Relationship of Self-perceived Stress and Expression of Salivary Cortisol in Relation to Gender and Academic Levels among Dental Students

Although cortisol is commonly regarded as the body's stress hormone, it also has a range of other effects on other biological functions. The aim of this prospective cohort's study was to examine the link between self-perceived stress and salivary cortisol expression in relation to gender and academic levels in a subgroup of dental students.

151 students (79 males and 72 females) who provided written consent took part in this study. To explore the causes of self-perceived stress and divide the participants into Mild, Moderate, and High-stress categories, a self-administered stress questionnaire was employed. The enzyme-linked immunosorbent assay (ELISA) was utilized to quantify the level of cortisol present in saliva samples. Salivary cortisol levels, self-perceived stress, and demographic data, including age, gender, and educational attainment, were recorded for every participant. Chi-square and two-tailed Student's t-tests (0.05) were employed to analyze group comparisons.

Female students responded more stressfully (P<0.05) to questions on decision-making issues, academic dishonesty, a hectic course load, a lack of downtime, the transition from the pre-clinic to the clinic, and the challenge of mastering fine manual dexterity. For male and female subjects, the mean & standard deviation of levels of cortisol were 1.54+0.41 and 1.28+0.45, respectively (p=0.000). At preclinical and clinical levels, the mean & standard deviation of levels of cortisol were 1.48+0.44 and 1.37+0.45, respectively (P=0.150).

Female students appeared to have a higher self-assessed stress level. Male students had significantly higher levels of salivary cortisol in comparison to female students. No significant differences were found for the levels of salivary cortisol at the preclinical and clinical academic levels.