Araştırma Makalesi
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Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital

Yıl 2025, Cilt: 8 Sayı: 6, 250 - 254, 15.11.2025
https://doi.org/10.19127/bshealthscience.1734070

Öz

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.

Etik Beyan

The study was conducted in accordance with the Declaration of Helsinki. Before starting the study, ethical approval was obtained from Tokat Gaziosmanpaşa University Clinical Research Ethics Committee (Aproval date: March 15, 2023, prodocol code: 23-KAEK-126).

Kaynakça

  • 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.
  • 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.
  • 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.
  • Brotman DJ, Golden SH, Wittstein IS. 2007. The cardiovascular toll of stress. Lancet, 370(9592): 1089-1100.
  • 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.
  • Cohen S, Kamarck T, Mermelstein R. 1983. A global measure of perceived stress. J Health Soc Behav, 24(4): 385-396.
  • 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.
  • 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.
  • 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.
  • 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.
  • Eskin M. 2013. The adaptation of the perceived stress scale into Turkish: a reliability and validity analysis. J New Symp, 51(3): 132-140
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Lee EH. 2012. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res, 6(4): 121-127.
  • 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.
  • McEwen BS. 2017. Neurobiological and systemic effects of chronic stress. Chronic Stress, 1: 2470547017692328.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Young EA, Abelson J, Lightman SL. 2004. Cortisol pulsatility and its role in stress regulation and health. Front Neuroendocrinol, 25(2): 69-76.

Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital

Yıl 2025, Cilt: 8 Sayı: 6, 250 - 254, 15.11.2025
https://doi.org/10.19127/bshealthscience.1734070

Öz

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.

Etik Beyan

The study was conducted in accordance with the Declaration of Helsinki. Before starting the study, ethical approval was obtained from Tokat Gaziosmanpaşa University Clinical Research Ethics Committee (Aproval date: March 15, 2023, prodocol code: 23-KAEK-126).

Kaynakça

  • 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.
  • 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.
  • 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.
  • Brotman DJ, Golden SH, Wittstein IS. 2007. The cardiovascular toll of stress. Lancet, 370(9592): 1089-1100.
  • 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.
  • Cohen S, Kamarck T, Mermelstein R. 1983. A global measure of perceived stress. J Health Soc Behav, 24(4): 385-396.
  • 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.
  • 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.
  • 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.
  • 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.
  • Eskin M. 2013. The adaptation of the perceived stress scale into Turkish: a reliability and validity analysis. J New Symp, 51(3): 132-140
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Lee EH. 2012. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res, 6(4): 121-127.
  • 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.
  • McEwen BS. 2017. Neurobiological and systemic effects of chronic stress. Chronic Stress, 1: 2470547017692328.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Young EA, Abelson J, Lightman SL. 2004. Cortisol pulsatility and its role in stress regulation and health. Front Neuroendocrinol, 25(2): 69-76.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Diş Hekimliği (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Gözde Işıker Kara 0000-0002-6011-6043

Hatice Balci Yuce 0000-0003-3574-9751

Sibel Acel 0000-0002-1142-9932

Tolgahan Kara 0000-0002-7252-2444

Erken Görünüm Tarihi 13 Kasım 2025
Yayımlanma Tarihi 15 Kasım 2025
Gönderilme Tarihi 5 Temmuz 2025
Kabul Tarihi 26 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 6

Kaynak Göster

APA Işıker Kara, G., Balci Yuce, H., Acel, S., Kara, T. (2025). Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital. Black Sea Journal of Health Science, 8(6), 250-254. https://doi.org/10.19127/bshealthscience.1734070
AMA Işıker Kara G, Balci Yuce H, Acel S, Kara T. Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital. BSJ Health Sci. Kasım 2025;8(6):250-254. doi:10.19127/bshealthscience.1734070
Chicago Işıker Kara, Gözde, Hatice Balci Yuce, Sibel Acel, ve Tolgahan Kara. “Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital”. Black Sea Journal of Health Science 8, sy. 6 (Kasım 2025): 250-54. https://doi.org/10.19127/bshealthscience.1734070.
EndNote Işıker Kara G, Balci Yuce H, Acel S, Kara T (01 Kasım 2025) Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital. Black Sea Journal of Health Science 8 6 250–254.
IEEE G. Işıker Kara, H. Balci Yuce, S. Acel, ve T. Kara, “Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital”, BSJ Health Sci., c. 8, sy. 6, ss. 250–254, 2025, doi: 10.19127/bshealthscience.1734070.
ISNAD Işıker Kara, Gözde vd. “Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital”. Black Sea Journal of Health Science 8/6 (Kasım2025), 250-254. https://doi.org/10.19127/bshealthscience.1734070.
JAMA Işıker Kara G, Balci Yuce H, Acel S, Kara T. Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital. BSJ Health Sci. 2025;8:250–254.
MLA Işıker Kara, Gözde vd. “Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital”. Black Sea Journal of Health Science, c. 8, sy. 6, 2025, ss. 250-4, doi:10.19127/bshealthscience.1734070.
Vancouver Işıker Kara G, Balci Yuce H, Acel S, Kara T. Vital Signs and Salivary Cortisol as Biomarkers of Stress among Senior Dental Trainees at a Dentistry Faculty Hospital. BSJ Health Sci. 2025;8(6):250-4.

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