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50 - Socioeconomic And Behavioral Factors Associated With Salivary Cortisol

Friday, May 22, 2026
4:20 PM - 4:35 PM PST
Has Audio

    Presenting Author(s)

  • HB

    Haizel Botwe, DMD (she/her/hers)

    Pediatric Dental Resident
    Howard University, Washington, D.C.
    Howard University
    Washington, District of Columbia, United States

    • Co-Author(s)

  • LB

    LaToya Barham, DDS

    Program Director
    Howard University College of Dentistry Pediatric Department
    Washington, District of Columbia, United States

    • Program Director(s)

  • LB

    LaToya Barham, DDS

    Program Director
    Howard University College of Dentistry Pediatric Department
    Washington, District of Columbia, United States

Abstract:

Purpose:
Salivary cortisol is a validated biomarker of physiologic stress in children; however, limited data exist regarding how social and behavioral determinants of health influence cortisol levels in pediatric dental patients. The purpose of this study was to evaluate the association between socioeconomic status (SES), caries experience, and appointment compliance with salivary cortisol concentrations.



Methods:
This study involves a secondary analysis of existing salivary cortisol data collected from pediatric dental patients treated at an academic dental clinic. Saliva samples were previously obtained using standardized passive drool collection techniques and analyzed using a high-sensitivity salivary cortisol enzyme-linked immunosorbent assay. Socioeconomic status was estimated using patient ZIP code–linked census data. Caries experience was assessed using documented caries indices from the dental record. Appointment compliance was determined based on the frequency of broken or missed appointments. Associations between salivary cortisol levels and exposure variables will be evaluated using appropriate statistical methods.



Results:
Analysis will assess whether salivary cortisol concentrations differ based on socioeconomic status, caries experience, and appointment compliance. It is anticipated that higher cortisol levels may be associated with lower socioeconomic status, greater caries burden, and poorer appointment compliance.



Conclusions:
Evaluating the relationship between social, behavioral, and clinical factors and physiologic stress may provide insight into underlying contributors to pediatric dental anxiety. These findings may inform more trauma-informed and patient-centered approaches to care.

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