title: Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes - a pilot study.
abstract: BACKGROUND
  Salivary biomarkers are suggested to provide a reliable, noninvasive and objective measurement of chronic psychosocial stress and helps in assessment of pivotal role of stress in causation or precipitation of multitude of health problems.
  
  
  OBJECTIVE
  To evaluate the usefulness of salivary alpha amylase activity as an objective indicator of chronic stress and to find out any correlation between stress- related mucosal complaints and its levels.
  
  
  METHODS
  Study was conducted among 50 subjects suffering from chronic stress related problems and 50 non-stressed individuals who were screened with a psychometric questionnaire. Brief case history and oral examination was carried out and about one ml of unstimulated saliva was collected. Salivary alpha amylase levels estimated were compared between study and control group and between subjects with and without oral mucosal changes using non parametric Mann Whitney U test.
  
  
  RESULTS
  There was statistically significant higher salivary alpha amylase levels in study group (p =.002) and salivary alpha amylase between the oral mucosal complaints group and without oral mucosal complaints group within the total study population were found to be statistically significant (p=0.045).
  
  
  CONCLUSIONS
  Salivary amylase activity increases in patients with chronic psychosocial stress and may be used as a biomarker of chronic stress, but it may not be an indicator to suggest the development of stress related oral mucosal changes. Key words:Salivary biomarker, salivary alpha amylase, psychosocial stress, sympathetic nervous system, oral mucosal changes.
authors.affiliation: MDS, Associate Professor. Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University. Karnataka State, India.
authors.forename: Ravindranath
authors.initials: R
authors.lastname: Vineetha
authors.affiliation: MDS, Professor and Head. Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University. Karnataka State, India.
authors.forename: Keerthilatha-M
authors.initials: KM
authors.lastname: Pai
authors.affiliation: MDS, Professor and Head. Department of Oral Medicine and Radiology, Vyas Dental College, Jodhpur, Rajasthan, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Vengal
authors.affiliation: M.Sc, PhD. Associate professor. Department of Biochemistry, Kasturba Medical College, Manipal University, Karnataka, India.
authors.forename: Kodyalamoole
authors.initials: K
authors.lastname: Gopalakrishna
authors.affiliation: MPhil, PhD, Associate Professor and Head. Department of Clinical Psychology, Kasturba Medical College, Manipal University, Karnataka, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Narayanakurup