The relationship between the level of salivary alpha amylase activity and pain severity in patients with symptomatic irreversible pulpitis

Abstract

ObjectivesAssessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis.Materials and MethodsThirty-six patients (20 females and 16 males) with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS) score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13.ResultsThe level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males.ConclusionsThere was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.

Correlation Between Wong-Baker Faces Pain Scale and Salivary Alpha-Amylase Level in Children Aged 6–11 Years

“…These results are similar to those reported previously by Shirasaki and Motamayel [4,5]. It has been reported that psychological stress activates the SAM system [6].…”

Salivary Alpha Amylase, Dental Anxiety, and Extraction Pain: A Pilot Study

“…Multiple peer-reviewed studies have validated the application of sAA concentration as a noninvasive biomarker for both objective pain intensity and emotional status in a stressful environment. [3][4][5] This study did not find that sAA factors (both sAA concentration and sAA output rate) were related to either VAS or DAS score. These findings corroborate those of Sadi et al, 14 who also found no significant correlation between DAS and sAA factors.…”

“…3 In our study, sAA was used as a biomarker for sympathetic activity on account of the powerful role the autonomic nervous system plays in sAA secretion and the acceptance within the published literature of sAA as a sympathetic biomarker. 4,5,[12][13][14][15] The net result of sympathetic stimulation on the salivary glands is a thicker, protein-rich saliva, in contrast to the watery saliva produced by parasympathetic activity. Multiple peer-reviewed studies have validated the application of sAA concentration as a noninvasive biomarker for both objective pain intensity and emotional status in a stressful environment.…”

“…3 Recently, sAA has emerged as a reliable biomarker for objectively assessing patient pain. 4,5 Separate studies have also found a relationship between Corah's Dental Anxiety Scale (DAS) and patient pain. 6,7 Pain perception is not simply a physiological experience.…”

Pain during embryo transfer is independently associated with clinical pregnancy in fresh/frozen assisted reproductive technology cycles

“…In the last few years, there has also been an interest in the assessment of stress biomarkers, such as salivary α‐amylase (sAA) and salivary cortisol, as surrogates for psychological stress in women with infertility . Within the broader literature, it is of great interest to note that sAA in particular has been associated both with psychosocial stress, including specific anxiety scores, such as the State–Trait Anxiety Inventory (STAI) score, and also physical stress/painful stimuli, with a strong correlation with the visual analogue scale (VAS) for pain . It is therefore evident that stress, anxiety and pain, along with their respective biomarkers, are intertwined …”