OBJECTIVE: To study the possibility of using salivary alpha-amylase (sAA) level to evaluate the stress response degree of patients undergoing surgical dental extraction. STUDY DESIGN: Twenty females with impacted wisdom teeth, aged 18-25 years, were selected (Group A). Another 20 young females at the same ages were selected as controls (Group B). Saliva was collected before injecting anesthetic (A1B1), before dental extraction (A2B2), as well as immediately (A3B3), 1 hour (A4B4), and 5 hours (A5B5) after dental extraction when the effects of anesthesia subsided. RESULTS: The cortisol levels of both groups increased from 7.94 and 7.34 nmol/L (A1B1, minima) to 22.43 and 17.01 nmol/L (A3B3, maxima), respectively, and then decreased to 9.32 and 8.21 nmol/L (A5B5), respectively. The sAA levels of both groups rose from 14.38 and 13.98 U/mL (A1B1, minima) to 25.53 and 22.21 U/mL (A3B3, maxima), respectively, and then dropped to 17.69 and 15.23 U/mL (A5B5), respectively. The sAA activity change (value after dental extraction minus that after local anesthesia) was positively correlated with that of cortisol level moderately (p < 0.05, r=0.378). CONCLUSION: The patients receiving minimally invasive dental extraction had lower stress levels than those receiving regular surgery. However, the levels of cortisol and sAA were closely correlated, following a similar trend. SAA can feasibly be used to evaluate the stress level changes induced by surgical dental extraction. © Science Printers and Publishers, Inc.