academic work (AW), clinical factors (CF), faculty and administration factors (FA) and personal factors (PF), was used to identify the potential stressors in the dental environment. A 4-point perceived stress scale was used to rank their self-perceived stress levels. Enzyme linked immunosorbent assay method was used to determine the salivary IgA level. One hundred and thirty students (81.3%--valid response rate) participated in the study. Overall, students ranked AW with the highest score (mean 2.76), followed by CF (2.67), FA (2.24) and PF (2.16). Among the 38 items of DES questionnaire, 1st year students perceived "fear of being unable to catch up if behind" as the most stressful event (mean 3.30). For 2nd and 3rd year students, examination and grades had the highest scores (mean 3.28, 3.19, respectively). Completing graduation requirements was the most important stressor for 4th year students (mean 3.89). Post graduates perceived atmosphere created by clinical faculty was most stressful to them (mean 3.05). The mean total perceived stress scores were highest (22.1) in 1st year students and lowest (21.0) in postgraduates, however, no significant different among various classes. First year students had had the lowest IgA secretion rates (geometric mean [GM] 46.8 microg/min), significantly lower (p<0.05) than postgraduates (GM 79.4 microg/min). An inverse correlation was noted between perceived stress scale and log IgA secretion rates (r= -0.20, p= 0.002). AW was also significantly inversely correlated with salivary IgA (r= -0.18, p= 0.04). Dental students in different academic years perceived different important stressors. Salivary IgA secretion rate correlated inversely with self perceived stress.
The result for cariogenicity of various types of infant formulas remains inconclusive, thus no concrete recommendations can be made. Further well-designed studies are needed to clarify the effect of casein content on cariogenicity.
Microleakage associated with a silver-reinforced restorative glass-ionomer cement (Hi-Dense) used with a composite resin (Z100) in a modified Class II bonded-base technique restoration was evaluated. The influence of long-term artificial saliva storage, thermal and load cycling was also determined. Class II composite (Z100) restorations used with a new dental adhesive system (Scotchbond Multi-Purpose Dental Adhesive) were used as controls. Results showed that the bonded-base technique can reduce the leakage observed with the direct composite technique. Thermocycling decreased the leakage at the composite-enamel interface but had no effect on the leakage at the composite-dentine interface or on the leakage patterns of bonded-base restorations. Load cycling had no significant influence on leakage patterns of either type of restorative mode. Storage in artificial saliva resulted in decreased leakage at the composite-enamel interface but had a minor adverse effect at the glass-ionomer-dentine interface.
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