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Abstract Early Childhood Caries (ECC) is a multifactorial disease and has numerous biological(133) psychological, and behavioral risk factors.(66) It has been suggested that the relationship between psychosocial factors and ECC might be influenced by stress. The association between stress in children and ECC has been receiving considerable attention in recent literature. (134) Salivary cortisol has been used as a biomarker to explore the role of stress in children with ECC. Salivary cortisol levels provide an accurate, reliable, and non-invasive measure of stress and offer a convenient way to monitor the systemic adrenocortical response to stress.(122,123) Therefore, the goal of the current study was to assess the salivary cortisol level as a stress biomarker in relation to ECC. The current study is a case-control study was conducted in the pediatric dentistry clinic, Faculty of Dentistry, Alexandria University, Egypt. It included 84 children 4-5 years old, divided into two groups; group 1 included children with ECC and group 2 included caries-free children (assessed using the World Health Organization caries criteria) and matched for age, gender and parental education. A questionnaire assessed oral health practices, dietary habits, nursing history and previous dental visits. Plaque was assessed using Silness and Loe index. Saliva samples were collected and tested for unbounded cortisol level using DRG®Salivary Cortisol ELISA kit (SLV-2930). Univariate logistic regression investigated the association of ECC with various factors and variables with significant associations were included in a multivariate model with calculation of adjusted mean salivary cortisol level in the two groups. |