Differences of salivary cortisol levels between long-term and short-term wearers of dento-maxillary prosthesis due to head and neck cancer resection

Purpose: The purpose of this study was to use cortisol awakening response (CAR) to investigate the differences in daily life stress experienced by individuals wearing either a long-term (LT) or a short-term (ST) dento-maxillary prosthesis following head and neck cancer (HNC) resection. Also we used the University of Washington Quality of Life (UW-QOL) version 4 questionnaire to evaluate the differences in quality of life (QOL) scores between ST and LT wearers of a dento-maxillary prosthesis. Methods: Salivary samples were collected from 11 LT and 10 ST prosthesis wearers on two consecutive days at two time points, immediately after waking up (T0) and 30. min later (T30), by passive drool collection. Cortisol levels were measured using a high sensitivity salivary cortisol enzyme immunoassay kit (Salimetrics, LLC, State College, PA, USA) and CAR (the differences between the cortisol levels at T0 and T30) was compared between LT and ST prosthesis wearers. In addition, both the groups completed the UW-QOL questionnaire and the scores were compared. Results: A significant difference was observed in CAR between the two groups. CAR of the ST prosthesis wearers was significantly lower compared with that of the LT prosthesis wearers; moreover, the ST prosthesis wearers revealed significantly lower total UW-QOL scores and there were significant differences in appearance, activity, recreation, speech, and anxiety. Conclusion: Within the limitations of this study, the findings suggest that individuals wearing ST dento-maxillary prostheses following HNC resection experience some sort of daily life stress and complicated socio-demographic factors may influence their QOL.