Correlation between Salivary Cortisol Levels in Patients with Psychological Stress and Incidence of Recurrent Aphthous Stomatitis: A Scoping Review

Fiki Muhammad Ridho(1*), Aufa Alma’as Nabila Maulidina(2), Bella Pardian Nur Allifiah(3)


(1) Faculty of Dental Medicine, Universitas Airlangga
(2) Faculty of Dental Medicine, Universitas Airlangga
(3) Faculty of Dental Medicine, Universitas Muhammadiyah Yogyakarta
(*) Corresponding Author

Abstract


Background: The etiology of recurrent aphthous stomatitis (RAS) is still unclear, but psychological stress is thought to contribute to the occurrence of RAS. One of the biomarkers for evaluating psychological stress levels is through measuring salivary cortisol levels. This scoping review aims to review and evaluate the correlation between salivary cortisol levels in individuals with psychological stress and an increased incidence of RAS.

Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through databases on PubMed, ScienceDirect, Scopus, ProQuest, and Google Scholar until November 2023. All included studies discussed salivary cortisol levels in RAS patients and controls.

Results: Eleven of the twelve studies showed an increase in salivary cortisol levels in RAS patients compared with the control group, with eight of them having a statistically significant increase. In addition, eight studies evaluated the level of psychological stress in respondents, seven of which concluded that there was an increase in stress levels in RAS patients with five of them showing a statistically significant increase.

Conclusion: In conclusion, the present study concludes that there is a correlation between increased salivary cortisol levels in individuals with psychological stress and an increased incidence of RAS.

Keywords


Aphthous; Cortisol; Recurrent Aphthous Stomatitis; Saliva; Stress

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References


Edgar NR, Saleh D, Miller RA. Recurrent Aphthous Stomatitis: A Review. The Journal of clinical and aesthetic dermatology. 2017 Mar;10(3):26–36.

Darjani A, Joukar F, Naghipour M, Asgharnezhad M, Mansour-Ghanaei F. Lifetime prevalence of recurrent aphthous stomatitis and its related factors in Northern Iranian population: The PERSIAN Guilan Cohort Study. Clinical Oral Investigations. 2021 Feb 8;25(2):711–8.

Kaur R, Behl AB, Punia RS, Nirav K, Singh KB, Kaur S. Assessment of Prevalence of Recurrent Aphthous Stomatitis in the North Indian Population: A Cross-Sectional Study. Journal of pharmacy & bioallied sciences. 2021 Jun;13(Suppl 1):S363–6.

Manoj MA, Jain A, Madtha SA, Cherian TM. Prevalence and risk factors of recurrent aphthous stomatitis among college students at Mangalore, India. PeerJ. 2023;11:e14998.

Jurge S, Kuffer R, Scully C, Porter S. Number VI Recurrent aphthous stomatitis. Oral Diseases. 2006 Jan 23;12(1):1–21.

Belenguer-Guallar I, Jiménez-Soriano Y, Claramunt-Lozano A. Treatment of recurrent aphthous stomatitis. A literature review. Journal of clinical and experimental dentistry. 2014 Apr;6(2):e168-74.

Cui RZ, Bruce AJ, Rogers RS. Recurrent aphthous stomatitis. Clinics in Dermatology. 2016 Jul;34(4):475–81.

Rivera C. Essentials of recurrent aphthous stomatitis (Review). Biomedical Reports. 2019 Jun 11;

Sánchez J, Conejero C, Conejero R. Recurrent Aphthous Stomatitis. Actas Dermo-Sifiliográficas (English Edition). 2020 Jul;111(6):471–80.

Keenan AV, Spivakovksy S. Stress associated with onset of recurrent aphthous stomatitis. Evidence-Based Dentistry. 2013 Mar 12;14(1):25–25.

Sharma M, Gupta R, Singh S. Correlation of psychological stress with recurrent aphthous stomatitis among dental students in an educational institution. Int J Appl Dent Sci. 2017;3(4):455–8.

Prehananto H, Istiati, Zahro S. Correlation Between Stress and Recurrent Aphthous Stomatitis in Bank BRI Tulungagung Employees: An Observational Analytic. Dentika: Dental Journal. 2023 Jul 31;26(1):67–71.

Sherman GD, Mehta PH. Stress, cortisol, and social hierarchy. Current Opinion in Psychology. 2020 Jun;33:227–32.

Shakeel M, Sharma M, Iqbal A, Alisha, Mukherjee A, Bhattacharjee A. Assessment of salivary cortisol and dehydroepiandrosterone as oral biomarkers to assess stress in patients with recurrent aphthous stomatitis. International journal of health sciences. 2022 May 26;8080–5.

Bilal N. An Assessment of the Levels of Anxiety and Depression in Patients with Recurrent Aphthous Stomatitis. Archives of Otolaryngology and Rhinology. 2016 Jan 8;2(1):001–5.

Harrison RF, Debono M, Whitaker MJ, Keevil BG, Newell-Price J, Ross RJ. Salivary Cortisone to Estimate Cortisol Exposure and Sampling Frequency Required Based on Serum Cortisol Measurements. The Journal of Clinical Endocrinology & Metabolism. 2019 Mar 1;104(3):765–72.

McCartan BE, Lamey P ‐J., Wallace AM. Salivary cortisol and anxiety in recurrent aphthous stomatitis. Journal of Oral Pathology & Medicine. 1996 Aug 28;25(7):357–9.

Albanidou-Farmaki E, Poulopoulos AK, Epivatianos A, Farmakis K, Karamouzis M, Antoniades D. Increased Anxiety Level and High Salivary and Serum Cortisol Concentrations in Patients with Recurrent Aphthous Stomatitis. The Tohoku Journal of Experimental Medicine. 2008;214(4):291–6.

Nadendla LK, Meduri V, Paramkusam G, Pachava KR. Relationship of salivary cortisol and anxiety in recurrent aphthous stomatitis. Indian journal of endocrinology and metabolism. 2015;19(1):56–9.

Michel AR, Luz C, Wudarcki S, Cherubini K, Figueiredo MAZ de, Salum FG. Cortisol and dehydroepiandrosterone salivary levels, stress and anxiety in patients with recurrent aphthous stomatitis. Revista Odonto Ciência. 2016 Mar 21;30(4):120.

Kunikullaya U. K, Kumar M. A, Ananthakrishnan V, Jaisri G. Stress as a Cause of Recurrent Aphthous Stomatitis and Its Correlation with Salivary Stress Markers. The Chinese journal of physiology. 2017 Aug 31;60(4):226–30.

Madkour G, El Refaie I. Salivary Levels of α-Amylase & Cortisol In Patients With Recurrent Aphthous Ulceration. Egyptian Dental Journal. 2018 Jul 1;64(3):2391–7.

Polat C, Düzer S, Ayyıldız H, Seç S, Aksoy N, Sakallıoğlu Ö, et al. Association Between Anxiety, Depression, and Salivary Cortisol Levels in Patients with Recurrent Aphthous Stomatitis. Turkish archives of otorhinolaryngology. 2018 Sep;56(3):166–9.

Zakaria M, Hosny R. Relation between salivary cortisol and alpha amylase levels and anxiety in Egyptian patients with minor recurrent aphthous stomatitis. Egyptian Dental Journal. 2018 Apr 1;64(2):1235–43.

Vandana S, Kavitha B, Sivapathasundharam B. Salivary cortisol and dehydroepiandrosterone as oral biomarkers to determine stress in patients with recurrent aphthous stomatitis. Journal of oral and maxillofacial pathology : JOMFP. 2019;23(2):213–7.

Mirzaei M, Zarabadipour M, Mirzadeh M. Evaluation the relationship between psychological profile and salivary cortisol in patients with recurrent aphthous stomatitis. Dental research journal. 2021;18:50.

Aijaz DrA, Vasundhara Dr, Patel DrP, Porwal B, Gupta DrP, Chandra DrA. Salivary cortisol and dehydroepiandrosterone in patients with recurrent aphthous stomatitis. International Journal of Applied Dental Sciences. 2022 Apr 1;8(2):210–2.

Corbett BA, Simon D. Adolescence, Stress and Cortisol in Autism Spectrum Disorders. OA autism. 2014 Feb 1;1(1):2.

Thau L, Gandhi J, Sharma S. Physiology, Cortisol [Internet]. StatPearls Publishing, Treasure Island (FL); 2022. Available from: http://europepmc.org/abstract/MED/30855827

Nurdiana N, Ritonga PWU, Wulandari P. The Role of Stress in Recurrent Aphthous Stomatitis. European Journal of General Dentistry. 2023 Jan 21;12(01):042–7.

Sushanthi LC, Ramani P, Ramasubramanian A, Gheena S, Krishnan RP. Serum Cortisol Levels in Lichen Planus: A Systematic Review with Meta-Analysis. Indian journal of dermatology. 2021;66(6):654–9.

Cay M, Ucar C, Senol D, Çevirgen F, Ozbag D, Altay Z, et al. Effect of increase in cortisol level due to stress in healthy young individuals on dynamic and static balance scores. Northern clinics of Istanbul. 2018;5(4):295–301.

Bozovic D, Racic M, Ivkovic N. Salivary cortisol levels as a biological marker of stress reaction. Med Arch. 2013;67(5):374–7.

Majid AA, Riolina A. Hubungan stomatitis aftosa rekuren (SAR) dan tingkat stres mahasiswa pada pembelajaran daring di Solo Raya. Padjadjaran Journal of Dental Researchers and Students. 2023;7(1):44–51.

de Barros Gallo C, Mimura MAM, Sugaya NN. Psychological Stress and Recurrent Aphthous Stomatitis. Clinics. 2009 Jul;64(7):645–8.

Sari RK, Ernawati DS, Soebadi B. Recurrent Aphthous Stomatitis Related to Psychological Stress, Food Allergy and GERD. ODONTO : Dental Journal. 2019 Jul 11;6(1):45.

Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Wu YC, Sun A. Recurrent aphthous stomatitis - Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. Journal of the Formosan Medical Association = Taiwan yi zhi. 2019 Sep;118(9):1279–89.


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DOI: https://doi.org/10.26714/ijd.v4i1.14026

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