The Relationship between State Anxiety Scale and Physiological Stress Markers before Dental Procedures: A Cross-sectional Analytical Study of Blood Pressure, Pulse Rate, Oxygen Saturation, and Salivary Amylase Activity

Dental Hypotheses · Published 2026-04-01 · DOI 10.4103/denthyp.denthyp_56_24

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Abstract

Introduction: We aimed to assess the effectiveness of the state anxiety scale as a pretreatment predictor of blood pressure, pulse rate, percutaneous arterial oxygen partial pressure, and salivary amylase activity before calculus removal and tooth extraction. Methods: To assess the patients’ anxiety levels before the dental procedure, the state anxiety scale was used. Vital signs, including blood pressure, pulse rate, and percutaneous arterial oxygen partial pressure, were measured at 2-minute intervals, 12 minutes before the initiation of calculus removal and tooth extraction using an automated sphygmomanometer. Salivary amylase activity was measured at 4-minute intervals, 12 minutes before the initiation of calculus removal and tooth extraction using the salivary amylase activity measuring device. Results: We found weak correlations between the state anxiety scale and psychological stress markers, including blood pressure, percutaneous arterial oxygen partial pressure, and salivary amylase activity, before scaling and extraction. Pulse rate showed a positive weak significant correlation with the state anxiety scale before scaling (r = 0.26, P-value <0.05) and extraction (r = 0.33, P-value <0.01). Diastolic blood pressure also showed a positive weak significant correlation with the state anxiety scale before extraction (r = 0.27, P-value <0.01). Regression analysis showed that the state anxiety scale was the only significant predictor of pulse rate before scaling (R2 = 0.131, coefficient = 0.303, P-value = 0.043) and extraction (R2 = 0.159, coefficient = 0.264, P-value = 0.0059). Conclusion: The state anxiety scale is a significant pretreatment predictor of pulse rate before calculus removal, a noninvasive dental treatment, and tooth extraction, an invasive dental treatment.

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Publication details

Year
2026

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