Salivary Stress Biomarkers During Academic Examinations in Second-Year Dental Students
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Objective: Academic assessments are recognized as potent stressors for dental students. This study aimed to evaluate changes in salivary stress biomarkers—cortisol, α-amylase, and chromogranin A—associated with academic examinations in second-year dental students.
Methods and Materials: In this pre–post observational study, 40 second-year dental students (aged 20–22 years) from Al Hadi University College of Dentistry participated voluntarily. Unstimulated whole saliva was collected on two occasions: during a non-assessment period one week before examinations and during the assessment period at the end of exams. Samples were obtained by passive drooling for 5 minutes, coded to ensure confidentiality, and stored at −18 °C until analysis. Salivary cortisol, α-amylase, and chromogranin A concentrations were measured using ELISA according to the manufacturers’ instructions. Paired t-tests were used to compare biomarker levels between the two time points, with p ≤ 0.05 considered statistically significant.
Findings: Significant differences were observed in salivary cortisol and chromogranin A between the non-assessment and assessment periods, with higher mean levels in the non-assessment period compared with the examination period. In contrast, salivary α-amylase showed no statistically significant change between the two time points. These results indicate that cortisol and chromogranin A are sensitive to changes across the academic assessment period, whereas α-amylase did not reflect these changes in this sample of dental students.
Conclusion: Academic examinations in second-year dental students are associated with measurable alterations in salivary cortisol and chromogranin A, supporting their use as non-invasive biomarkers of academic stress. Monitoring these biomarkers may help educators identify high-stress periods and design interventions to reduce stress and promote students’ psychological well-being.
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