title: Assessment of the impact of stress and anxiety on pain perception in patients undergoing surgery for placement of their first dental implant.
abstract: OBJECTIVE
  This study aimed to record, both subjectively and objectively the anxiety of patients awaiting placement of their first dental implant and their long term stress levels; and evaluate their relation to the perception of pain by the patient during and after the procedure.
  
  
  METHODS
  Early morning salivary cortisol samples were collected from 47 patients awaiting the placement of their first dental implant to evaluate long term stress. The patients filled out a dental anxiety stress questionnaire before the procedure. Heart rate and oxygen saturation were recorded at four key intervals; in the waiting room, while seated in the dental chair, during the placement of the implant and five minutes post operatively. The patients were asked to describe their post-operative sensation of pain on a Wong-Baker facial pain scale. The readings were then compared using regression models to assess the best predictor of pain immediately after the operation
  
  
  CONCLUSIONS
  The regression models showed that while heart rate in the waiting area was a significant predictor of the reported pain of the patient, long term stress and reported anxiety were not.
authors.affiliation: Division of Pediatric and Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, PO Box 84891, Riyadh 11681, Saudi Arabia; Tel: +966 920000842; e-mail: sharat@riyadh.edu.sa.
authors.forename: Sharat Chandra
authors.initials: SC
authors.lastname: Pani
authors.forename: Bishi
authors.initials: B
authors.lastname: AlGarni
authors.forename: Lulya Mohammad
authors.initials: LM
authors.lastname: AlZain
authors.forename: Nora Saad
authors.initials: NS
authors.lastname: AlQahtani