Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study

Abstract Dental caries remains the most common chronic disease in childhood. This study aimed to identify environmental stressors in children and estimate the association between salivary cortisol level as a stress biomarker and childhood caries. We conducted a case-control study involving 80 Egypti...

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Main Authors: Yosra Ahmed Hussein, Rania Hussein Refai, Mai M. K. Hussein, Mamdouh Hanafy Abdou, Magdy Mohamed El Bordini, Ola Mohamed Ewais, Mohamed Fakhry Hussein
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94327-0
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author Yosra Ahmed Hussein
Rania Hussein Refai
Mai M. K. Hussein
Mamdouh Hanafy Abdou
Magdy Mohamed El Bordini
Ola Mohamed Ewais
Mohamed Fakhry Hussein
author_facet Yosra Ahmed Hussein
Rania Hussein Refai
Mai M. K. Hussein
Mamdouh Hanafy Abdou
Magdy Mohamed El Bordini
Ola Mohamed Ewais
Mohamed Fakhry Hussein
author_sort Yosra Ahmed Hussein
collection DOAJ
description Abstract Dental caries remains the most common chronic disease in childhood. This study aimed to identify environmental stressors in children and estimate the association between salivary cortisol level as a stress biomarker and childhood caries. We conducted a case-control study involving 80 Egyptian children. The cases were 40 children with early childhood caries (ECC). The controls included 40 caries-free children. Data were collected from the parents or caregivers of the children using a questionnaire. The clinical examination included caries experience and an oral hygiene index. Saliva samples were collected and tested for unbounded cortisol levels. The results from the current study showed that the mean age for participants was 5.09 ± 0.66 years. Twenty-one of the children with ECC were girls. In multivariate regression, there is a significant association between ECC and elevated salivary cortisol levels (> 0.57 µg/dl) with an adjusted odds ratio (AOR) of 9.649 (p = 0.003), father smoking (AOR = 5.791, p = 0.030), sleeping with a bottle or food in the mouth (AOR = 8.481, p = 0.027), and poor oral hygiene evaluated through the Silness-Löe Plaque Index (AOR = 6.681, p = 0.001). As a conclusion, the study indicates that salivary cortisol is an independent stress biomarker in relation to early childhood caries. Salivary cortisol as a stress biomarker can help clinicians provide an additional assessment tool for identifying caries risk in children.
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spelling doaj-art-8e352c34cec74974ab67958430a8b9dd2025-08-20T03:07:40ZengNature PortfolioScientific Reports2045-23222025-04-0115111210.1038/s41598-025-94327-0Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control studyYosra Ahmed Hussein0Rania Hussein Refai1Mai M. K. Hussein2Mamdouh Hanafy Abdou3Magdy Mohamed El Bordini4Ola Mohamed Ewais5Mohamed Fakhry Hussein6Dental Unit, Medical Research Institute, Alexandria UniversityDepartment of Medicine Supply and Pharmacy, Alexandria University Hospitals, Alexandria UniversityClinical Research Administration, Alexandria Directorate of Health AffairsDepartment of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria UniversityDepartment of Clinical Pathology, Faculty of Medicine, Alexandria UniversityDental Unit, Medical Research Institute, Alexandria UniversityDepartment of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria UniversityAbstract Dental caries remains the most common chronic disease in childhood. This study aimed to identify environmental stressors in children and estimate the association between salivary cortisol level as a stress biomarker and childhood caries. We conducted a case-control study involving 80 Egyptian children. The cases were 40 children with early childhood caries (ECC). The controls included 40 caries-free children. Data were collected from the parents or caregivers of the children using a questionnaire. The clinical examination included caries experience and an oral hygiene index. Saliva samples were collected and tested for unbounded cortisol levels. The results from the current study showed that the mean age for participants was 5.09 ± 0.66 years. Twenty-one of the children with ECC were girls. In multivariate regression, there is a significant association between ECC and elevated salivary cortisol levels (> 0.57 µg/dl) with an adjusted odds ratio (AOR) of 9.649 (p = 0.003), father smoking (AOR = 5.791, p = 0.030), sleeping with a bottle or food in the mouth (AOR = 8.481, p = 0.027), and poor oral hygiene evaluated through the Silness-Löe Plaque Index (AOR = 6.681, p = 0.001). As a conclusion, the study indicates that salivary cortisol is an independent stress biomarker in relation to early childhood caries. Salivary cortisol as a stress biomarker can help clinicians provide an additional assessment tool for identifying caries risk in children.https://doi.org/10.1038/s41598-025-94327-0Preschool childrenEarly childhood cariesEnvironmental risk factorsSalivary cortisolStress
spellingShingle Yosra Ahmed Hussein
Rania Hussein Refai
Mai M. K. Hussein
Mamdouh Hanafy Abdou
Magdy Mohamed El Bordini
Ola Mohamed Ewais
Mohamed Fakhry Hussein
Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
Scientific Reports
Preschool children
Early childhood caries
Environmental risk factors
Salivary cortisol
Stress
title Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
title_full Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
title_fullStr Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
title_full_unstemmed Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
title_short Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study
title_sort association between environmental stress factors salivary cortisol level and dental caries in egyptian preschool children a case control study
topic Preschool children
Early childhood caries
Environmental risk factors
Salivary cortisol
Stress
url https://doi.org/10.1038/s41598-025-94327-0
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