The effect of examination stress conditions on the cortisol content of saliva - a study of students from clinical semesters

Eur J Med Res. 2004 May 28;9(5):256-60.


Purpose: Psychological stress factors can lead to changes in the immune system, the nervous system, and to psychosomatic diseases, besides releasing typical stress metabolites. This study on hand was to record the reliability of stress self assessment of students in various stress periods, and to be compared with the cortisol value of the saliva.

Materials and methods: A total of 38 healthy students (18 women and 20 men), with an average age of 26.9 participated. The saliva of the participants was always tested between 9 AM and 10 AM, and always in various stress periods - during a typical semester internship, and immediately following the oral final examination. This was followed by a questionnaire concerning daily life styles (nutrition, part-time employment, sleeping pattern). The evaluation of the respective cortisol concentration of the total saliva resulted in a statistically high significant difference of values, relevant to stress levels (p = 0.0001).

Results: An average value for cortisol of 0.085 microg/dl total saliva was measured in the non-stress period, and in the stress period of 0.315 microg/dl total saliva. The comparison of the questionnaire evaluation to life styles did not show anything significant, the comparison to the cortisol concentration of the saliva showed significant deviations from the individual stress assessments by the participants.

Conclusion: The results cover a significant correlation of particular stress factors to changes in cortisol values. It is important for dental therapy to use stress reducing measures, or reduce them as much as possible in order to avoid factors that pre-operatively can affect the patient in a stressful way.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Educational Measurement*
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Immune System
  • Male
  • Saliva / metabolism*
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / etiology
  • Students, Dental / psychology
  • Surveys and Questionnaires


  • Hydrocortisone