Study of Emotional and Personality Characteristics and Salivary Cortisol Levels in Patients with Unjustified Complaints about Aesthetic Treatment Outcomes in Dentistry

Relevance. The study of hormonal markers of stress, particularly salivary cortisol levels as an objective indicator of patients’ psychoemotional state, is of particular importance. Cortisol is an important biomarker reflecting the body’s response to stress and emotional tension, making it a promising research object in the context of studying patients’ unjustified complaints about the quality of aesthetic dental treatment.

The aim of the study was to investigate the personality type and salivary cortisol levels in patients with unjustified complaints about aesthetic dental treatment outcomes.

Materials and methods. The study involved 42 patients of both sexes aged 21 to 50 years who underwent aesthetic restorations of the anterior teeth group between 2019 and 2023. Exclusion criteria included patients under 18 and over 50 years of age; patients with high caries intensity and poor oral hygiene, as well as those requiring periodontal disease treatment; patients who violated the study protocol or refused further participation. Exclusion criteria also included patients with general somatic pathology in the decompensation stage; acute pain; patients with severe personality changes due to organic CNS lesions; gross mental and behavioral disorders; pregnant women. The control group consisted of 10 patients aged 21 to 40 years (5 men and 5 women) who had previously undergone aesthetic dental treatment, without significant somatic pathology (according to history), with low anxiety levels, and balanced personality traits according to psychological testing. Psychological testing was conducted using the scales of personal (PT) and reactive (RT) anxiety by C.D. Spielberger in the modification by Yu.L. Khanin, as well as the Mini-Mult Questionnaire (Mini-Mult), Three-Factor Perfectionism Questionnaire, MOCIs Scale of Obsessive-Compulsive Symptoms. Salivary cortisol measurement was performed using high-performance liquid chromatography-mass spectrometry (HPLC-MS) in 4 stages at the following time intervals: 1st portion (6:00–10:00); 2nd portion (10:00–14:00); 3rd portion (14:00–20:00); 4th portion (20:00–24:00). All patients gave voluntary consent to participate in the studies. Statistical analysis was performed using IBM SPSS Statistics v.20.0, MedCalc v 14.8.1, and software packages written in R.

Conclusions. An analysis of the results of our study showed that the frequency of respondents with a pronounced hypochondriac radical among patients making unfounded complaints about the quality of aesthetic treatment was 24%, with paranoid alertness-17%, with physical perfectionism-38%, with obsessive-compulsive personality traits-21%. It was revealed that the highest concentration of cortisol in saliva was observed in patients with a pronounced hypochondriac radical and a high level of personal anxiety. Significantly lower cortisol levels were found in the group of patients with obsessive-compulsive personality traits, but with higher levels of both personal and situational anxiety.

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