TY - JOUR T1 - Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital TT - Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital AU - Kara, Tolgahan AU - Işıker Kara, Gözde AU - Balci Yuce, Hatice AU - Acel, Sibel PY - 2025 DA - November Y2 - 2025 DO - 10.19127/bshealthscience.1734070 JF - Black Sea Journal of Health Science JO - BSJ Health Sci. PB - Karyay Karadeniz Yayımcılık Ve Organizasyon Ticaret Limited Şirketi WT - DergiPark SN - 2619-9041 SP - 250 EP - 254 VL - 8 IS - 6 LA - en AB - Senior dental trainees tend to experience increased stress since they have to deal with graduation and career concerns, on top of the challenges of their clinical duties. Increased stress can cause stress-related physiological changes. This study aimed to investigate perceived stress, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood oxygen saturation (OS), and salivary cortisol levels (SCL) among senior dental trainees of Tokat Gaziosmanpaşa University Dental Hospital. This cross-sectional study was conducted on 73 systemically healthy senior dental trainees of Tokat Gaziosmanpaşa University Dental Hospital in June 2023. Perceived stress scores (PSS) were obtained via the Perceived Stress Scale-14. SBP, DBP, HR, and OS measurements were performed. An enzyme-linked immunosorbent assay (ELISA) was used to evaluate SCL. No statistically significant correlation was found between PSS and SBP, DBP, HR, OS, and SCL (P>0.05). In addition, there was no statistically significant difference in terms of all variables among the clinical sections (P>0.05). The stress levels of healthy dentistry senior trainees did not cause a significant change in stress biomarkers such as SBP, DBP, HR, OS, and SCL. Dental trainees performing different clinical tasks did not show a significant difference in terms of PSS, SBP, DBP, HR, OS, and SCL. KW - Dentistry students KW - Perceived stress KW - Blood pressure KW - Heart rate KW - Oxygen saturation KW - Salivary cortisol N2 - Senior dental trainees tend to experience increased stress since they have to deal with graduation and career concerns, on top of the challenges of their clinical duties. Increased stress can cause stress-related physiological changes. This study aimed to investigate perceived stress, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood oxygen saturation (OS), and salivary cortisol levels (SCL) among senior dental trainees of Tokat Gaziosmanpaşa University Dental Hospital. This cross-sectional study was conducted on 73 systemically healthy senior dental trainees of Tokat Gaziosmanpaşa University Dental Hospital in June 2023. Perceived stress scores (PSS) were obtained via the Perceived Stress Scale-14. SBP, DBP, HR, and OS measurements were performed. An enzyme-linked immunosorbent assay (ELISA) was used to evaluate SCL. No statistically significant correlation was found between PSS and SBP, DBP, HR, OS, and SCL (P>0.05). In addition, there was no statistically significant difference in terms of all variables among the clinical sections (P>0.05). The stress levels of healthy dentistry senior trainees did not cause a significant change in stress biomarkers such as SBP, DBP, HR, OS, and SCL. Dental trainees performing different clinical tasks did not show a significant difference in terms of PSS, SBP, DBP, HR, OS, and SCL. CR - Alamoush RA, Al-Sawaeir S, Baker DA, Aljamani SA, Alomoush SA, Al-Omiri MK. 2024. Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study. J Occup Health, 66(1): uiae006. CR - Alhajj M, Khader Y, Murad A, Celebic A, Halboub E, Márquez J, Macizo CC, Hkan S, Basnet BB, Makzoume JE, de Sousa-Neto MD, Camargo N, Prasad DA, Faheemuddin M, Mir S, Elkholy S, Abdullah AG, Ibrahim AA, Al-Anesi MS, Al-Basmi AA. 2018. Perceived sources of stress amongst dental students: A multicountry study. Eur J Dent Educ, 22(4): 258-271. CR - Bialka S, Copik M, Ubych A, Marciniak R, Smereka J, Szarpak L, Misiolek H. 2021. Effect of high-fidelity simulation on alpha-amylase activity and concentrations of secretory immunoglobulin class A, cortisol, and testosterone among medical students. Endocrine, 73: 431-438. CR - Brotman DJ, Golden SH, Wittstein IS. 2007. The cardiovascular toll of stress. Lancet, 370(9592): 1089-1100. CR - Cavaleri R, Withington A, Chalmers KJ, Blackstock F. 2023. The influence of stress on student performance during simulation-based learning: a pilot randomized trial. ATS Sch, 4(4): 474-489. CR - Cohen S, Kamarck T, Mermelstein R. 1983. A global measure of perceived stress. J Health Soc Behav, 24(4): 385-396. CR - Collin V, O’Selmo E, Whitehead P. 2020. Stress, psychological distress, burnout and perfectionism in UK dental students. Br Dent J, 229(9): 605-614. CR - Collin V, Toon M, O'Selmo E, Reynolds L, Whitehead P. 2019. A survey of stress, burnout and well-being in UK dentists. Br Dent J, 226(1): 40-49. CR - De Vente W, Olff M, Van Amsterdam J, Kamphuis J, Emmelkamp P. 2003. Physiological differences between burnout patients and healthy controls: blood pressure, heart rate, and cortisol responses. Occup Environ Med, 60(suppl 1): i54-i61. CR - Elagra ME, Rayyan MR, Bin Razin KI, Alanazi AA, Aldossary MF, Alqahtani AM., Alhomoud SA, Almutair AM. 2022. Self-reported stress among senior dental students during complete denture procedures. J Family Med Prim Care, 11(11): 6726-6730. CR - Eskin M. 2013. The adaptation of the perceived stress scale into Turkish: a reliability and validity analysis. J New Symp, 51(3): 132-140 CR - Fang Y, Yang M, Huang W, Zhang Y, Gao X, Chen Y, meng SI, Zeng S. 2025. The evaluation of depression, anxiety, and stress among undergraduate dental students in graduation year in Mainland China: a cross-sectional study. BMC Med Educ, 25(1): 543. CR - Gellisch M, Bablok M, Brand-Saberi B, Schäfer T. 2024. Neurobiological stress markers in educational research: A systematic review of physiological insights in health science education. Trends Neurosci Educ, 37: 100242. CR - Guthardt L, Niedworok C, Muth T, Loerbroks A. 2024. Stress, psychosocial resources and possible interventions: a qualitative study among dental students. BMC Med Educ, 24(1): 1479. CR - Halboub E, Alhajj MN, AlKhairat AM, Sahaqi AM, Quadri MFA. 2018. Perceived stress among undergraduate dental students in relation to gender, clinical training and academic performance. Acta Stomatol Croat, 52(1): 37. CR - Huang Z, Yang X, Huang Y, Tang Z, Chen Y, Liu H, . . . Wang Q. 2023. Saliva–a new opportunity for fluid biopsy. Clin Chem Lab Med, 61(1): 4-32. CR - Irshad L, Faustini S, Evans L, Drayson MT, Campbell JP, Heaney JL. 2020. Salivary free light chains as a new biomarker to measure psychological stress: the impact of a university exam period on salivary immunoglobulins, cortisol, DHEA and symptoms of infection. Psychoneuroendocrinology, 122: 104912. CR - Lee EH. 2012. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res, 6(4): 121-127. CR - Magnusson Hanson LL, Westerlund H, Goldberg M, Zins M, Vahtera J, Hulvej Rod N, Stenholm S, Steptoe A, Kivimäki M. 2017. Work stress, anthropometry, lung function, blood pressure, and blood-based biomarkers: a cross-sectional study of 43,593 French men and women. Sci Rep, 7(1): 9282. CR - McEwen BS. 2017. Neurobiological and systemic effects of chronic stress. Chronic Stress, 1: 2470547017692328. CR - Nijakowski K, Gruszczyński D, Łaganowski K, Furmańczak J, Brożek A, Nowicki M, Farmanowicz D, Surdacka A. 2022. Salivary morning cortisol as a potential predictor for high academic stress level in dental students: a preliminary study. Int J Environ Res Public Health, 19(5): 3132. CR - Noushad S, Ahmed S, Ansari B, Mustafa UH, Saleem Y, Hazrat H. 2021. Physiological biomarkers of chronic stress: A systematic review. Int J Health Sci (Qassim), 15(5): 46. CR - Nyberg ST, Fransson EI, Heikkilä K, Alfredsson L, Casini A, Clays E, De Bacquer D, Dragano N, Elber R, Ferrie JE, Hamer M, Jöckel KH, Kittel F, Knutsson A, Ladwig KH, Lunau T, Marmot MG, Nordin M, Rugulies R, Siegrist J, Steptoe A, Westerholm PJM, Westerlund H, Theorell T, Brunner EJ, Singh-Manoux A, Batty GD, Kivimaki M. 2013. Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47,000 men and women. PLoS One, 8(6): e67323. CR - Pani SC, Al Askar AM, Al Mohrij SI, Al Ohali TA. 2011. Evaluation of stress in final‐year Saudi dental students using salivary cortisol as a biomarker. J Dent Educ, 75(3): 377-384. CR - Roudsari MS, Namdari M, Mortazavi H, Malek-Mohammadi M, Tohidi S. 2022. Psychosocial impacts, perceived stress, and learning effects during the transition from preclinical to clinical dental education: Validation and translation of a questionnaire. Dent Res J (Isfahan), 19(1): 26. CR - Sanogo F, Ruth A, Cortessis VK, Ding L, Watanabe RM, & Weigensberg MJ. 2025. Associations between perceived stress and cortisol biomarkers in predominantly Latino adolescents. Sci Rep, 15(1): 11572. CR - Tangade PS, Mathur A, Gupta R, Chaudhary S. 2011. Assessment of stress level among dental school students: an Indian outlook. Dent Res J (Isfahan), 8(2): 95. CR - Young EA, Abelson J, Lightman SL. 2004. Cortisol pulsatility and its role in stress regulation and health. Front Neuroendocrinol, 25(2): 69-76. UR - https://doi.org/10.19127/bshealthscience.1734070 L1 - https://dergipark.org.tr/tr/download/article-file/5019819 ER -