Stressful Life Events of Dental Students and Salivary Immunoglobulin A

Abstract

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.

Biomarkers of Stress in Saliva / Biomarkeri stresa u pljuvački

“…Consequently, a cross-sectional study encompassing 106 emergency nurses and 56 general nurses, where the mentioned stress scale was applied and concentration of secretory IgA in saliva measured, has shown that emergency nurses experience greater stress (on average 1.51 vs. 1.30) and at the same time have significantly lower values of secretory IgA in saliva (49.1 vs. 68.2 µg/min) in relation to general nurses (10). It was also established that the value of secretory IgA in saliva stands in negative correlation to the degree of stress experienced among the tested populations of dental students (students on undergraduate and postgraduate studies) (Spearman's r =-0.20, p <0.05) (19). On the other hand, Ng et al (20) have studied differences in the experience of stress in 31 junior year dental students, before and after exams, measuring the levels of cortisol, secretory IgA and chromogranin A (Cg A) in saliva.…”

Cellular and Humoral Systemic and Mucosal Immune Responses Stimulated by an Oral Polybacterial Immunomodulator in Patients with Chronic Urinary Tract Infections

“…In the course of our investigation we preferred to use saliva, because it is the most easily accessible source of immunoglobulins. It is known that secretory immunoglobulins measured in saliva have been considered an index of mucosal immunity (48)(49)(50)(51)(52).…”

Salivary levels of SIgA and perceived stress among dental students

“…Nevertheless, Ng et al7 did not find gender differences in stress levels in Singaporean dental students, although women demonstrated greater insecurity regarding their professional future. They also find out that DES scores presented a low inverse correlation with SIgA levels in male and female Singaporean dental students 7 . Polychronopoulou and Divaris reported that females generally reported higher perceived stress in some aspects of the educational process, especially those related to insecurity 5 .…”

“…Besides the stressors commonly reported by undergraduate students, dental students also face the pressure to develop clinical competencies and interpersonal skills; all within a short period of time, in order to become a responsible dental professional [3][4][5][6] . These include unfavorable physical positions, noise, repetitive movements, high professional competitiveness, heavy course work and lack of time for relaxation and interaction with friends and family [3][4][5][6][7][8] . All these factors may contribute to make the undergraduates feel insecure, stressed, anxious, depressed and sometimes even display suicidal intentions 7,8 .…”

“…These include unfavorable physical positions, noise, repetitive movements, high professional competitiveness, heavy course work and lack of time for relaxation and interaction with friends and family [3][4][5][6][7][8] . All these factors may contribute to make the undergraduates feel insecure, stressed, anxious, depressed and sometimes even display suicidal intentions 7,8 . Such stressors may have an important impact on oral immunity since salivary secretion and immune functions are controlled by stress-modulated systems such as the endocrine and nervous systems 1,2 .…”