title: Relationship of salivary cortisol and anxiety in recurrent aphthous stomatitis.
abstract: OBJECTIVE
  Recurrent aphthous stomatitis (RAS) is one of the most frequently encountered oral mucosal disorders. Despite extensive amount of research, the etiology of RAS remains unclear. Psychological-emotional factors were considered as one of the major predisposing factors. The aim of the study was to assess the levels of anxiety and salivary cortisol levels in patients with RAS and also to determine the association and relationship of salivary cortisol levels to variations of stress.
  
  
  METHODS
  A total of 30 patients suffering with RAS, along with the same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects at 9.00 am to avoid diurnal variations of cortisol levels. Salivary cortisol levels were measured by competitive enzyme linked immunosorbent assay. Anxiety levels of both groups were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups.
  
  
  RESULTS
  The mean salivary cortisol level of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The mean anxiety scores of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The values of Pearson correlation coefficient between anxiety and salivary cortisol was 0.980 and one with a P value of 0.000 showing that there is a highly positive correlation between anxiety and salivary cortisol.
  
  
  CONCLUSIONS
  Results suggest that anxiety may be involved in the pathogenesis of RAS. Thus besides traditional treatment of RAS patients, our findings suggest that psychological support is also needed.
authors.affiliation: Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda District, Andhra Pradesh, India.
authors.forename: Lakshmi Kavitha
authors.initials: LK
authors.lastname: Nadendla
authors.affiliation: Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda District, Andhra Pradesh, India.
authors.forename: Venkateswarlu
authors.initials: V
authors.lastname: Meduri
authors.affiliation: Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda District, Andhra Pradesh, India.
authors.forename: Geetha
authors.initials: G
authors.lastname: Paramkusam
authors.affiliation: Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda District, Andhra Pradesh, India.
authors.forename: Koteswara Rao
authors.initials: KR
authors.lastname: Pachava
keywords: Anxiety; enzyme linked immunosorbent assay; recurrent aphthous stomatitis; salivary cortisol