We observed that the overall sIgA level decreased

following dental treatment, with significant differences, suggesting that dental treatment represents an undesirable event [29]. Therefore, we are convinced that using salivary sIgA as a stress marker is beneficial for evaluating the change in the sIgA level in each category of selleck chemical the medical records. Although there were no differences between the two groups in the categories not only during pre-treatment but also post-treatment, as assessed by Mann-Whitney U-tests, significant differences were detected in the changes after treatment in some categories. Males might be more sensitive, with greater responses in salivary sIgA, compared with females. There is a report that there Selleck VX770 are no differences in basal salivary sIgA amounts between the sexes; however, the differential responses between the sexes to the stress have not yet been elucidated [40]. It has been reported that salivary sIgA remains relatively stable up to 9 years old [41], or that children do not achieve adults levels of salivary sIgA until they are almost 11 years old [42]; however, the response of salivary sIgA to stress among children has not been elucidated. In this study [29], there was a more significant difference in the younger group (less than 7 years old) than children over 7 years old, suggesting that the fear might decrease with the

increasing age of children. There was a significant difference between the treatment times; prolonged treatment (≥20 min) might be more stressful for children. As for the classification of treatment, there was also a significant difference in patients given infiltration anesthesia and the type of surgical operation. As for the children’s IMP dehydrogenase response to the stressors, there was also a significant difference in children who experienced

not only a painful procedure but also a painless procedure, suggesting that a tense feeling while in the chair and the treatment procedure itself are sufficient to induce stress, independent of whether or not the children experienced a painful procedure. However, the results from the use of infiltration anesthesia and painful treatment procedures appear to be inconsistent. The use of infiltration anesthesia might induce a kind of stress in children, whereas painful stimulation might affect the autonomic nervous system and enhance the activity of salivary glands. Interestingly, salivary sIgA was significantly decreased in children who showed uncooperative behavior and appeared to show few signs of stress; however, those children might be able to effuse some of the stress through their behaviors. On comparison between sIgA, cortisol, and α-amylase, the sIgA and α-amylase levels showed rapid changes as treatment prolonged or infiltration anesthesia was applied, compared to the cortisol level. In children without maladjustment behavior, the sIgA and cortisol levels were significantly altered by treatment, suggesting that maladjustment behavior reduces stress.