ISSN - 0975-7058 Vol 9, Special Issue 2, 2017 ISSN - 0975-7058 SALIVARY ALPHA-AMYLASE AS A MEASURE OF ANXIETY BEFORE AND AFTER DENTAL TREATMENT FOR VISUALLY AND HEARING-IMPAIRED CHILDREN AND THEIR MOTHERS EKA S SHOFIYAH 1 , MARGARETHA SOVARIA 1 , MOCHAMAD F RIZAL 2 *, SARWORINI B BUDIARDJO 2 1 Department of Pediatric Dentistry Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia. 2 Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia. Email: Levipedo@gmail.com Received: 16 September 2017, Revised and Accepted: 3 October 2017 ABSTRACT Methods: Our objective was to evaluate sAA levels in visually and hearing-impaired children and their mothers before and after dental treatment. This study included 60 children with visual and hearing impairments and their mothers. sAA level of both children and mothers was sampled while they were together in the waiting room before treatment. The children then underwent dental prophylaxis in a separate room, and their post-treatment sAA was measured immediately afterward. At that time, their mother’s post-treatment sAA was sampled in the waiting room. Data were analyzed using a Wilcoxon test. Results: sAA levels were found to differ significantly between pre- and post-dental treatment (p<0.05). Conclusions: This difference indicates that reducing maternal anxiety would be of great benefit in reducing anxiety in visually and hearing-impaired children. Practical implications: Appropriately managing anxiety in this group of children can be of great benefit to dentists in daily practice, helping them provide the care that these children need. Keywords: Salivary alpha-amylase, Anxiety, Children, Sensory impairment, Dental treatment. INTRODUCTION Visual and hearing impairments are those conditions of the eyes and ears that are classified as disabilities and health problems that affect communication and performance of daily activities [1]. When such impairments appear during childhood, behavioral development may be disrupted [2]. The assistance of parents, particularly of mothers as primary caregivers, is needed until the child is able to perform daily activities independently [3].This dependency of impaired children on their mothers heightens emotional connection and strengthens the bond between them. For instance, if a mother is anxious about something, her child may feel the same way about it [1]. Anxiety toward dental care is a very common problem that is heightened in people with impaired sensory organs. The incomplete information gathered by impaired senses can induce feelings of fear or anxiety, which in dental treatment may lead to unsuccessful visits. Maciel reported a high prevalence of oral problems in patients with sensory impairments due to difficulties in maintaining oral hygiene without the help of others [4]. Level of anxiety can be measured using self-report analysis, behavioral measures, or by means of biomarker samples in blood, urine, or saliva. Measuring biomarker levels in saliva is a convenient method to use in young subjects, especially in special needs populations because it is a non-invasive technique [5]. Secretion of salivary alpha-amylase (sAA) is triggered by sympatho-adrenomedullary system, and increased sAA is thought to be related to anxiety and discomfort [6]. Anxiety in children with visual and hearing impairments and its relationship to their mothers’ anxiety during dental treatment are subjects worthy of further investigation to benefit the quality of dental care, thereby reducing the potential for risk. This study aimed to evaluate the sAA levels in visually and hearing-impaired children and their mothers before and after dental treatment. METHODS This study was clinical experimental research using 60 mother-child pairs, in which the child was age 5, visually and hearing-impaired, and registered at a School of the Sensory Impaired in Jakarta, Indonesia. Children who participated in this study had no previous dental treatment. Mothers and children who had asthma, diabetes, kidney failure, congenital heart disease, salivary gland disorders, and pancreatitis were excluded from our study. This study also excluded mothers and children who were taking beta-blockers, antidepressants, parasympathetic medications, or long-term steroids. Children who did not cooperate during sample taking or who had examinations or sports activities at school on the day of sampling were also excluded from this study. Before dental treatment, mothers and children waited together in the waiting room, where the first sAA measurements were taken. Then, children were moved to treatment room without their mothers to have their first dental prophylaxis and their second sAA measurement immediately afterward. At the same time, as the second sAA measurement in her child, each mother also had her second sAA measurement in the waiting room. The rooms were separated, so mothers could hear treatment activities but could not see them. sAA measurements were performed using a handheld sAA monitor (Nipro; Osaka, Japan) following manufacturer’s instructions. Data were analyzed using Wilcoxon and Spearman’s analysis with IBM SPSS Statistics software version 23. Research Article © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ijap.2017.v9s2.32 International workshop on Dental Research hosted by Faculty of Dentistry Universitas Indonesia, Jakarta, 2017 Objective: Visual and hearing impairments are known to profoundly affect children’s psychological development, including their anxiety. However, strong emotional relationship with their mother found in these children may help them cope. Measuring salivary alpha-amylase (sAA) in saliva samples is widely used in clinical settings as a reliable, non-invasive biomarker of anxiety level.