Assessment of Levels of Salivary Cortisol and Stress in Patients with Signs and Symptoms of Temporomandibular Joint Disorders

Aims: This study aimed to determine the association of stress and salivary cortisol levels in the adult Indian population with and without temporomandibular disorder (TMD) and to validate it with bite force. Settings and Design: The present study had an observational, case–control study design. Materials and Methods: This study sample comprised two groups of 25 cases and 25 controls between 18 and 45 years of age. Diagnostic criteria-TMD questionnaire Axis I was used to assess TMD classification, the TMD Disability Index and modified Perceived Stress Scale (PSS) questionnaires were filled, and salivary cortisol levels were measured using electrochemiluminescence immunoassay (ECLIA). Bite force analysis was performed using a portable load indicator. Statistical Analysis Used: To characterize and analyze the study variables, means, standard deviations, Mann–Whitney U -test, and logistic regression were employed (STATA 14.2 [Texas, USA]). Shapiro–Wilk test was used to test the normality of the data. P < 0.05 was considered statistically significant (95% power). Results: Female gender was proportionately higher in both the groups ( P = 0.508), TMD Disability Index was significantly higher for cases ( P < 0.001), TMD cases perceived higher stress levels ( P = 0.011), there was no statistically significant difference in salivary cortisol level between cases and controls ( P = 0.648), and the median bite force was lower for cases ( P = 0.0007). Conclusions: This study concluded that the chance of developing TMD increased with age. An increase in the TMD Disability Index score and modified PSS scores; and a decrease in the bite force increased the likelihood of TMD. Modified PSS score was negatively correlated with salivary cortisol concentrations, indicating a two-way response to TMD symptoms.

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“…[ 8 11 12 13 14 ] According to Delboni, 2007, and Di Laccio et al , every person had a varied threshold for stress. [ 15 16 ]…”

Section: Discussionmentioning

confidence: 99%

A case–control investigation of the psychological and physiological stress markers with salivary cortisol levels in patients with temporomandibular joint disorders: A short clinical study

Aparna¹,

Rajesh²,

Ranukumari³

et al. 2023

J Indian Prosthodont Soc

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“…TMD can present with varying degrees of signs and symptoms affecting individuals of any age group and sex [2][3][4]. The validity and reliability of the techniques in the RDC/TMD questionnaire for diagnosis of TMD have been critically assessed for their use in clinical settings and research purposes [2,10,19]. Symptoms of stress usually present as clinical manifestations of TMDs, resulting in changes in the levels of cortisol secretion.…”

Section: Discussionmentioning

confidence: 99%

“…A single examiner performed the clinical examination following the method mentioned in RDC/TMD, and the findings were recorded. The range of mandibular movements (mouth opening, protrusion, and lateral movements) and mandibular movements were recorded by the Okeson method [19].…”

Section: Tmd Assessmentmentioning

confidence: 99%

“…The Perceived Stress Scale (PSS) questionnaire consisting of 10 questions was modified and administered to the participants and they were instructed to answer on the same day as the collection of the saliva sample [19]. The questionnaire included a few direct questions regarding the existing stress levels.…”

Section: Perceived Stress Scalementioning

confidence: 99%

“…A quick response is facilitated by the adrenaline and noradrenaline hormones, and a slow response is facilitated by the cortisol hormone. The cortisol hormone is generally considered as a stress level indicator [19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Temporomandibular Disorders and its Correlation with Stress and Salivary Cortisol Levels among Students

Venkatesh

Shetty

Kamath

2021

Pesqui. Bras. Odontopediatria Clín. Integr.

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Objective: To evaluate the prevalence of temporomandibular disorders (TMD) in students and to evaluate if any relationship existed between the stress levels, salivary cortisol levels, and TMD. Material and Methods: A total of 348 students, 187 female, and 161 male students, participated in this cross-sectional study. Students were evaluated based on the Research Diagnostic Criteria for TMD. The stress levels were evaluated using the Perceived Stress Scale. The students were divided into the control and TMD groups. Salivary cortisol levels in the salivary samples were analyzed. Results: The prevalence rate of TMDs was 30.7% in the study population. Of the female students, 61% had TMD compared with 46% of male students. Muscle disorders were the most predominant disorder in 14.2% of the students with TMD. The TMD group showed significantly higher salivary cortisol and stress levels than the control group. The TMD group also showed a moderate positive correlation between cortisol and stress levels (p=0.01). Conclusion:The study showed a strong association between salivary cortisol levels, stress, and temporomandibular disorders. Salivary cortisol could be used as a prognostic biomarker for stress while assessing the severity of TMJ problems in stressed individuals.

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Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

Alam,

Zaman,

Alqhtani

et al. 2023

J of Oral Rehabilitation

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BackgroundThe present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non‐invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent.MethodsElectronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB‐2 was used to assess the risk of bias.ResultsEleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL‐1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL‐1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls:ConclusionThe findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD.

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Assessment of Levels of Salivary Cortisol and Stress in Patients with Signs and Symptoms of Temporomandibular Joint Disorders

Cited by 4 publications

References 23 publications

A case–control investigation of the psychological and physiological stress markers with salivary cortisol levels in patients with temporomandibular joint disorders: A short clinical study

A case–control investigation of the psychological and physiological stress markers with salivary cortisol levels in patients with temporomandibular joint disorders: A short clinical study

Prevalence of Temporomandibular Disorders and its Correlation with Stress and Salivary Cortisol Levels among Students

Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

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